We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Iodized Salt and Hypertension—Reply

Franz H. Messerli, MD; Roland E. Schmieder, MD
Arch Intern Med. 2002;162(1):105. doi:.
Text Size: A A A
Published online


In reply

The comment of Cann et al suggesting that a reduction in dietary salt intake may occur at the expense of iodine intake deserves to be scrutinized carefully. The purpose of our editorial was to recognize possible harmful effects of an excessive dietary sodium intake on the cardiovascular system.1 Cann et al are rightly concerned that the practice of supplying most of our iodine needs by supplementing table salt could potentially pose a dilemma that may be worth consideration by public health authorities. We also agree with the authors that hypothyroidism, overt or subclinical, can be an independent risk factor for atherosclerosis and coronary heart disease. However, iodine deficiency is by no means synonymous with hypothyroidism. Most patients who have hypothyroidism do not have iodine deficiency, and only the most severe form of iodine deficiency leads to hypothyroidism. The evidence that iodine should be considered as "an alternative treatment for cardiovascular disease and control of hypertension" is rather shaky. The authors quote 3 articles, one of which2 deals with the effects of iodine baths on central hemodynamics, and the other 2 studies3,4 are thinly veiled advertisements for a health spa (Bad Hall) in Austria. In this spa, most patients vacation at taxpayers' expense to take a daily bath in iodinated saline. According to these studies, the "badekur" supposedly has been documented to be beneficial for hypertension, atherosclerosis, angina pectoris, hyperlipidemia, diabetes, peripheral vascular disease, varicosis, and thrombophlebitis, among others. Specifically, the authors found an average maximal decrease in blood pressure of 42.9/18.6 mm Hg within 10 minutes of immersion into the bath. Not only does the iodine bath have a good effect on cardiovascular disease, but these studies also point out that it has been shown to help in patients with respiratory problems, such as acute or chronic bronchitis, asthma, and sinusitis; musculoskeletal diseases, such as degenerative joint disease, osteoporosis, low back pain, and parkinsonism; in a wide variety of eye disorders ranging from cataracts to macular degeneration; and in women with infertility and other gynecologic disorders. Since these wonderful results are achieved by daily immersion in an iodine bath, it seems to be a great leap of faith to conclude from these "studies" that iodine taken orally should be used as a treatment for hypertensive cardiovascular disease. We also remain skeptical that moderate iodine deficiency per se should be considered as a "risk for cardiovascular disease morbidity and mortality."

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Original Article: Does This Patient Have a Hemorrhagic Stroke?

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Quick Reference