Moderation is key when it comes to sodium intake, based on study findings that link low sodium diets to increased cardiovascular risk in healthy adults.

Published in The Lancet, this study looked at the effects of sodium in adults with and without high blood pressure. It’s well established that high sodium intake increases risk for high blood pressure, heart events and death. That’s why guidelines suggest that all Americans consume less than 2,300 mg of sodium each day—the equivalent to 1 teaspoon of salt. However, too little salt can be just as harmful, since our bodies need sodium to function properly. Experts wonder if sodium restriction is beneficial in all adults or just those with high blood pressure.

To learn more, researchers analyzed data from four large studies that included more than 133,000 adults from 49 different countries. All studies used 24-hour urine samples to assess sodium consumption and followed participants for over four years, tracking key outcomes like heart events and death.

Overall, roughly half of study participants had high blood pressure. After analysis, researchers found that sodium intake affected adults with and without hypertension differently.

In both groups, low sodium intake (less than 3,000 mg/day) was associated with 26–34% greater risk for heart events and death compared to moderate sodium intake (4,000–5,000 mg/day). However, high sodium intake (more than 7,000 mg/day) only increased risk for heart events and death in adults with hypertension.

Findings suggest that a low-sodium diet may not be for everyone. As other studies have shown, too little salt can be harmful in adults with and without hypertension. Authors believe current guidelines may be too low for the general population.

However, that doesn’t mean that sodium guidelines should be thrown out the window. There’s no question that a low-sodium diet is important for patients with high blood pressure. In this study, high sodium intake increased blood pressure much more in patients with hypertension than those without. High sodium diets significantly increased risk for heart attack, stroke and death in patients with hypertension. Therefore, authors suggest that lowering sodium intake should mainly be targeted at adults with hypertension and high sodium diets. The average American consumes excess sodium, so the 2,300 mg/day guidelines still hold true without further research. As they learn more, experts hope to refine sodium guidelines for patients with and without high blood pressure.