Fact Check: Is Salt the Real Culprit Behind High Blood Pressure?

A Facebook video claimed that Salt is not the Real Culprit Behind High Blood Pressure. This claim is Misleading.

Claim

A Facebook post claims that Salt is not the Real Culprit Behind high blood pressure. Priyank Mehta, a Facebook user claims that salt is frequently blamed for causing high blood pressure, but it is not the main culprit. In the video the user while talking to a lady says that Salt is not the real culprit for high blood pressure. The user further adds that whenever we eat salt and sugar we feel bloated. The woman responds and says, "That's because our body holds more water exactly, and because of that excess fluid, the Heart has to beat faster, which leads to high blood pressure. The woman then questions whether salt is bad right. The user responds that the body can eliminate salt through sweat, pee and poop but for sugar there's the catch. He says that sugar is used for energy or either it stores excess sugar as fat leads to insulin resistance body holds more fluid and the Heart has to beat faster leading to high blood pressure. The woman responds, "Wow, so the body has a mechanism to eliminate salt, but not sugar." The user then explains that as long as you're leading a healthy, Active lifestyle and eating balanced food, then salt is not a problem, but carbs are. As per the user, the problem excess carbs and there is so much misinformation about salt and high blood pressure. 

The post has 4.1 million views and can be accessed here. 

Fact Check

The Facebook user's claims to say that salt is not a culprit for high blood pressure and that carbohydrates/sugar are the primary cause is misleading. Both salt and excessive sugar consumption can contribute to high blood pressure, and reducing sodium intake is a well-supported method for managing hypertension.

What is High Blood Pressure?

According to WHO, High blood pressure or Hypertension is when the pressure in blood vessels is high (140/90 mmHg or higher). It is common but can be serious if not treated. The risk factors of hypertension are genetics, overweight or obese, physical inactivity, age and consumption of alcohol.

Modifiable risk factors include unhealthy diets such as excessive salt consumption, a diet high in saturated fat and trans fats, low intake of fruits and vegetables, physical inactivity, consumption of tobacco and alcohol, and being overweight or obese. In addition, there are environmental risk factors for hypertension and associated diseases, where air pollution is the most significant.

Non-modifiable risk factors include a family history of hypertension, age over 65 years and co-existing diseases such as diabetes or kidney disease.

What is the role of salt and sugar in high blood pressure?

Salt and Sugar both play a role in high blood pressure. Higher salt consumption can lead to water retention in the body, increasing blood volume in the arterial vessels and ultimately causing high blood pressure.

Similarly, excessive sugar intake contributes to hypertension and elevated blood pressure. The excessive intake of added sugars promotes obesity, which subsequently is also a risk factor for blood pressure. Excessive sugar intake can also contribute to the development of diabetes, a condition that is a significant risk factor for hypertension. Managing both conditions is vital, as diabetes greatly increases the likelihood of high blood pressure and associated cardiovascular risks.

Therefore, it is important to consume both sugar and salt in moderation, as excessive intake can lead to high blood pressure and other health problems.

Can Body Not Remove Extra Sugar? 

The body can remove sugar and has various metabolisms to remove sugar from the body. When sugar is consumed, it is broken down into glucose, which enters the bloodstream. Several mechanisms regulate glucose metabolism, including glycolysis, gluconeogenesis, glycogenolysis, and glycogenesis. The pancreas releases insulin to help cells absorb glucose for energy. Inside the cells, glucose undergoes glycolysis to generate ATP, the body’s primary energy source. Excess glucose is stored as glycogen in the liver and muscles, but once these glycogen stores are full, the surplus glucose is converted into fat. 

If sugar intake remains consistently high, it can lead to weight gain, obesity, cardiovascular disease, diabetes and non-alcoholic fatty liver disease (NAFLD), cognitive decline, cancers and insulin resistance, where the body’s response to insulin becomes impaired, affecting the liver, muscles, and fat tissue. Insulin resistance increases the risk of developing type 2 diabetes and other metabolic disorders.

