"Resistant hypertension" is the name doctors give to high blood pressure that turns out to be very difficult to treat effectively. Specifically, resistant hypertension is said to be present if your blood pressure is still not adequately controlled despite taking at least three medications for hypertension. Resistant hypertension affects more than 20% of all patients with high blood pressure.
A small study published this week in the journal Hypertension suggests that in people with resistant hypertension, significant restriction of dietary salt can result in rather large improvements in blood pressure control - generally, the improvement was greater than would normally be expected by adding an additional medication.
I
n this study, 12 patients with resistant hypertension at the University of Alabama were randomized to one of two diets - a 5700 mg per day sodium diet or a 1150 mg per day sodium diet. All patients were treated, in a randomized cross-over pattern, with each of these diets for a period of time. Investigators found that when the patients were on the lower sodium diet, their blood pressures were signficantly improved, by more than 22 mm Hg for systolic, and more than 9 mm Hg for diastolic pressures.
Somewhat surprisingly (since salt restriction has long been a staple of blood pressure control) this small trial was the first time sodium restriction was specifically evaluated in patients with resistant hypertension.
Because the trial was so small, and the duration of the trial was limited to about two weeks, the trial cannot be considered definitive. Undoubtedly, larger, longer-lasting trials will now be designed to test the sodium-restriction hypothesis in patients with restistant hypertension.
But if you are one of the 20+% of patients with high blood pressure who is taking at least three medications with poor blood pressure control, you might want to talk to your doctor about trying a strict limited-salt diet before adding yet another drug.
Sources
Pimenta E, Gaddam KK, Oparil S, et al. Effects of dietary sodium reduction on blood pressure in subjects with resistant hypertension. Results from a randomized trial. Hypertension 2009; DOI: 10.1161/HYPERTENSIONAHA.109.131235.
Monday, July 27, 2009
DASH Diet Combats Mental Decline
July 14, 2009 (Vienna, Austria) -- The low-fat, high-fiber diet recommended for lowering blood pressure may help prevent memory loss and sharpen mental skills.
Known as the Dietary Approaches to Stop Hypertension ( DASH) diet, the plan emphasizes fruits and vegetables, nuts and legumes, whole grains, and low-fat dairy products. Sodium, sweets, and red meats are to be consumed sparingly.
In a new study, the greater a person’s adherence to the DASH diet, the slower the rate of mental decline, reports Heidi Wengreen, PhD, RD, assistant professor of nutrition at Utah State University in Logan, and colleagues.
It’s not surprising that the diet worked: The DASH eating plan has been proven to lower blood pressure, and high blood pressure is a known risk factor for Alzheimer’s disease and dementia, says Ron Munger, PhD, a professor of nutrition at Utah State who also worked on the study.
“Over the years, researchers have tried to slow cognitive decline using single nutrients and supplements, with mixed results. [That’s because] the total diet is greater than the sum of its parts,” he tells WebMD.
Vegetables, Nuts, Whole Grains Help
The study involved 3,831 people 65 and older with no signs of dementia.
At the start of the study, they filled out a 142-item food questionnaire asking what they ate and how often they ate it. Based on their adherence to the components of the DASH diet, the participants were divided into five groups, or quintiles.
A standard test that measures overall cognitive function, including memory, attention span, and problem solving, was given at the outset and four other times over an 11-year period.
The researchers found that those in the highest quintile had the best cognitive functioning at the beginning of the study and the least decline in mental skills over time.
The best foods at curbing mental decline: vegetables, whole grains, low-fat dairy products, and nuts and legumes, Munger says.
The findings were presented at the Alzheimer’s Association 2009 International Conference on Alzheimer’s Disease.
Not Easy to Follow
The DASH diet isn’t easy to follow, he acknowledges. It calls for a total of eight to 10 servings of fruits and vegetables a day, for example, and “only about 25% of Americans eat even five servings a day,” Munger says.
“The good news is there’s lots of room for improvement,” he says.
Also, the study doesn’t prove that the diet slows mental decline. It could be the diet itself or some other lifestyle factor shared by people who eat well that is responsible for the protective effect.
On the other hand, DASH is proven safe and effective and lowers blood pressure, so there’s no reason not to follow it, Munger says.
Each day that you follow the eating plan “helps you to preserve a little bit of cognitive function that otherwise would have been lost,” says Maria Carrillo, PhD, director of medical and scientific relations at the Alzheimer’s Association.
“And it’s cumulative, so ultimately there’s a big difference,” she tells WebMD
Source: WebMD
Known as the Dietary Approaches to Stop Hypertension ( DASH) diet, the plan emphasizes fruits and vegetables, nuts and legumes, whole grains, and low-fat dairy products. Sodium, sweets, and red meats are to be consumed sparingly.
