Is low salt dietary advice a useful therapy in hypertensive patients with poorly controlled blood pressure?
Bulpitt, C.J.; Daymond, M.; Bulpitt, P.F.; Ferrier, G.; Harrison, R.; Lewis, P.J.; Dollery, C.T.
Annals of Clinical Research 16(Suppl): 143-149
1984
ISSN/ISBN: 0003-4762 PMID: 6398984 Document Number: 236174
To decide whether or not to advise a low sodium trial routinely in a hypertension clinic, a randomized controlled 'management' trial was made to assess dietary compliance, well-being and changes in antihypertensive medication as a result of such a diet. A total of 65 outpatients on drug treatment for hypertension but with diastolic blood pressures greater than 95 mmHg on 2 successive occasions were randomly allocated to an index group on a diet with 1 g (44 mmol) Na daily or to a reference group. Dietary advice was given in detail and repeated as necessary to ensure there was no misunderstanding. After 3 months 28% of the index group still added salt to their cooking and 13% sometimes added salt at the table. The difference between the groups in 24-h Na excretion was on average 59 mmol at the end of the trial but 55% of the index group had a 24-h Na excretion greater than 80 mmol. The average blood pressure at the end of the trial was only 4 mmHg systolic and 3 mmHg diastolic lower in the index group. The index group enjoyed their food as much as before and tended to require less drug treatment. The index group complained more of transient unsteadiness suggestive of postural hypotension.