Salt versus Sugar Intake: Which is the Worse Opponent in Blood Pressure Control?


Rational for the Argument that Sugar is Worse for Blood Pressure than Salt.

First, there’s an established link between sugar and metabolic syndrome; a conglomeration of cardiovascular markers that includes insulin resistance, high cholesterol, high blood pressure, high triglycerides (blood fats), and excess weight, especially in the form of belly fat.

Second, studies have shown that consuming sugar also seems to lead to increases insulin levels, which activates the sympathetic nervous system, leading to increases in heart rate and blood pressure.

Thirdly, and most importantly, sugar depletes ATP (our energy stores), which, again through several steps and events, constricts blood vessels, and increases blood pressure.

Which of the Sugar Type is Most Notorious?

By far, high-fructose corn syrup the simple type of sugar has been shown to contribute more to increase blood pressure compared to complex sugars. Why? Fructose decreases the insulin activation to break down complex sugar such as glucose and glycogen and the body then tries to resort to using protein and fat to produce energy and this gives rise to the formation of ketones and uric acid (bad inflammatory markers).

The uric acid levels for example, leads to gout formation and increase blood pressure by constricting the blood vessels. Besides, Fructose also tells the kidney to hold back on salt and this again can increase Blood Pressure.

What is then the Consensus?

Looking at a patient’s history and current diet is important and what’s is not recommended is to let salt off the hook and turn our attention completely to sugar. As with most things, for better or for worse, it’s all about moderation. For people with existing high blood pressure or who have had cardiovascular disease in the past, salt intake is certainly worth keeping an eye on. But to say we should trade concern for salt for that of its sweeter counterpart, may not be advisable at all. In the end, it may do more harm than good.

That means people with metabolic syndrome (pre-diabetes) and diabetes should be more cautious of their salt intake. And for people who have congestive heart failure, limiting salt intake can make the difference from staying home or being hospitalized, as extra sodium can increase fluid retention causing edema (swelling) that a weak heart can’t tolerate.

The good news is there is no harm from eating more fruit, so don’t fret over having an apple, a peach, or a cup of berries but do try to avoid fruit juice and dried fruit.

How else can you Improve Blood Pressure Control if you don’t cut Down on Salt and/or Sugar?

You should eat five cups of vegetables and fruits and exercise for 30 minutes daily.

You should listen to your body and how you feel and check your blood pressure routinely (say every two weeks).

You should communicate with your healthcare provider when you notice higher than normal blood pressure, knowing fully well that hypertension is a silent killer.



DiNicolantonio JJ, Lucan SC. Open Heart 2014;1:3000167

Preuss HG, Fournier RD. Life Sci 1982;30:879-886


DeArk Medical Center, located in Charlotte, North Carolina, is a Primary Care Internal Medicine clinic for ages 10 and older. Led by William Iyamu, MD, Ph.D., we provide comprehensive healthcare services including management of chronic diseases such as Hypertension, Diabetes, weight loss, High Cholesterol, Opioid abuse and diagnosis/treatment of acute illness, and wellness services (complete physical exams, immunizations, cancer screenings, and lifestyle modifications. If you have any concerns or questions regarding your health, do not hesitate to contact us at 980-888-8011 or on the web at:



E. William Iyamu, MD, PHDE. William Iyamu, MD, PHD, of DeArk Medical Center is a board-certified internal medicine doctor. He received his Medical Training at the University of Kansas School of Medicine, Kansas City, KS in 2008 and then completed his Internal Medicine Internship at the University of Nebraska Medical Center in Omaha, NE, followed by Internal Medicine Residency Training at Meharry Medical College, Nashville, TN. He then served as Chief Medical Resident at Meharry Medical College for one year and received additional training in Hematology/Oncology at the University of Arkansas for Medical Sciences, Little Rock, AR. He practiced as a Hospitalist for several years, including his position as a staff physician at The Carolinas Healthcare Systems. Dr. Iyamu has expertise in preventative health care and in the management of medically complex patient including, but not limited to, those with hypertension, heart disease, chronic lung disease, opioid used disorder and diabetes. His is married with children.

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