National Academies of Sciences, Engineering, and Medicine. (2019). Dietary Reference Intakes for Sodium and Potassium. National Academies Press. The PubMed book abstract (PMID 30844154) gives no reference values; it says the report updates the sodium and potassium DRIs with an expanded model that adds chronic-disease endpoints (the Chronic Disease Risk Reduction Intake). The numeric AIs and CDRRs were not re-read for this note (abstract). www.ncbi.nlm.nih.gov/books/NBK538102
Sacks, F. M., Svetkey, L. P., Vollmer, W. M., Appel, L. J., Bray, G. A., Harsha, D., Obarzanek, E., Conlin, P. R., Miller, E. R., Simons-Morton, D. G., Karanja, N., & Lin, P.-H. (DASH-Sodium Collaborative Research Group). (2001). Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. New England Journal of Medicine, 344(1), 3-10. Randomized feeding trial (n=412): within both a control diet and the DASH diet, reducing sodium from high to low further lowered blood pressure; the effects of sodium reduction and of the DASH diet were additive, with the largest reduction from combining a low-sodium DASH diet. 10.1056/NEJM200101043440101
World Health Organization. (2012). Guideline: Sodium intake for adults and children. World Health Organization. Recommends a reduction to less than 2 g/day of sodium (5 g/day of salt) in adults - a strong recommendation. For children, the recommended maximum adult level of 2 g/day sodium should be adjusted downward based on the energy requirements of children relative to those of adults. www.who.int/publications/i/item/9789241504836
He, F. J., Li, J., & MacGregor, G. A. (2013). Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ, 346, f1325. 34 randomised trials (3,230 participants), at least 4 weeks. Mean urinary sodium fell 75 mmol/24 h (about 4.4 g/day less salt); systolic pressure fell 4.18 mmHg (95% CI 5.18 to 3.18) and diastolic 2.06 mmHg overall. In people with hypertension, systolic −5.39 mmHg (−6.62 to −4.15), diastolic −2.82; in normotensive people, systolic −2.42 mmHg (−3.56 to −1.29), diastolic −1.00. A 6 g/day salt reduction was associated with a 5.8 mmHg fall in systolic pressure after adjustment (abstract, PMID 23558162). 10.1136/bmj.f1325
General Office of the National Health Commission of China. (2023). Dietary guidelines for adults with hypertension (2023 edition). Issued January 2023. Five food-and-nourishment principles: cut sodium and raise potassium with a light diet; reasonable balanced diet; balance eating with activity for a healthy weight; stop smoking and limit alcohol; monitor blood pressure and self-manage. Verified specifics: salt intake should be brought down step by step to under 5 g per person per day; more than 75 percent of dietary sodium among Chinese residents comes from salt used in home cooking, followed by high-salt condiments, with processed food a growing third route; potassium should be raised through potassium-rich foods and, for people with good renal function, potassium-enriched low-sodium salt - but potassium SUPPLEMENTS (including drugs) are explicitly NOT recommended for lowering blood pressure, and anyone with impaired renal function must consult a doctor before supplementing potassium; inadequate dietary calcium is described as a widespread problem among Chinese residents; whole grains or mixed beans should make up one quarter to one half of the grain portion. www.nhc.gov.cn/sps/c100088/202301/f01895a06c5349ef999f25da833c166d/files/1732844468193_68545.pdf
Neal, B., Wu, Y., Feng, X., Zhang, R., Zhang, Y., Shi, J., et al. (2021). Effect of salt substitution on cardiovascular events and death (SSaSS). New England Journal of Medicine, 385(12), 1067-1077. Open-label cluster-randomised trial in 600 rural Chinese villages. Verbatim: "A total of 20,995 persons were enrolled in the trial"; mean age 65.4, 72.6% with prior stroke, mean follow-up 4.74 years. Stroke rate ratio 0.86 (95% CI 0.77-0.96, P=0.006); major cardiovascular events also lower. 10.1056/NEJMoa2105675