Sugar (especially the kind in fruit juice) is replacing salt as blood pressure enemy No. 1.

MedPage Today is among the sources spreading the determination (with no mincing of words) that sugar is just as bad as salt – if not worse – for your blood pressure:

In a research review published Dec. 11 in the BMJ journal Open Heart, James J. DiNicolantonio, PharmD, of Saint Luke’s Mid America Heart Institute, Kansas City, Mo., and Sean C. Lucan, MD, MPH, of Montefiore Medical Center, Bronx, New York argued that the emphasis on lowering dietary sodium in guidelines aimed at reducing hypertension is misguided and not evidence-based.

“Added sugars probably matter more than dietary sodium for hypertension, and fructose in particular may uniquely increase cardiovascular risk by inciting metabolic dysfunction and increasing blood pressure variability, myocardial oxygen demand, heart rate, and inflammation,” the authors wrote.

DiNicolantonio, who is an associate editor of Open Heart, was more blunt in an interview with MedPage Today, calling sodium restriction guidelines “the greatest con in preventive nutrition in human history.”

In their analysis of the scientific evidence examining the impact of both salt and sugar consumption on hypertension, DiNicolantonio and Lucan noted that there is little debate about where most sodium in the average American’s diet comes from.

“While there is no argument that recommendations to reduce consumption of processed foods are highly appropriate and advisable, the arguments in this review are that the benefits of such recommendations might have less to do with sodium — minimally related to blood pressure and perhaps even inversely related to cardiovascular risk — and more to do with highly-refined carbohydrates,” they wrote.

In a randomized trial of 74 adult men, a high fructose diet for just 2 weeks not only significantly increased 24 hour ambulatory blood pressure (+7/5 mmHg, P<0.004 and P=0.007, respectively) and increased pulse rate by 8% (4 bpm), but also increased triglycerides, fasting insulin, and homeostatic model assessment index (a measure of insulin resistance and beta-cell function).

OK, nobody in there is talking about fruit juice, but fructose, as in corn syrup. But still.