Unexpected Source of Sodium Increases Heart Attack Risk

It may surprise you to learn that many prescription and over-the-counter medications contain hidden sodium, especially the drugs that dissolve in your mouth or are added to water. Because sodium-containing drugs are so commonplace, researchers attempted to determine whether patients taking these drugs have a higher incidence of cardiovascular events like heart attacks or stroke in comparison to patients taking the same drugs without the sodium.

In a study published in the medical journal BMJ researchers assessed 1,292,337 patients and concluded that “Exposure to sodium-containing formulations of effervescent, dispersible, and soluble medicines was associated with significantly increased odds of adverse cardiovascular events compared with standard formulations of those same drugs.” As a result, they added that “Sodium-containing formulations should be prescribed with caution only if the perceived benefits outweigh these risks.”

While food products are regulated as to the maximum amount of sodium they can contain, drugs are not subjected to similar regulations, according to the study authors who add: “Curiously, unlike foods, pharmaceutical manufacturers are not placed under any restrictions or obligations with regards to sodium content or labeling of these sodium-containing formulations.”

Earlier research in the journal Hypertension found a link between excess sodium in healthy individuals to an impaired lining of blood vessels, a type of heart malfunction that causes 60 percent of heart attacks, and impairment of electrical impulses in the heart.

For many years sodium was viewed as the enemy when it came to heart disease or high blood pressure, but there has been a recent trend toward claims of sodium, even in high amounts, being completely healthy. This view has even become popular among nutritionists and other health experts.

So what is the truth in all of the research and hype? Let’s first consider sodium’s role in the body. Sodium is an essential mineral, meaning that we need it to survive; however, excessive amounts can be harmful. That’s because sodium is one of the minerals that is known as an electrolyte which is a class of substances that regulate the healthy function of cells and organs, particularly the cells’ ability to conduct electricity and regulate water.

In other words, sodium is intricately involved in heart muscle contractions which help to regulate overall heart function. Together with another electrolyte, potassium, sodium significantly influences heart health—for better or worse depending on the amount we ingest through diet or drugs. To simplify the science, sodium increases blood pressure and potassium decreases it. Taken in the right proportions, sodium and potassium can regulate blood pressure and significantly influence heart health. And, as you learned earlier, the BMJ study of nearly 1.3 million people showed a significant increase in heart disease and stroke risk among those obtaining sodium in their medications. And in other research, a high sodium and low potassium diet like the one most North Americans eat is linked to a 50 percent increased risk of death from heart disease.

So what is the right dose of sodium? There is no simple response here. The reality is that there is no “one-size-fits-all” amount of sodium that everyone should obtain in their diet, contrary to what many health experts say. The right amount of sodium depends on how much potassium you get in your diet and vice versa. Sodium and potassium work together in the body and depend on each other for balance (think of a teeter-totter effect: when one goes up the other drops and vice versa). Most health experts recommend a maximum sodium intake of 2,300 milligrams daily while those with heart disease or high blood pressure are frequently advised to keep their sodium intake to less than 1,500 milligrams daily and to strive to obtain 4700 milligrams of potassium per day.

The easiest way to ensure a healthy sodium:potassium ratio is to minimize your consumption of packaged and processed foods, which tend to be extremely high in sodium and contain little, if any, potassium. Eating a plant-based diet naturally improves the sodium:potassium ratio since plant-based foods naturally contain plentiful amounts of potassium along with lesser amounts of sodium. And don’t forget about the high amounts of hidden sodium you may be getting in your drugs. Because there is no legal requirement for sodium disclosure or labeling, this information is often difficult to obtain, but here is one source for sodium content in some drugs.

Photo Credit: ThinkStock


Sarah Hill
Sarah Hill3 years ago

Another example of drug companies not looking out for consumers.

Siyus Copetallus
Siyus Copetallus3 years ago

Thank you for sharing.

Valentina R.
Valentina R3 years ago

Thanks for sharing.

Julia Oleynik
Julia Oleynik3 years ago

Thank you for sharing:)

Joemar Karvelis
Joemar Karvelis3 years ago


Jim Ven
Jim Ven3 years ago

thanks for the article.

Elena Poensgen
Elena Poensgen3 years ago

Thank you

Fi T.
Past Member 3 years ago

Check before consumption

Panchali Yapa
Panchali Yapa3 years ago

Thank you

Heidi Aubrey
Heidi Aubrey3 years ago

Using No-Salt(potassium chloride) to season your food with instead of salt is a good step for balancing the potassium/sodium within the body. The No-Salt contains over 600 mg potassium per 1/4 tsp. That is a pretty hefty dose of potassium.