Highlights in clinical autonomic neuroscience: how much salt is salubrious?

Individuals differ in their preference for, sensitivity to, and physiologic need for, salt. Increasing the dietary intake of salt is considered first line treatment for orthostatic hypotension, orthostatic intolerance, and syncope. Dietary salt intake is also an important contributing cause for hypertension, which is the leading modifiable risk factor for mortality worldwide. Recent research calls into question the assumption that there is one ideal dose of dietary salt appropriate for everyone. Individualized salt recommendations for some patients should take into account orthostatic blood pressure patterns and in the future may also be guided by genetic information. An as yet unanswered question is whether high salt diets helpful in the treatment of orthostatic disorders would, if continued long-term, increase the risk of developing hypertension.