Published Online
on June 13, 2005

A more recent version of this article appeared on July 1, 2005

This Article Full Text (PDF) All Versions of this Article: 46/1/66    most recent 01.HYP.0000171474.84969.7av1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by He, F. J. Articles by MacGregor, G. A. Search for Related Content PubMed PubMed Citation Articles by He, F. J. Articles by MacGregor, G. A. Pubmed/NCBI databases Medline Plus Health Information Diets High Blood Pressure Related Collections Clinical Studies Related Article

Modest Salt Reduction Lowers Blood Pressure in Isolated Systolic Hypertension and Combined Hypertension

Feng J. He; Nirmala D. Markandu; and Graham A. MacGregor^*

From the Blood Pressure Unit, St. George’s Hospital Medical School, London, UK.

^* To whom correspondence should be addressed. E-mail: g.macgregor{at}sghms.ac.uk.

Abstract--Many randomized trials have shown that a reduction in salt intake lowers blood pressure in hypertensive individuals. However, few have looked at the effects according to hypertension category. A recent analysis of the third and fourth National Health and Nutrition Examination Survey suggests that salt intake may not be related to blood pressure in isolated systolic or combined hypertension. To look at this further, we reanalyzed the data of our previous salt reduction trials. Hypertensive individuals were studied in randomized double-blind crossover studies: 1 month of usual salt intake compared with 1 month of reduced salt intake. In isolated systolic hypertension (n=24), blood pressure was reduced from 166±19/86±7 to 156±20/85±7 mm Hg (systolic P<0.001; diastolic P=0.459) with a reduction in urinary sodium from 175±51 to 87±38 mmol per 24-hour period (10.3 to 5.1 g per day of salt). In combined hypertension (n=88), blood pressure was reduced from 161±16/100±9 to 154±17/96±9 mm Hg (P<0.001) with a reduction urinary sodium from 176±65 to 98±51 mmol per 24-hour period (10.4 to 5.8 g per day of salt). These results demonstrate that salt reduction has a significant effect on blood pressure in isolated systolic and combined hypertension. The fall in systolic observed in isolated systolic hypertension would be predicted to reduce stroke by approximately one third, ischemic heart disease by one quarter, and heart failure by one quarter in the population between 60 and 80 years of age, in whom isolated systolic hypertension is the predominate form of hypertension and carries the highest risk. These results provide strong support for universal salt reduction in all hypertensives.

Key words: blood pressure • sodium, dietary

Related Article:

Salt Restriction in the Treatment of Isolated Systolic and Combined Hypertension: Is That Enough?

Myron H. Weinberger
Hypertension 2005 46: 31-32. [Extract] [Full Text] [PDF]

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