The Importance of Dietary Salt in the Process of Atherosclerosis the Results of the International Survey

Excessive dietary salt intake is an identified as ASCVD risk factor, and leads to approximately 1.89 million deaths annually. There is also an extant discussion whether dietary salt might be correlated with the direct ASCVD risk. Therefore, Banach M, presented a session held at the American Heart Association (AHA) from 16 -18 November 2024, in Chicago, Illinois aimed to examine the knowledge, perception, diagnosis, and treatment of indirect and direct salt-related ASCVD risk between healthcare professionals.

The survey, comprising of 17 questions, was developed by the Polish Lipid Association (PoLA). In March 2024, it was launched and promoted via multiple online channels. Many questions permitted for multiple responses. The questionnaire is ongoing and accessible at the PoLA webpage.

313 respondents (48.6% females) from 40 countries included in the survey by the end of May, 70% of whom were physicians. They mostly came from cities with across 500 thousand inhabitants (53.4%). The largest percentage of responses were from Poland (28.7%), Lithuania (19.4%), and Romania (14.8%). More than 1/3 of the respondents accurately showed the permissible amount of salt in the diet recommended by WHO; even larger percentage (86.3%) accurately showed that limiting salt intake in the diet applies to both healthy and sick people. Excess salt in the diet was showed as a recognized risk factor in the case of hypertension 82.4%, atrial fibrillation 28.8%, obesity 36.4%, type 2 diabetes 20.4%, lipid disorders 18.5%, heart failure 59.1%, stroke 56.9%, and atherosclerosis 42.2%. It is value highlighting that a substantial percentage did not show or showed incorrect knowledge about excessive salt consumption and the risk of the above diseases – from 6.4% to even 53%. In the context of data exhibiting a large number of deaths associated to excessive salt intake, only 57.5% of respondents clearly accurately answered the question on the excess salt correlation with a greater risk of mortality. The respondents’ knowledge about the methods associating excessive dietary salt intake with the development of atherosclerosis differed greatly, with the majority (38%) showing that it was only an outcome of increased BP.

A substantial percentage of respondents show incomplete knowledge about the role of excessive dietary salt intake on ASCVD risk. It is value highlighting that excessive salt intake in the diet directly damages the vascular endothelium and hence gives rise to ASCVD progression. Only 24% of respondents showed this very significant mechanism.