The American Heart Association calls a healthy diet and lifestyle "your best weapons to fight cardiovascular disease," especially when it comes to high blood pressure, heart disease’s most detrimental risk factor. A recent paper featured in the British Medical Journal (BMJ) suggests that dietary guidelines for treating hypertension and subsequent cardiovascular disease should focus on reducing the amount of added sugars, primarily fructose, consumed by people at risk for heart disease.

"Sugar may be much more meaningfully related to blood pressure than sodium, as suggested by a greater magnitude of effect with dietary manipulation," the study’s research team said in a statement. "Compelling evidence from basic science, population studies, and clinical trials implicates sugars, and particularly the monosaccharide fructose, as playing a major role in the development of hypertension (high blood pressure)."

James DiNicolantonio from the Department of Preventive Cardiology at Saint Luke's Mid America Heart Institute in Kansas City and Sean Lucan from the Department of Family and Social Medicine at Albert Einstein College of Medicine, Montefiore Medical Center in the Bronx called the dietary approach of cutting salt intake to lower high blood pressure “debatable.” They argue that restricting salt intake leads to a relatively small drop in blood pressure readings. Some research even suggests that between 3 and 6 grams of salt per day is optimal for health, while less than 3 grams of salt can be harmful.

DiNicolantonio and Lucan suggests that dietary guidelines target sugar, high fructose corn syrup in particular. High fructose corn syrup is the most common sweetener used in processed food and drink, such as sugary fruit juice and soda. A diet consisting of daily added sugar intake that adds up to a quarter of total daily calories can triple a person’s heart disease risk compared to people who consume less than 10 percent. Consuming over 74 grams of fructose a day can also lead to a 77 percent higher risk of blood pressure above 160/110 mm Hg.

"Moreover, evidence suggests that sugars in general, and fructose in particular, may contribute to overall cardiovascular risk through a variety of mechanisms. Worldwide, sugar sweetened beverage consumption has been implicated in 180,000 deaths a year," researchers explained.

According to a report issued by the Centers for Disease Control and Prevention, around 16 percent of children and adolescents’ total caloric intake comes from added sugars. Over 40 percent of calories from added sugar come from sugar-laden beverages, like soda. DiNicolantonio and Lucan noted that naturally occurring sugar found in fruit and vegetables have no harmful effect on our health.

"Just as most dietary sodium does not come from the salt shaker, most dietary sugar does not come from the sugar bowl; reducing consumption of added sugars by limiting processed foods containing it, made by corporations, would be a good place to start," the research team added. "The evidence is clear that even moderate doses of added sugar for short durations may cause substantial harm."

Source: DiNicolantonio J, Lucan S. The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. BMJ. 2014.