Abstract
Ninety four patients with mild hypertension (average supine diastolic blood pressure (phase V) 95-110 mm Hg) were allocated at random to receive restriction of dietary sodium (maximum allowed 70 mmol(mEq)/24 h) or a normal diet. In addition, they received in random order 25 mg chlorthalidone, 200 mg metoprolol (slow release), and a fixed combination of these two drugs. Each drug treatment was given for four weeks and alternated with four weeks of placebo. Forty four patients were allocated to sodium restriction (group 1) and 50 to normal diet (group 2). The mean 24 hour urinary sodium excretion in group 1 was 74 (SD 31) mmol(mEq)/24 h, and in group 2 132 (51) mmol/24 h. Compared with the screening blood pressure the average decrement of the supine blood pressure in group 1 was 16.0/8.6 mm Hg with placebo, 21.7/11.5 mm Hg with the diuretic, 28.5/17.8 mm Hg with the beta blocker, and 28.9/18.4 mm Hg with the combined agent; in group 2 these values were 13.3/6.1, 20.3/9.7, 21.3/12.9, and 29.4/16.8 mm Hg, respectively. There was a sharp decrease of the average potassium concentration during chlorthalidone and combination treatment periods (average value 3.3 mmol(mEq)/1). These results suggest that moderate salt restriction used as sole treatment has a limited though demonstrable blood pressure lowering effect but that when it is used as an adjuvant to beta blocker treatment its value is greatly enhanced.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ames R. P., Hill P. Elevation of serum lipid levels during diuretic therapy of hypertension. Am J Med. 1976 Nov;61(5):748–757. doi: 10.1016/0002-9343(76)90156-x. [DOI] [PubMed] [Google Scholar]
- Ames R. P., Hill P. Improvement of glucose tolerance and lowering of glycohemoglobin and serum lipid concentrations after discontinuation of antihypertensive drug therapy. Circulation. 1982 May;65(5):899–904. doi: 10.1161/01.cir.65.5.899. [DOI] [PubMed] [Google Scholar]
- Andrews G., MacMahon S. W., Austin A., Byrne D. G. Hypertension: comparison of drug and non-drug treatments. Br Med J (Clin Res Ed) 1982 May 22;284(6328):1523–1526. doi: 10.1136/bmj.284.6328.1523. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hollifield J. W., Slaton P. E. Thiazide diuretics, hypokalemia and cardiac arrhythmias. Acta Med Scand Suppl. 1981;647:67–73. doi: 10.1111/j.0954-6820.1981.tb02640.x. [DOI] [PubMed] [Google Scholar]
- 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]
- Parijs J., Joossens J. V., Van der Linden L., Verstreken G., Amery A. K. Moderate sodium restriction and diuretics in the treatment of hypertension. Am Heart J. 1973 Jan;85(1):22–34. doi: 10.1016/0002-8703(73)90522-x. [DOI] [PubMed] [Google Scholar]
- Swales J. D. Dietary salt and hypertension. Lancet. 1980 May 31;1(8179):1177–1179. doi: 10.1016/s0140-6736(80)91631-1. [DOI] [PubMed] [Google Scholar]
- 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]
- Wright B. M., Dore C. F. A random-zero sphygmomanometer. Lancet. 1970 Feb 14;1(7642):337–338. doi: 10.1016/s0140-6736(70)90709-9. [DOI] [PubMed] [Google Scholar]
- van Brummelen P., Schalekamp M., de Graeff J. Influence of sodium intake on hydrochlorothiazide-induced changes in blood pressure, serum electrolytes, renin and aldosterone in essential hypertension. Acta Med Scand. 1978;204(3):151–157. doi: 10.1111/j.0954-6820.1978.tb08417.x. [DOI] [PubMed] [Google Scholar]