Adding Salt to Foods and Risk of Cardiovascular Disease

J Am Coll Cardiol. 2022 Dec 6;80(23):2157-2167. doi: 10.1016/j.jacc.2022.09.039.


Background: We recently found that the frequency of adding salt to foods could reflect a person's long-term salt taste preference and sodium intake, and was significantly related to life expectancy.

Objective: We analyzed whether the frequency of adding salt to foods was associated with incident cardiovascular disease (CVD) risk.

Methods: This study included 176,570 adults in UK Biobank who were initially free of CVD. Cox proportional hazards models were used to estimate the association between the frequency of adding salt to foods and incident CVD events.

Results: During a median of 11.8 years of follow-up, 9,963 total CVD events, 6,993 ischemic heart disease (IHD) cases, 2,007 stroke cases, and 2,269 heart failure cases were documented. Lower frequency of adding salt to foods was significantly associated with lower risk of total CVD events after adjustment for covariates and the DASH (Dietary Approaches to Stop Hypertension) diet (a modified DASH score was used without considering sodium intake). Compared with the group of always adding salt to foods, the adjusted HRs were 0.81 (95% CI: 0.73-0.90), 0.79 (95% CI: 0.71-0.87), and 0.77 (95% CI: 0.70-0.84) across the groups of usually, sometimes, and never/rarely, respectively (P trend < 0.001). Among the subtypes of CVD, adding salt showed the strongest association with heart failure (P trend <0.001), followed by IHD (P trend < 0.001), but was not associated with stroke. We found that participants who combined a DASH-style diet with the lowest frequency of adding salt had the lowest CVD risk.

Conclusions: Our findings indicate that lower frequency of adding salt to foods is associated with lower risk of CVD, particularly heart failure and IHD.

Keywords: CVD; DASH diet; heart failure; salt.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / prevention & control
  • Heart Failure* / epidemiology
  • Humans
  • Hypertension* / epidemiology
  • Myocardial Ischemia*
  • Sodium Chloride, Dietary / adverse effects
  • Stroke*


  • Sodium Chloride, Dietary