Background The epidemic data shows that heavy dietary salt intake could improve the developing of hypertension, cardiovascular and cerebrovascular disease. We detected the mechanism of effect on coronary atherosclerosis of prehypertensive patients with different levels of dietary salt intake.

Methods In total, 243 patients aged 45 to 75 with prehypertension were followed-up from 2003 to 2009. They were all diagnosed with coronary heart disease and had no history of myocardial infarction, coronary revascularisation, congenital heart disease or cerebrovascular disease.

Results The results showed that compared with normal-salt group, the patients who took heavy salt daily were younger (60.8 ± 7.4 vs 58.7 ± 7.5 years), with higher body mass indexes, and patients who had a history of coronary heart disease were more in high-salt group, especially in men. (p < 0.05). After a median follow-up period of 4.53 years, there were 71 (29.2%) patients who experienced the end point events (fatal and nonfatal myocardial infarction, or coronary revascularisation). The odds radios of the patients with high-salt diet was 2.659 (95% CI: 1.438–4.919). Meanwhile, among the patients with progression to hypertension, heavy salt intake was in a high risk of cardiovascular disease, which did not performed in the patients normotensive or prehypertensive.

Conclusions Heavy salt intake is a risk factor of the developing of coronary atherosclerosis in the patients with prehypertensive. The results of our study suggest that the mechanisms of the influence of salt intake to coronary atherosclerosis may be associated with obesity, hypertension, high triglycerides and total cholesterol.