EFFECT OF DIETARY COUNSELING ON BLOOD-PRESSURE AND ARTERIAL PLASMA-CATECHOLAMINES IN PRIMARY HYPERTENSION

There is still a need of support for nonpharmacologic treatment of unc omplicated, mild-to-moderate essential hypertension. We investigated w hether a low sodium-based diet implemented by a nutritionist could low er blood pressure and affect sympathetic activity. Middle-aged, otherw ise healthy men with never-treated essential hypertension (n = 95) wer e randomized to an intervention group, a blood pressure control group, and a time control group. The intervention group was advised to use l ess sodium chloride in their diet, and if necessary, less saturated fa t and decrease body weight. They attended regular clinic visits as did the blood pressure control group. After 1 year, the intervention grou p had achieved on average 72 mmol/24 h lower urinary sodium excretion (P <.001) and a decrease in body weight of 2.7 +/- 0.5 kg (P <.001). B oth supine and standing mean blood pressure were on average 8 to 10 mm Hg lower after intervention compared with the two control groups (P < .001). Arterial plasma epinephrine, measured in all 40-year-old subjec ts (n = 30), decreased in parallel in all three groups (P <.05), indic ating some habituation to the invasive procedure and clinic visits. Ho wever, the decrease in norepinephrine was significant (P <.001) only i n the intervention group; it correlated with the weight loss (r = 0.76 , P <.05) and was significantly higher (P <.05) than in both control g roups. These results suggest that broad dietary advice (ie, low intake of sodium chloride, saturated fat and energy), implemented by a nutri tionist, may have a significant blood pressure lowering effect and a f avorable sympathicolytic effect in uncomplicated, mild-to-moderate ess ential hypertension.