In a new study, the greater a person’s adherence to the DASH diet, the slower the rate of mental decline, reports Heidi Wengreen, PhD, RD, assistant professor of nutrition at Utah State University in Logan, and colleagues.
It’s not surprising that the diet worked: The DASH eating plan has been proven to lower blood pressure, and high blood pressure is a known risk factor for Alzheimer’s disease and dementia, says Ron Munger, PhD, a professor of nutrition at Utah State who also worked on the study.
“Over the years, researchers have tried to slow cognitive decline using single nutrients and supplements, with mixed results. [That’s because] the total diet is greater than the sum of its parts,” he tells WebMD.
Vegetables, Nuts, Whole Grains Help
The study involved 3,831 people 65 and older with no signs of dementia.
At the start of the study, they filled out a 142-item food questionnaire asking what they ate and how often they ate it. Based on their adherence to the components of the DASH diet, the participants were divided into five groups, or quintiles.
A standard test that measures overall cognitive function, including memory, attention span, and problem solving, was given at the outset and four other times over an 11-year period.
The researchers found that those in the highest quintile had the best cognitive functioning at the beginning of the study and the least decline in mental skills over time.
The best foods at curbing mental decline: vegetables, whole grains, low-fat dairy products, and nuts and legumes, Munger says.
The findings were presented at the Alzheimer’s Association 2009 International Conference on Alzheimer’s Disease.
Not Easy to Follow
The DASH diet isn’t easy to follow, he acknowledges. It calls for a total of eight to 10 servings of fruits and vegetables a day, for example, and “only about 25% of Americans eat even five servings a day,” Munger says.
“The good news is there’s lots of room for improvement,” he says.
Also, the study doesn’t prove that the diet slows mental decline. It could be the diet itself or some other lifestyle factor shared by people who eat well that is responsible for the protective effect.
On the other hand, DASH is proven safe and effective and lowers blood pressure, so there’s no reason not to follow it, Munger says.
Each day that you follow the eating plan “helps you to preserve a little bit of cognitive function that otherwise would have been lost,” says Maria Carrillo, PhD, director of medical and scientific relations at the Alzheimer’s Association.
“And it’s cumulative, so ultimately there’s a big difference,” she tells WebMD
Source: WebMD
Thursday, June 25, 2009
Thursday, June 18, 2009
Thursday, June 11, 2009
Wednesday, June 10, 2009
Sunday, June 7, 2009
Thursday, June 4, 2009
Sunday, January 4, 2009
Hypertension: Factors that can be changed
Overweight (obesity): Obesity is defined as having a body mass index (BMI) greater than 30 kg/m2. It is very closely related to high blood pressure. Medical professionals strongly recommend that all obese people with high blood pressure lose weight until they are within 15% of their healthy body weight.
Sodium (salt) sensitivity: Some people have high sensitivity to sodium (salt), and their blood pressure goes up if they use salt. Reducing sodium intake tends to lower their blood pressure. Americans consume 10–15 times more sodium than they need. Fast foods and processed foods contain particularly high amounts of sodium. Many over–the–counter medicines, such as painkillers, also contain large amounts of sodium.
Alcohol use: Drinking more than one to two drinks of alcohol per day tends to raise blood pressure in those who are sensitive to alcohol.
Birth control pills (oral contraceptive use): Some women who take birth control pills develop high blood pressure.
Lack of exercise (physical inactivity): A sedentary lifestyle contributes to the development of obesity and high blood pressure.
Drugs: Certain drugs, such as amphetamines (stimulants), diet pills, and some pills used for cold and allergy symptoms, tend to raise blood pressure.
Sodium (salt) sensitivity: Some people have high sensitivity to sodium (salt), and their blood pressure goes up if they use salt. Reducing sodium intake tends to lower their blood pressure. Americans consume 10–15 times more sodium than they need. Fast foods and processed foods contain particularly high amounts of sodium. Many over–the–counter medicines, such as painkillers, also contain large amounts of sodium.
Alcohol use: Drinking more than one to two drinks of alcohol per day tends to raise blood pressure in those who are sensitive to alcohol.
Birth control pills (oral contraceptive use): Some women who take birth control pills develop high blood pressure.
Lack of exercise (physical inactivity): A sedentary lifestyle contributes to the development of obesity and high blood pressure.
Drugs: Certain drugs, such as amphetamines (stimulants), diet pills, and some pills used for cold and allergy symptoms, tend to raise blood pressure.
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