Told to Cut Salt? Fewer Than Half of Adults With High Blood Pressure Were, in 2015

High blood pressure (hypertension) is a major risk factor for cardiovascular disease, and cutting sodium helps. When a health professional advises it, people eat less sodium and their blood pressure falls — and the 2017 hypertension guideline of the American College of Cardiology and American Heart Association stresses non-drug steps like sodium reduction. How often do patients actually get that advice?

The data

In 2015, nine states — Alabama, Indiana, Iowa, Kentucky, Maine, Nebraska, North Carolina, Oregon and Tennessee — and Puerto Rico added a sodium module to the Behavioral Risk Factor Surveillance System (BRFSS) telephone survey. CDC analyzed answers from 50,576 adults.

• Hypertension: ever told by a doctor, nurse or other professional they had high blood pressure (not only in pregnancy, and not "borderline").
• Advice: ever advised by a professional to reduce sodium or salt.
• Action: currently watching or reducing sodium.

Few are told — but most who are, act

Adjusted for sociodemographic and cardiovascular risk factors.

Advice made the difference whether or not people had hypertension.

Who got advice

Among adults with hypertension, advice ranged from 32.3% in Oregon to 56.7% in Puerto Rico — where self-reported hypertension (42.2%) is well above the national 30.9%. It was more common among:

Among adults without hypertension, advice ranged from 9.4% (Oregon) to 22.0% (Puerto Rico) — and even those at higher cardiovascular risk were advised less than 30% of the time.

Why it matters

Fewer than half of adults with high blood pressure were told to cut sodium — a large missed opportunity for prevention and treatment. Saying you're watching sodium isn't the same as cutting it enough to matter, but advice clearly raises awareness. Health professionals can encourage healthy food choices and support wider efforts to lower sodium.

Limits: answers were self-reported; the survey didn't record what advice was given or what people did; and results come from nine states and Puerto Rico, with a median response rate of 51.3% (range 38.6%–59.0%).

Sources

Based on Puthiery Va, Cecily Luncheon, Angela M. Thompson-Paul, Jing Fang, Robert Merritt and Mary E. Cogswell, "Self-Reported Receipt of Advice and Action Taken To Reduce Dietary Sodium Among Adults With and Without Hypertension — Nine States and Puerto Rico, 2015," MMWR, volume 67, Centers for Disease Control and Prevention; a work of the United States government in the public domain. An erratum was later published for this report. The response-rate range follows CDC's erratum (MMWR volume 67, issue 13), which corrected the report.