The Heart and Stroke Foundation South Africa is sounding the alarm on the devastating impact of excessive salt consumption on the nation’s heart and brain health. This year’s theme, “Your Brain and Heart Cannot Take the Pressure!” highlights the importance of maintaining a stable blood pressure for good overall health, and specifically for heart and brain health. Understanding the critical link between excessive salt consumption, hypertension, and cardiovascular and cerebrovascular ill-health is crucial. The Foundation’s theme was carefully crafted to align with World Hypertension Day on May 17th and draws inspiration from global public health initiatives, including those driven by the World Action on Salt, Sugar and Health (WASSH). This synergy is reflected in the global theme for Salt Awareness Week (12-18 May 2025), “5 Ways to 5 Grams”, and the World Hypertension League’s theme, “Measure Your Blood Pressure Accurately, Control It, Live Longer”. Both themes emphasize the importance of managing blood pressure through informed choices. The causes of hypertension are complex, involving behavioral factors like unhealthy diets, tobacco use, and excessive alcohol consumption, as well as genetic predispositions.
Hypertension, or high blood pressure, is identified as a condition in which the blood pressure is over 140/90 mmhg on multiple occasions. Blood pressure is the pressure that is exerted by the blood on the interior arterial walls. It is measured and recorded as a systolic pressure over a diastolic pressure. Systolic (the top number) is the pressure exerted on the arterial walls when the heart contracts or beats and the diastolic pressure (the bottom number) is the pressure exerted between heart beats or when the heart muscles relax. Elevated blood pressure can cause significant damage to both blood vessels and organs like the kidneys, heart, and brain. The longer and higher the pressure remains elevated, the greater the risk of damage. This can lead to conditions such as arteriosclerosis (hardening and thickening of arteries) and aneurysms (bulges or weakening of blood vessels), which can have severe consequences. A ruptured aneurysm can be life-threatening, while arteriosclerosis can reduce blood flow, straining organs and blood vessels, and potentially causing heart failure, kidney damage, vision loss, cognitive issues, and dementia. Your brain and heart literally cannot handle the increased pressure!
The strain on the body from these conditions is significant, and the risks associated with hypertension don’t stop there. Hypertension during pregnancy can have severe consequences for both the mother and baby, increasing the risk of cardiovascular disease (CVD) later in life. Conditions like gestational hypertension and pre-eclampsia affect up to 10% of pregnancies and can program long-term cardiovascular health risks. The critical first 1000 days of a child’s life, from conception to age two, shape cardiovascular development and future hypertension risk. Maternal health and nutrition during this period play a crucial role in fetal development, influencing the child’s cardiovascular system and potentially setting the stage for lifelong blood pressure trends.
This early life foundation can be further compounded by genetic factors, as seen in familial hypertension. Knowing your family medical history is essential, as individuals with a family history of hypertension are more likely to develop high blood pressure due to the interaction of multiple genetic variants and environmental factors. A study by Li et al., (2021) revealed that individuals with a family history of hypertension are four times more likely to develop high blood pressure compared to those without. Building on this, a recent South African study by Katsukunya et al., (2024) further explored the genetic aspect, finding that certain genes may influence an individual’s response to antihypertensive medication, potentially making some people more resistant to treatment.
Managing hypertension requires a comprehensive approach that includes medication adherence and behavior modifications. Unfortunately, medication non-adherence remains a significant challenge, particularly in low- to middle-income countries. A recent study (2024) in Sub-Saharan Africa found that 43.5% of adults treated for hypertension were non-adherent, translating to two out of every five adults struggling with their treatment plans. The challenges are multifaceted, including other health issues, side effects, and complex medication regimens, often exacerbated by limited resources or inadequate healthcare access. Socioeconomic factors like unemployment, poverty, and lack of social support further compound the issue. According to the American Heart Association, 12% of patients never fill their initial prescriptions, and non-persistence rates range from 30% to 80% in the first year. To address these challenges, prioritizing social support and patient-centered care is crucial. Systemic issues like lack of health insurance and high medication costs must also be tackled to improve treatment adherence and reduce hypertension-related morbidity and mortality.
As mentioned, excessive salt consumption is a significant risk factor for high blood pressure, and reducing salt intake to less than 5g per day is recommended by the World Health Organization. Seasoning smart involves gradually reducing salt in favorite recipes and exploring flavorful alternatives like herbs, raw spices, garlic, ginger, chilli, and lemon. When shopping, reading labels and opting for low-sodium options is a good idea – consider joining the Heart and Stroke Foundation South Africa webinar to learn how to decode food labels and spot the Heart Mark logo, a seal of approval. Breaking the salt habit means ditching the salt shaker and encouraging others to do the same. It’s also important to be mindful of hidden salt in everyday foods like bread, cereals, and processed meats. Cooking meals at home using fresh ingredients can help control salt intake. A diet rich in nutrient-dense foods like fruit, vegetables, whole grains, lentils, beans, and low-fat dairy can support healthy blood pressure.
In conclusion, prioritizing heart and brain health is crucial in the fight against hypertension. By adopting simple yet powerful habits – reducing salt intake, increasing physical activity, getting regular blood pressure checks, adhering to medication regimens, and knowing your family medical history – individuals can significantly reduce their risk of developing heart, brain, and other circulatory conditions. Given that CVD remains a leading cause of death in South Africa, claiming one in every seven lives, collective action can drive meaningful change. By supporting one another in embracing healthier habits, we can save thousands of lives, reduce CVD morbidity and mortality, and improve overall well-being.