Climate change and sea level rise will continue to exacerbate existing freshwater salinization and affect large populations in many low-lying countries of the world including in Bangladesh. While ample evidence, mainly based on food consumption, indicates high salt intake causes significant health problems (e.g. elevated blood pressure (BP), hypertension and cardiovascular diseases), the evidence for health effects of consuming highly saline water is limited. In coastal Bangladesh, with over 35 million inhabitants, projected climate change points toward further intensification of the exposure to high salinity in water and presents significant threats to population’s health. Furthermore, in order to better understand potential health risks and assist in developing future response options, data about the water supply situation and consumption is imperative. Such data are scarce. This research aimed firstly to examine the salt (sodium) exposure, and the association between high drinking water salinity and blood pressure (BP) in young adults in coastal Bangladesh. There is currently limited data available about BP on healthy young adults in Bangladesh, particularly from salinity affected coastal areas. Second, this research investigated existing water supply and water consumption in order to explore appropriate adaptation opportunities for actions and strategies.