Skip to main content
NCBI home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1987 Feb 28;294(6571):531–534. doi: 10.1136/bmj.294.6571.531

Moderate sodium restriction with angiotensin converting enzyme inhibitor in essential hypertension: a double blind study.

G A MacGregor, N D Markandu, D R Singer, F P Cappuccio, A C Shore, G A Sagnella
PMCID: PMC1245574  PMID: 3103761

Abstract

Fifteen unselected patients who had essential hypertension and whose average supine blood pressure when they were not receiving any treatment and their usual sodium intake was 162/107 mm Hg were treated with captopril 50 mg twice daily. After one month's treatment their supine blood pressure had decreased to 149/94 mm Hg. They were then instructed to reduce their sodium intake to about 80 mmol(mEq)/day. After two weeks of moderate sodium restriction they were entered into a double blind randomised crossover study comparing the effect of 10 Slow Sodium tablets (100 mmol sodium chloride) with matching placebo tablets while continuing to take captopril and restrict sodium in their diet. After one month of taking placebo their mean supine blood pressure was 137/88 mm Hg with a urinary sodium excretion of 83 mmol/24 h, while after one month of taking Slow Sodium tablets their mean supine blood pressure was 150/97 mm Hg (p less than 0.001) with a sodium excretion of 183 mmol/24 h. The mean supine blood pressure during moderate sodium restriction therefore decreased by 9% and correlated significantly with the reduction in urinary sodium excretion. These results suggest that the combination of treatment with a moderate but practical reduction in sodium intake and an angiotensin converting enzyme inhibitor is effective in decreasing the blood pressure in patients with essential hypertension. This combined approach overcomes some of the objections that have been made to salt restriction alone and to converting enzyme inhibitors alone.

Full text

PDF
531

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Beauchamp G. K., Bertino M., Engelman K. Modification of salt taste. Ann Intern Med. 1983 May;98(5 Pt 2):763–769. doi: 10.7326/0003-4819-98-5-763. [DOI] [PubMed] [Google Scholar]
  2. Brown J. J., Lever A. F., Robertson J. I., Semple P. F. Should dietary sodium be reduced? The sceptics' position. Q J Med. 1984 Autumn;53(212):427–437. [PubMed] [Google Scholar]
  3. Cappuccio F. P., Markandu N. D., Sagnella G. A., MacGregor G. A. Sodium restriction lowers high blood pressure through a decreased response of the renin system--direct evidence using saralasin. J Hypertens. 1985 Jun;3(3):243–247. doi: 10.1097/00004872-198506000-00008. [DOI] [PubMed] [Google Scholar]
  4. George C. F., Lewis P. J., Petrie A. Clinical experience with use of ultrasound sphygmomanometer. Br Heart J. 1975 Aug;37(8):804–807. doi: 10.1136/hrt.37.8.804. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Gill J. S., Zezulka A. V., Beevers D. G., Davies P. Relation between initial blood pressure and its fall with treatment. Lancet. 1985 Mar 9;1(8428):567–569. doi: 10.1016/s0140-6736(85)91219-x. [DOI] [PubMed] [Google Scholar]
  6. Longworth D. L., Drayer J. I., Weber M. A., Laragh J. H. Divergent blood pressure responses during short-term sodium restriction in hypertension. Clin Pharmacol Ther. 1980 Apr;27(4):544–546. doi: 10.1038/clpt.1980.76. [DOI] [PubMed] [Google Scholar]
  7. MacGregor G. A., Markandu N. D., Banks R. A., Bayliss J., Roulston J. E., Jones J. C. Captopril in essential hypertension; contrasting effects of adding hydrochlorothiazide or propranolol. Br Med J (Clin Res Ed) 1982 Mar 6;284(6317):693–696. doi: 10.1136/bmj.284.6317.693. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. MacGregor G. A., Markandu N. D., Best F. E., Elder D. M., Cam J. M., Sagnella G. A., Squires M. Double-blind randomised crossover trial of moderate sodium restriction in essential hypertension. Lancet. 1982 Feb 13;1(8268):351–355. doi: 10.1016/s0140-6736(82)91389-7. [DOI] [PubMed] [Google Scholar]
  9. MacGregor G. A., Markandu N. D., Roulston J. E., Jones J. C. Essential hypertension: effect of an oral inhibitor of angiotensin-converting enzyme. Br Med J. 1979 Nov 3;2(6198):1106–1109. doi: 10.1136/bmj.2.6198.1106. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. MacGregor G. A. Sodium is more important than calcium in essential hypertension. Hypertension. 1985 Jul-Aug;7(4):628–640. doi: 10.1161/01.hyp.7.4.628. [DOI] [PubMed] [Google Scholar]
  11. Misleading paper about misleading statistics. Lancet. 1985 Apr 20;1(8434):926–927. [PubMed] [Google Scholar]
  12. Ondetti M. A., Rubin B., Cushman D. W. Design of specific inhibitors of angiotensin-converting enzyme: new class of orally active antihypertensive agents. Science. 1977 Apr 22;196(4288):441–444. doi: 10.1126/science.191908. [DOI] [PubMed] [Google Scholar]
  13. Richards A. M., Nicholls M. G., Espiner E. A., Ikram H., Maslowski A. H., Hamilton E. J., Wells J. E. Blood-pressure response to moderate sodium restriction and to potassium supplementation in mild essential hypertension. Lancet. 1984 Apr 7;1(8380):757–761. doi: 10.1016/s0140-6736(84)91276-5. [DOI] [PubMed] [Google Scholar]
  14. Thaler B. I., Paulin J. M., Phelan E. L., Simpson F. O. A pilot study to test the feasibility of salt restriction in a community. N Z Med J. 1982 Dec 8;95(721):839–842. [PubMed] [Google Scholar]
  15. Watt G. C., Edwards C., Hart J. T., Hart M., Walton P., Foy C. J. Dietary sodium restriction for mild hypertension in general practice. Br Med J (Clin Res Ed) 1983 Feb 5;286(6363):432–436. doi: 10.1136/bmj.286.6363.432. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES