Salt and Blood Pressure

Q:  Today's newsletter once again cautioned about "too much salt". I was under the impression that this controversy had been settled -- that only people with high blood pressure had to watch salt intake. I have been a "salter" since early childhood. I blame this on my mother's bland cooking.

Actually, although back in the '30s no one connected salt and high blood pressure, my mother's body may have told her to go light on salt. She had blood pressure over 200 all her life and suffered periodic nosebleeds that may have reduced the pressure. She died at age 79.

Anyway, despite salting just about everything (even before tasting), I have had low-to-normal pressure all my life. My father and his entire family and my brother and sister also have had low-to-normal pressure. Dad lived to age 87. My brother (72), sister (66) and I (68) are all basically healthy except for allergies.

My question: Is salt a health hazard or not? My blood pressure remains fairly low, and I have never had water retention (edema), even during nine pregnancies. What is the so-called risk?

A:  The salt controversy may never be truly settled, but certainly the recommendations from the American Heart Association, Food and Drug Administration, nutritionists, etc. are all in the direction of "less salt" for optimal health. Just a month ago the National Institutes of Health had a conference on salt and again reiterated that people (whether or not they have high blood pressure) should eat no more than 6 grams of salt a day (The average American eats about 8-10 grams per day.). If everyone ate less salt and we shifted blood pressures even a little lower, there would be less strokes and heart attacks in this country. Six grams means you can have some salt in the processing or cooking of food, but shouldn't add salt at the table. There are lots of spices that can keep your food from tasting bland. Especially now in the summer you can buy fresh basil, oregano, peppers, thyme, etc. It will take some time, since you're used to "salty" food, but no one is too old to change their taste buds gradually.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.