Hormone replacement therapy and low-salt diets
USA Today turned 25 this week and ran a series of articles about changes in the world in the past quarter century. In their list of "25 Top Medical Events " was no mention of salt at all, not even recognition that during that time frame there's been a 50% increase in the number of infants born protected against the scourge of mental retardation. This achievement is due almost entirely to the massively successful global campaign to iodize salt.
One of the 25 was of some interest, however. Ranked 16th was the odyssey of hormone replacment therapy. USA Today says:
Hormones begone
Hormone therapy was once thought to be a fountain of youth for postmenopausal women, but a landmark study in 2002 found that estrogen plus progestin raises the risk of breast cancer, heart attacks, stroke and blood clots. Women stopped taking the hormones in droves, and today, they're prescribed only for relief of hot flashes and other symptoms.
As tragic as is the HRT story, it's important lesson is to teach us to demand high quality science on health outcomes before we launch a major population health recommendation. Before the government began to advise all Americans to reduce dietary salt, it should have looked at the health outcomes studied. Had it done so, we could have avoided the expensive delays -- and potential risks -- of having the "salt hypothesis" blow up in its face as HRT already has. Too bad.
