Hypertension Due to Toxic White Crystals in the Diet: Should We Blame Salt or Sugar?

Prog Cardiovasc Dis. 2016 Nov-Dec;59(3):219-225. doi: 10.1016/j.pcad.2016.07.004. Epub 2016 Jul 20.


The "Salt Hypothesis" is the notion that an increase in salt intake will increase blood pressure and thus increase the risk of cardiovascular disease (CVD),which has been a point of contention for decades. Despite this, numerous health organizations, dietary guidelines, and government policies advocate population-wide salt restriction. However, there is no conclusive proof that restricting salt intake reduces the risk of hypertension (HTN) and/or CVD events; sodium restriction in fact may paradoxically lead to adverse health outcomes. Importantly, another white crystal, sucrose (or table sugar) but also high-fructose corn syrup are much more detrimental food additives. Indeed, added sugars have the ability to induce hypertension via the promotion of inflammation, oxidative stress, insulin resistance, and obesity. Considering that there is no physiologic requirement for dietary carbohydrate, there is little reason to suspect adverse health consequences from cutting back on sugar. This paper reviews the evidence relating to salt and sugar on HTN and CVD. Based on our review of the scientific literature, guidelines should focus more on reducing sugar rather than salt for the prevention and treatment of HTN and its consequences.

Keywords: Carbohydrate; Diet; Hypertension; Salt; Sodium; Sugar.

Publication types

  • Review

MeSH terms

  • Diet Therapy / methods*
  • Dietary Sucrose* / adverse effects
  • Dietary Sucrose* / metabolism
  • Humans
  • Hypertension / metabolism
  • Hypertension / prevention & control*
  • Nutritional Requirements
  • Sodium Chloride, Dietary* / adverse effects
  • Sodium Chloride, Dietary* / metabolism


  • Dietary Sucrose
  • Sodium Chloride, Dietary