Published February 23, 2015

The Blue Cross Blue Shield Health IndexSM identifies hypertension, also called high blood pressure, as one of the top five health conditions affecting the health and well-being of individuals and their communities. The Blue Cross Blue Shield Association is a partner of Million Hearts®.

Each year, more than 800,000 people die of cardiovascular disease in the United States, making it the leading cause of death for both men and women.

Today, we know more about cardiovascular disease than ever before — we’ve learned how to prevent, reverse and treat it, often with simple lifestyle changes. In 2012, the Centers for Disease Control and Prevention, in collaboration with the Centers for Medicare & Medicaid Services (CMS) launched the Million Hearts® initiative. The aim was to prevent 1 million heart attacks over 5 years by making it easier for people to make healthier choices and improving performance on the ABCS: aspirin when appropriate, blood pressure control, cholesterol management and smoking cessation.  



Though tremendous progress has been made in the past 5 years, we will fall short of this ambitious goal. The good news is that since 2011, some 7 million people quit smoking, and the number of patients whose blood pressure is under control and whose cholesterol is appropriately managed continues to rise steadily. Unfortunately sodium, also known as salt, consumption remains high.

About 1 in 3 adults have high blood pressure, and consuming too much sodium is a contributing factor. Excess sodium in the body pulls additional water into the blood vessels, swelling the volume of blood and increasing the pressure on the vessels, just as blasting a high volume of water strains a garden hose. Over time, the stressed walls of the blood vessel can be damaged and lead to additional problems. High blood pressure is called the silent killer, because it has few symptoms but is a leading cause of strokes, heart attacks, kidney disease and heart disease. 

Americans consume an average of more than 3,400 milligrams (mg) of sodium each day. But the 2015–2020 Dietary Guidelines for Americans recommend that Americans consume less than 2,300 mg of sodium each day. Increasing access to lower sodium foods and giving consumers the power of choice could help prevent millions of cases of high blood pressure and save billions of health care dollars.

Most of the sodium Americans eat comes from packaged, processed, store-bought and restaurant foods. Only a small amount comes from salt added during cooking or at the table. In fact, most Americans already exceed the daily recommended limit before they ever pick up a salt shaker.

More than 40% of the sodium we eat each day comes from just 10 types of foods, ranging from the number 1 source — breads and rolls — to snack foods, which are 10th on the list. Foods that otherwise seem healthy may have high levels of sodium. Examples include cottage cheese and turkey breast deli meat. Importantly, high sodium intake often begins early in life — nearly 9 in 10 children eat more sodium than recommended, and 1 in 9 already have elevated blood pressure.

The good news is that there are many simple ways to reduce sodium intake. Processed and prepared foods are common high-salt culprits, so a good first step is to prepare food at home and be aware of what goes into each meal. When eating processed foods, such as frozen dinners or canned soup, it’s important to study nutrition labels and choose options with lower levels of sodium. At restaurants, patrons should feel free to request nutrition information and pick lower sodium options.

People can also avoid pre-made sauces and marinades and instead season foods with herbs, spices and citrus. Choose fresh fruits and vegetables that are naturally low in sodium. Foods rich in potassium, such as bananas, help regulate the body’s sodium levels.

Decades ago, it seemed that Americans would never be able to quit smoking. Now, after a coordinated public health campaign, fewer people are lighting up than ever before. We can make this same progress with our diets. This year, it’s time to cut back on sodium and encourage others to do the same.

It’s a gift from — and to — the heart.

Million Hearts is a national initiative to prevent 1 million heart attacks and strokes in five years. CDC co-leads Million Hearts with the Centers for Medicare & Medicaid Services. For more information about the initiative and to access resources, visit

The Blue Cross Blue Shield Association is an association of 36 independent, locally operated Blue Cross and/or Blue Shield companies.