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In a blood pressure screening program involving 6589 high school students, 180 male (4.7%) and 17 female (0.6%) students were identified as borderline hypertensive. The 174 hypertensive male adolescents studied further showed pathophysiological features such as a significantly higher frequency of obesity, higher 24-hour urinary sodium excretion, higher hematocrit value, higher sodium and lower potassium concentration in red blood cells, and higher ouabain-sensitive sodium efflux compared with the control group (231 male students; p less than 0.05). When used alone, the ordinary 10-week period of counseling about a low salt diet failed to significantly reduce the blood pressure of hypertensive students. However, when education and counseling efforts were combined with self-monitoring of salt (chloride) excretion in overnight urine samples using a new salt titrator tape developed in our laboratory, 24-hour urinary sodium excretion, weight, and blood pressure decreased significantly over 10 weeks (mean reduction: 52 mEq/day for 24-hour urinary sodium excretion, 1.7 kg for weight, 12/7 mm Hg for blood pressure). These results indicate that blood pressure of borderline hypertensive adolescents could be effectively reduced with this nonpharmacological method of dietary education. Such systematic management might be of importance for the prevention of essential hypertension.

Management of hypertension in high school students by using new salt titrator tape.