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Influence of dietary modifications on the blood pressure response to antihypertensive medication

  • Catherine E. Huggins (a1), Claire Margerison (a1), Anthony Worsley (a2) and Caryl A. Nowson (a1)
  • DOI:
  • Published online: 01 September 2010

Identifying dietary modifications that potentiate the blood pressure (BP)-lowering effects of antihypertensive medications and that are practical for free-living people may assist in achieving BP reduction goals. We assessed whether two dietary patterns were effective in lowering BP in persons on antihypertensive therapy and in those not on therapy. Ninety-four participants (38/56 females/males), aged 55·6 (sd 9·9) years, consumed two 4-week dietary regimens in random order (Dietary Approaches to Stop Hypertension (DASH)-type diet and low-Na high-K (LNAHK) diet) with a control diet before each phase. Seated home BP was measured daily for the last 2 weeks in each phase. Participants were grouped based on antihypertensive drug therapy. The LNAHK diet produced a greater fall in systolic BP (SBP) in those on antihypertensive therapy ( − 6·2 (sd 6·0) mmHg) than in those not on antihypertensive therapy ( − 2·8 (sd 4·0) mmHg) (P = 0·036), and this was greatest for those on renin–angiotensin system (RAS) blocker therapy ( − 9·5 (sd 6·4) mmHg) (interaction P = 0·007). The fall in SBP on the DASH-type diet, in those on therapy (overall − 1·1 (sd 6·2) mmHg; renin–angiotensin blocker therapy − 4·2 (sd 4·7) mmHg), was not as marked as that observed on the LNAHK diet. Dietary modifications are an important part of all hypertension management regimens, and a low-Na and high-K diet enhances the BP-lowering effect of antihypertensive medications, particularly those targeting the RAS.

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*Corresponding author: Professor, C. A. Nowson, fax +61 3 9244 6017, email
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2AV Chobanian , GL Bakris , HR Black , (2003) Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 42, 12061252.

3R Vasan , M Larson , E Leip , (2001) Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med 345, 12911297.

4FJ He & GA Macgregor (2008) A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. J Hum Hypertens 23, 363384.

5GA MacGregor , ND Markandu , DR Singer , (1987) Moderate sodium restriction with angiotensin converting enzyme inhibitor in essential hypertension: a double blind study. Br Med J (Clin Res Ed) 294, 531534.

7G Navis , PE de Jong , AJ Donker , (1987) Moderate sodium restriction in hypertensive subjects: renal effects of ACE-inhibition. Kidney Int 31, 815819.

8SG Chrysant , AB Weder , DA McCarron , (2000) Effects of isradipine or enalapril on blood pressure in salt-sensitive hypertensives during low and high dietary salt intake. MIST II Trial Investigators. Am J Hypertens 13, 11801188.

9A Anderson & T Morgan (1990) Interaction of enalapril with sodium restriction, diuretics, and slow-channel calcium-blocking drugs. Nephron 55, Suppl. 1, 7072.

10MR Weir , DH Smith , JM Neutel , (2001) Valsartan alone or with a diuretic or ACE inhibitor as treatment for African American hypertensives: relation to salt intake. Am J Hypertens 14, 665671.

11T Morgan , A Anderson , D Wilson , (1987) The effect of perindopril on blood pressure in humans on different sodium intakes. J Cardiovasc Pharmacol 10, Suppl. 7, S116S118.

13GA MacGregor , JB Pevahouse , FP Cappuccio , (1987) Nifedipine, sodium intake, diuretics, and sodium balance. Am J Nephrol 7, Suppl. 1, 4448.

14G Leonetti , L Rupoli , P Sangiorgio , (1987) Effects of different sodium intakes on the antihypertensive and renal effects of single oral doses of nifedipine in hypertensive patients. J Cardiovasc Pharmacol 10, Suppl. 10, S138S139.

15FP Cappuccio , ND Markandu , DR Singer , (1987) Does oral calcium supplementation lower high blood pressure? A double blind study. J Hypertens 5, 6771.

17T Morgan & A Anderson (1988) Interaction of slow-channel calcium blocking drugs with sodium restriction, diuretics and angiotensin converting enzyme inhibitors. J Hypertens Suppl 6, S652S654.

18G Kimura , F Deguchi , S Kojima , (1988) Antihypertensive drugs and sodium restriction. Analysis of their interaction based on pressure-natriuresis relationship. Am J Hypertens 1, 372379.

19CJ Owens & NC Brackett (1978) Role of sodium intake in the antihypertensive effect of propranolol. South Med J 71, 4346.

20A Siani , P Strazzullo , A Giacco , (1991) Increasing the dietary potassium intake reduces the need for antihypertensive medication. Ann Intern Med 115, 753759.

21LJ Appel , TJ Moore , E Obarzanek , (1997) A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 336, 11171124.

23NR Cook , E Obarzanek , JA Cutler , (2009) Joint effects of sodium and potassium intake on subsequent cardiovascular disease: the Trials of Hypertension Prevention follow-up study. Arch Intern Med 169, 3240.

24CA Nowson & TO Morgan (1988) Change in blood pressure in relation to change in nutrients effected by manipulation of dietary sodium and potassium. Clin Exp Pharmacol Physiol 15, 225242.

25P Elliott , J Stamler , R Nichols , (1996) Intersalt revisited: further analyses of 24 hour sodium excretion and blood pressure within and across populations. Intersalt Cooperative Research Group. BMJ 312, 12491253.

26PW Sanders (2009) Dietary salt intake, salt sensitivity, and cardiovascular health. Hypertension 53, 442445.

27M Franco , LG Sanchez-Lozada , R Bautista , (2008) Pathophysiology of salt-sensitive hypertension: a new scope of an old problem. Blood Purif 26, 4548.

29G Mule , G Caimi , S Cottone , (2002) Value of home blood pressures as predictor of target organ damage in mild arterial hypertension. J Cardiovasc Risk 9, 123129.

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British Journal of Nutrition
  • ISSN: 0007-1145
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