Table 1. Cardiovascular and non-cardiovascular health risks associated with excessive sodium intake.

Domain	Health outcome	Evidence summary	Representative references
Cardiovascular	Elevated blood pressure	Excessive sodium intake increases extracellular volume and vascular resistance, resulting in dose-dependent blood pressure elevation.	6, 14, 21, 17, 22
	Cardiovascular disease events	High sodium intake is associated with increased risks of cardiovascular events and mortality; large cohort and pooled analyses demonstrate linear or J-shaped associations depending on intake level and assessment method.	6, 13, 23, 16
	Stroke	Excess sodium intake contributes substantially to global stroke burden; sodium reduction lowers stroke incidence, particularly when combined with potassium-enriched salt substitutes.	13, 24, 17
	Heart failure progression	Sodium-induced volume overload and neurohormonal activation may exacerbate heart failure outcomes; excessive restriction may also activate the RAAS in vulnerable populations.	25, 26
Renal	Chronic kidney disease progression	High sodium intake impairs renal hemodynamics, increases glomerular pressure, and accelerates CKD progression independent of blood pressure effects.	20
	Albuminuria	Modest dietary salt reduction significantly lowers urinary albumin excretion in individuals with diabetes or impaired glucose tolerance.	18
	Nephrolithiasis	Excess sodium intake increases urinary calcium excretion, contributing to kidney stone formation.	27, 22
Gastrointestinal	Gastric cancer	High dietary salt intake increases gastric cancer risk, particularly in Asian populations; mechanisms include mucosal damage and enhanced Helicobacter pylori colonization.	28, 29
Skeletal	Osteoporosis	Sodium-induced calciuria is associated with reduced bone mineral density and increased osteoporosis risk, especially in post-menopausal women.	27, 22
Immune/inflammatory	Immune dysregulation	High sodium intake alters gut microbiota and modulates immune cell differentiation toward a pro-inflammatory phenotype.	30
Neurological/cognitive	Cognitive impairment and dementia	High sodium intake is associated with cognitive decline and increased dementia risk, potentially mediated through vascular dysfunction and immune dysregulation.	31-33
Metabolic	Metabolic syndrome and insulin resistance	Excess sodium intake is associated with increased waist circumference, insulin resistance, and metabolic syndrome components, beyond hemodynamic effects.	34, 35

CKD, chronic kidney disease; RAAS, renin–angiotensin–aldosterone system.