But Messerli found it difficult to lead the victory parade, noting, "this is a modeling study, and statements such as, 'A modest reduction of one gram per day would be more cost effective than using medication to lower blood pressure in all persons with hypertension' are to be taken with a good grain of salt."
Messerli's measured response was not echoed by his colleagues in the hypertension world. Dr. Henry Black, president of the American Society of Hypertension and director of hypertension research at the New York University School of Medicine, said that while the paper extended the findings of many other studies, the new work is "more comprehensive and is especially useful by comparing the benefits of [sodium] and [salt] reduction to those of other widely accepted public health approaches that the public and governmental bodies have embraced, including drug treatment."
Dr. Clyde Yancy, president of the American Heart Association, said that while the study was a computer modeling analysis, in terms of research on this topic it may be as good as it gets. "It would be impossible to do a randomized trial in large numbers of high vs. low sodium consumption, and the use of modeling with reasonable assumptions represents a solid if not ideal alternative," he said.
Yancy went so far as to say that the data from this study could provide a strong enough imperative to set or change national policy.
Still, for average Americans, cutting back on salt could be a hard concept to swallow. While it's true that three grams of salt comes to about a teaspoonful, Goldman said it was foolish to think of sodium reduction in terms of such measurements because some much sodium comes from processed foods and from restaurant food. For that reason, he said, achieving the needed reduction requires a concerted national effort.