Association Between Dietary Salt Intake and Blood Pressure Among Adults in Cross River State: A Community-Based Study

Background: Dietary sodium excess is a modifiable risk factor for hypertension with population-wide blood pressure reduction potential. Its quantified association with blood pressure in the South South geopolitical zone of Nigeria provides evidence for dietary public health interventions. This study examines the association between dietary salt intake and blood pressure among adults in Calabar, Cross River State. Methods: A cross-sectional community-based study enrolled 340 adults through multistage cluster sampling. Dietary sodium intake was estimated using 24-hour dietary recall and spot urine sodium excretion. Blood pressure was measured in triplicate following WHO methodology. Multivariate linear regression adjusted for body mass index, physical activity, alcohol use, and potassium intake. Results: Mean dietary sodium intake substantially exceeded WHO recommended limits across all demographic groups. Sodium intake was independently and positively associated with both systolic and diastolic blood pressure. The association was strongest in participants aged over 50 years and those with a family history of hypertension. Conclusion: High dietary sodium intake is a significant independent predictor of blood pressure elevation in Cross River State. Family medicine practitioners should provide structured dietary counselling integrating sodium reduction as a primary lifestyle intervention for all hypertensive and pre-hypertensive patients. Keywords: dietary salt, sodium, blood pressure, Cross River State, hypertension