Unit of Hypertension, Clinical Endocrinology, Department of Internal Medicine, Ospedale Policlinico San Martino Genova, University of Genoa Medical School, 6-16132 Genoa, Italy.
Int J Environ Res Public Health. 2020 Apr 19;17(8):2811. doi: 10.3390/ijerph17082811.
Salt intake is too high for safety nowadays. The main active ion in salt is sodium. The vast majority of scientific evidence points out the importance of sodium restriction for decreasing cardiovascular risk. International Guidelines recommend a large reduction in sodium consumption to help reduce blood pressure, organ damage, and cardiovascular risk. Regulatory authorities across the globe suggest a general restriction of sodium intake to prevent cardiovascular diseases. In spite of this seemingly unanimous consensus, some researchers claim to have evidence of the unhealthy effects of a reduction of sodium intake, and have data to support their claims. Evidence is against dissenting scientists, because prospective, observational, and basic research studies indicate that sodium is the real villain: actual sodium consumption around the globe is far higher than the safe range. Sodium intake is directly related to increased blood pressure, and independently to the enlargement of cardiac mass, with a possible independent role in inducing left ventricular hypertrophy. This may represent the basis of myocardial ischemia, congestive heart failure, and cardiac mortality. Although debated, a high sodium intake may induce initial renal damage and progression in both hypertensive and normotensive subjects. Conversely, there is general agreement about the adverse role of sodium in cerebrovascular disease. These factors point to the possible main role of sodium intake in target organ damage and cardiovascular events including mortality. This review will endeavor to outline the existing evidence.
目前，盐的摄入量过高，存在安全隐患。盐的主要活性离子是钠。绝大多数科学证据都指出，限制钠的摄入量对于降低心血管风险非常重要。国际指南建议大幅减少钠的摄入量，以帮助降低血压、减轻器官损伤并降低心血管风险。全球各地的监管机构都建议限制钠的摄入，以预防心血管疾病。尽管存在这种看似一致的共识，但一些研究人员声称有证据表明减少钠的摄入量会带来健康风险，并提供了数据来支持他们的观点。但这些证据与持不同意见的科学家相悖，因为前瞻性、观察性和基础研究表明，钠才是真正的罪魁祸首：实际上全球的钠摄入量远远高于安全范围。钠的摄入量与血压升高直接相关，并且与心脏质量的增大独立相关，可能在诱导左心室肥厚方面发挥独立作用。这可能是心肌缺血、充血性心力衰竭和心脏性死亡的基础。尽管存在争议，但高钠摄入可能会导致高血压和正常血压患者的肾脏初始损伤和进展。相反，钠在脑血管疾病中的不良作用已得到普遍认可。这些因素表明，钠的摄入量可能在靶器官损伤和包括死亡率在内的心血管事件中起着主要作用。本综述将努力概述现有证据。
