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[Correspondence] Sodium and cardiovascular disease – Authors’ reply

Nicholas Wald and Malcolm Law, and Pasquale Strazzullo and colleagues propose that the association between sodium intake and blood pressure should parallel its association with cardiovascular disease events. Their reductionist assumption is that all lowering of blood pressure will translate into reductions in cardiovascular disease, irrespective of baseline measurement of blood pressure. This assumption is not supported by the HOPE-3 trial1 and a recent systematic review of 49 trials,2 which show a benefit of lowering systolic blood pressure when it is above 140 mm Hg at baseline, but adverse effects using the same intervention when baseline was below 140 mm Hg.