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Metabolic effects of strict salt restriction in essential hypertensive patients
Author(s) -
RÍO A.,
RODRÍGUEZVILLAMIL J. L.
Publication year - 1993
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1993.tb00692.x
Subject(s) - medicine , blood pressure , plasma renin activity , endocrinology , renal function , creatinine , cholesterol , uric acid , microalbuminuria , essential hypertension , ambulatory blood pressure , renin–angiotensin system
. Objetive . Some observations suggest that a strict low‐salt diet may induce unfavourable metabolic side‐effects. The main aim of this study was to analyse the possible consequences of severe salt restriction in mildly hypertensive patients. Design . The study was carried out through a randomized double‐blind protocol. Subjects . Forty‐seven ambulatory patients proceeding from the hypertension unit were initially admitted: 17 were lost, and 30 non‐diabetic mildly hypertensives (DBF 90–104 mmHg) with normal renal function completed the protocol. Intervention . After a wash‐out period, patients were maintained on a low‐salt intake (2.8 ± 1.0 g day −1 of NaCl) and placebo for 2 weeks, and the same diet and salt supplements (11.7± 2.5 g day −1 of NaCl) for another 2 weeks, separated by a second wash‐out period. Measures . At the end of each dietary period, blood pressure (BP) and body weight were measured, and a blood sample was taken for determination of routine serum chemistries, plasma lipid and apolipoprotein concentrations, immunoreactive insulin (IRI), and plasma renin activity (PRA). Urinary 24 h excretion of sodium and potassium were measured. Results . During the salt restriction period BP did not change, weight lowered, and PRA raised. There was a significant increase in serum level of creatinine, uric acid, JRI, total cholesterol and apo B, and a decrease in HDL cholesterol and apo A‐I. Conclusion . As previously suggested, these observations seem to indicate that strict salt restriction may cause, at least in the short‐term, adverse metabolic changes in hypertensive patients.