Simple dietary advice reduces 24-hour urinary sodium excretion, blood pressure, and drug consumption in hypertensive patients

Natale Musso; Beatrice Carloni; Maria C Chiusano; Massimo Giusti

doi:10.1016/j.jash.2018.06.012

Simple dietary advice reduces 24-hour urinary sodium excretion, blood pressure, and drug consumption in hypertensive patients

J Am Soc Hypertens. 2018 Sep;12(9):652-659. doi: 10.1016/j.jash.2018.06.012. Epub 2018 Jun 30.

Authors

Natale Musso¹, Beatrice Carloni², Maria C Chiusano², Massimo Giusti²

Affiliations

¹ Secondary Hypertension Unit, Chair of Endocrinology, Ospedale Policlinico San Martino Genova, Genoa, Italy. Electronic address: natale.musso@hsanmartino.it.
² Secondary Hypertension Unit, Chair of Endocrinology, Ospedale Policlinico San Martino Genova, Genoa, Italy.

PMID: 30033124
DOI: 10.1016/j.jash.2018.06.012

Abstract

Sodium intake should be restricted to 100 mEq, that is, about 2.3 grams per day. Strict diets, however, are often cumbersome and seldom matched by rigorous compliance. We studied 291 patients on antihypertensive treatment, 240 of whom were instructed to avoid salty foods, such as cheese and cured meats, and to switch from regular bread to salt-free bread. The remaining 51 matched patients constituted a control group and received only generic dietary advice. Na[U]/24h, K[U]/24h, and office BP (automated repeated measurements) were recorded before dieting started and after 9 ± 1 weeks of dieting. Our intervention group showed a significant decrease in body weight (71.75 ± 14.0 to 70.54 ± 13.33 kg, P < .0001), sodium excretion (153.1 ± 44.61 to 133.5 ± 37.1 mEq/24h, P < .05), systolic and diastolic BP (134.16 ± 16.0 to 126.5 ± 10.53 mm Hg, P = .014 and 80.59 ± 11.47 to 75.9 ± 8.72 mm Hg, P = .026, respectively), and drug consumption (1.71 ± 0.91 to 1.49 ± 0.84 DDD, P < .05). The rate of responders to antihypertensive therapy increased (51.4% to 79.5%). In the control group neither significant nor substantial changes were seen. Our data suggest that even a minimal reduction in the apparent sodium intake (∼0.5 grams per day) can improve both BP values and responder rates in treated hypertensive patients, while reducing the consumption of antihypertensive drugs.

Keywords: Blood pressure; dietary salt; hypertension; sodium.