Document Detail

Double-blind randomised trial of modest salt restriction in older people.
MedLine Citation:
PMID:  9310603     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Stroke is directly related to blood pressure and treatment trials in older hypertensive individuals show a reduction in strokes. However, the majority of strokes occur in normotensive individuals in whom no attempt is made to lower blood pressure. We compared the effects of modest salt restriction on blood pressure in older hypertensive and normotensive people. METHODS: 47 untreated elderly people (24 men, age range 60-78 years; blood-pressure range 123-205 mm Hg systolic and 64-112 mm Hg diastolic) completed a 2-month double-blind randomised placebo-controlled crossover study of modest salt restriction with slow sodium and placebo to give a salt intake of either 10 g (equivalent to the normal amount for the UK population) or 5 g. FINDINGS: On the normal salt intake for the UK population, supine blood pressure was 163/90 (SD 21/10) mm Hg with urinary sodium excretion of 177 (49) mmol/day. With modest sodium restriction, blood pressure fell to 156/87 (22/9) mm Hg (p < 0.001/0.004) with a urinary sodium excretion of 94 (50) mmol/day. A reduction in sodium intake of 83 mmol/day was associated with a reduction of 7.2/3.2 mm Hg. There was no significant difference in the blood-pressure fall between 18 normotensive and 29 hypertensive participants (8.2/3.9 vs 6.6/2.7 mm Hg). INTERPRETATION: A modest reduction in salt intake leads to a fall in blood pressure in both normotensive and hypertensive older people similar to that in outcome trials of thiazide-based treatment. Since the majority of strokes in older people occur below the current definition of hypertension, our results have important implications for the prevention of stroke.
F P Cappuccio; N D Markandu; C Carney; G A Sagnella; G A MacGregor
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lancet     Volume:  350     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-10-23     Completed Date:  1997-10-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  850-4     Citation Subset:  AIM; IM    
Department of Medicine, St George's Hospital Medical School, London, UK.
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MeSH Terms
Blood Pressure
Cerebrovascular Disorders / prevention & control*
Cross-Over Studies
Diet, Sodium-Restricted*
Double-Blind Method
Hypertension / diet therapy*,  prevention & control
Middle Aged
Sodium Chloride, Dietary / administration & dosage*
Reg. No./Substance:
0/Sodium Chloride, Dietary
Comment In:
Lancet. 1997 Sep 20;350(9081):825-6   [PMID:  9310596 ]
Lancet. 1997 Dec 6;350(9092):1702-3   [PMID:  9400533 ]
Lancet. 1997 Dec 6;350(9092):1702; author reply 1703   [PMID:  9400531 ]
Lancet. 1997 Dec 6;350(9092):1702; author reply 1703   [PMID:  9400532 ]

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