The FDA and new safety warnings.

Comment. The majority of primary health care providers agree that their patients should reduce sodium intake; report providing specific advice in line with recommended strategies; and counsel patients with prehypertension, hypertension, or chronic kidney disease to consume less salt. In contrast to 2010 dietary guidelines, a minority of health care providers report counseling patients with diabetes or older patients to consume less salt. Also, a minority of providers of race/ethnicity groups other than African American report counseling African American patients to consume less salt. The most frequent types of advice provided to patients were in line with current recommended strategies to reduce sodium intake. Interestingly, the majority of health care providers also indicated they advise patients to remove the salt shaker or add less salt during cooking, despite current knowledge that for most people these behaviors are unlikely to result in major salt reduction. The results should be interpreted in the context of some potential selection and reporting biases. The survey was not a nationally representative sample of physicians or nurse practitioners, and health care providers who are more concerned about patient care may be more likely to respond and respondents may overstate their counseling behaviors. However, physicians were selected to be representative of the age, sex, and race/ethnicity of the American Medical Association master file. Our results suggest that more effort is required to inform health care providers about the need for all patients to reduce sodium intake and their ability to make a difference in their patient’s behavior. Specifically, the primary care physicians and nurse practitioners’ knowledge, attitudes, and practices regarding dietary salt intake will play an important role in the effort to reduce sodium intake for Americans, especially for those who seek care for hypertension and other cardiovascular diseases.