Some people with high blood pressure get better when they eat less salt, but others don't because their problem is more about hormones than salt.

“There's also a clear distinction between patients who respond well to salt restriction and those who don't. Young, lean patients with primary hypertension often see significant pressure drops when they reduce their sodium intake because their kidneys and vessels are still flexible enough to adjust. Older patients with insulin resistance with obesity or metabolic syndrome rarely see meaningful change from salt restriction alone because their pressure is being driven hormonally, not just mechanically. That doesn't mean that salt doesn't matter to them. It means that salt isn't the primary driver and treating it as if it is will lead to frustration and non-compliance.”