Importance of Weight Loss and Sodium Restriction in the Treatment of Mild and Moderate Essential Hypertension

The effectiveness of non pharmacological treatment of chronic arterial hypertension has been evaluated in 116 treated or not primary hypertensive out-patients. Those receiving diuretics were however excluded. This population was requested to follow for 3 months a modification of their usual diet characterized by salt restriction combined with energy intake restriction when the patients were above their ideal body weight. Only 62 patients (53%) completed the study. However, this approach was effective by decreasing blood pressure and total cholesterol. The weight loss appears the most effective way to decrease blood pressure in untreated patients, but needs 3 months to be significant. In drug-treated patients, the sodium restriction significantly influences the blood pressure level, already after 1 month. However, salt sensitivity has been noted, especially in the most severe forms of the hypertensive disease. The combination of both modifications (weight loss and sodium restriction) does not appear to be more effective than each separate dietary measure.