Properly managing sugar intake is essential to prevent these complications, as the body can effectively remove excess sugar through energy utilization, storage, and excretion under normal conditions. 

Is Sugar/Carbs a Culprit Behind High Blood Pressure?

This is correct. Sugar and carbs are one of the contributing factors to high blood pressure. Scientific evidence indicates a clear link between excessive sugar consumption and an increased risk of high blood pressure particularly on systolic blood pressure. Emerging research highlights that excessive sugar intake, especially from sugary beverages and processed foods, can also play a significant role in the development of hypertension.

A study published in Critical Reviews in Food Science and Nutrition identified the detrimental effects of sugar consumption on hypertension and blood pressure, particularly systolic blood pressure. The research also revealed a positive association between high intake of sugar, artificially sweetened beverages, and the development of hypertension.

James J. DiNicolantonio et. al's review study found that consuming one sugar-sweetened beverage per day raises the risk of hypertension by at least 6% and increases systolic blood pressure by at least 1.8 mm Hg over about 18 months.

The study by Feng J He et. al. indicates that a high intake of added sugar contributes to increased obesity, which subsequently raises blood pressure. Additionally, recent research suggests that added sugars, especially those found in soft drinks, may directly elevate blood pressure.

Is Salt Not The Culprit Behind High Blood Pressure?- 

This is incorrect. Salt in simple terms can be called one of the major culprits behind high blood pressure . There is clear cut scientific evidence and medical consensus to support the claim that high salt intake is related to elevation in high blood pressure. The role of salt in high blood pressure (hypertension) has been well-established in medical research.

A review published in The American Journal of Medicine found that high salt intake is associated with increased blood pressure, and reducing dietary salt intake can help lower blood pressure in patients with hypertension.

A crossover trial conducted by Deepak K. Gupta et. al. found that reducing dietary sodium significantly lowered blood pressure in most middle-aged to elderly adults.

Even medical guidelines support the control of salt for management of hypertension. Guidelines such as European Society of Cardiology noted that lowering dietary salt intake can result in a decrease in blood pressure as well as a reduction in cardiovascular disease and mortality rates.

Insights from Experts

The Medical Dialogues Fact Check Team spoke with Dr Prem Aggarwal, MBBS, MD (Medicine), DNB (Cardiology), Director, Sanjeevan Hospital, Daryaganj, Delhi and he said, "It is important to understand that salt and sugar play a significant role in the development of high blood pressure. The impact of salt on hypertension is well-established, it's equally important to recognize that excessive sugar consumption can also contribute to elevated blood pressure levels. For optimal blood pressure control and heart health, it’s crucial to reduce intake of both salt and sugar. Additionally, adopting a healthy lifestyle, including a balanced diet, regular physical activity and stress management can further aid in the prevention and management of hypertension. Regular check-ups with your doctor are essential for management and proper treatment of high blood pressure."

Dr Divya Tripathi, Assistant Professor, Department of Nutrition and Dietetics, Manav Rachna International Institute of Research and Studies further explained, "Both sugar and salt play a significant role in raising blood pressure. While salt is commonly known for causing fluid retention and increasing blood pressure, excessive sugar intake, especially from processed foods and sugary drinks, can lead to insulin spikes that contribute to sodium retention and further elevate blood pressure. It is important to focus on a balanced diet that reduces both sugar and salt while incorporating more whole, unprocessed foods. It's also important to regularly consult a dietician to get personalized dietary advice and manage hypertension effectively."

Medical Dialogues Final Take

Both Sugar/carbs and salt are contributing factors for hypertension. The role of salt in high blood pressure has been well-established in medical research and there is no scientific evidence or medical consensus to support the claim that salt isn't responsible for high blood pressure. While salt has traditionally been blamed it is important to note that excessive sugar intake also plays a significant role in high blood pressure. 

Hence, the claim that Sugar, Not Salt is the Real Culprit Behind High Blood Pressure is MISLEADING,