EFFECT OF COUNSELING OF SALT RESTRICTION IN HYPERTENSIVE PATIENTS

Main Article Content

Dr. Javeria Wazir
Dr. Wahaj ul Hassan Khan
Dr. Maryam Hussain
Dr. Jamshed Khan
Dr. Muhammad Yaseen
Dr. Muhammad Mehroon Razzaq

Keywords

Hypertension, Salt Restriction, Sodium Reduction

Abstract

ABSTRACT


Background: Hypertension presents a significant health challenge globally. Dietary modifications, particularly salt restriction, have emerged as crucial, non-pharmacological strategy to manage hypertension. Prior studies have demonstrated the efficacy of salt restriction in reducing blood pressure and cardiovascular risk.


Objective: To evaluate the impact of dietary salt restriction counseling on blood pressure management, focusing on individuals with elevated blood pressure, without relying on drugs.


Methods: This study was conducted at a tertiary care hospital in Peshawar, Pakistan, targeting individuals aged 30 and above with blood pressure upto140/90. Excluding those with secondary hypertension or complications, the study employed personalized counseling sessions to limit salt intake to 2.5 gm per day (1/2 Teaspoon salt), monitoring participants over 3 and 6 months. The sample size was 288, determined by a 95% confidence level and a 5% margin of error, considering the local prevalence of hypertension.


Results: The cohort included 158 males (54.9%) and 130 females (45.1%), with mean weight of 75.5 kg (SD = 15.2) and initial systolic and diastolic blood pressures of 138.7 (SD = 1.5) and 88.4 (SD = 1.1) mmHg, respectively. After 6 months, significant reductions in systolic (127.9 ± 2.0 mmHg) and diastolic (82.9 ± 1.3 mmHg) blood pressures were observed, indicating effective control through dietary salt restriction.


Conclusion: Dietary counseling on salt restriction significantly lowers blood pressure in hypertensive patients, offering a non-pharmacological approach to managing hypertension. This strategy can substantially contribute to reduction of cardiovascular risks associated with hypertension.

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References

1. Yu J, Thout SR, Li Q, Tian M, Marklund M, Arnott C, et al. Effects of a reduced-sodium added-potassium salt substitute on blood pressure in rural Indian hypertensive patients: a randomized, double-blind, controlled trial. The American Journal of Clinical Nutrition. 2021;114(1):185-93.
2. D'Elia L, La Fata E, Giaquinto A, Strazzullo P, Galletti F. Effect of dietary salt restriction on central blood pressure: A systematic review and meta‐analysis of the intervention studies. The Journal of Clinical Hypertension. 2020;22(5):814-25.
3. Bovée DM, Visser WJ, Middel I, De Mik–van Egmond A, Greupink R, Masereeuw R, et al. A randomized trial of distal diuretics versus dietary sodium restriction for hypertension in chronic kidney disease. Journal of the American Society of Nephrology. 2020;31(3):650-62.
4. Zhang Z, Zhou X, Mei Y, Bu X, Tang J, Gong T, et al. Novel low-sodium salt formulations combined with Chinese modified DASH diet for reducing blood pressure in patients with hypertension and type 2 diabetes: a clinical trial. Frontiers in Nutrition. 2023;10.
5. Ayşe A. Effects of salt restriction counseling on primary hypertension patients already receiving pharmacotherapy; A Randomized controlled trial. Turkish Journal of Family Medicine and Primary Care. 2019;13(4):514-22.
6. Nakajima T, Murata M, Nitta S, Shitara T, Kazama H, Satoh Y, et al. Sodium restriction counseling reduces cardiac events in patients with heart failure. Circulation Journal. 2021;85(9):1555-62.
7. Ratchford SM, Broxterman RM, La Salle DT, Kwon OS, Park S-Y, Hopkins PN, et al. Salt restriction lowers blood pressure at rest and during exercise without altering peripheral hemodynamics in hypertensive individuals. American Journal of Physiology-Heart and Circulatory Physiology. 2019;317(6):H1194-H202.
8. Iuchi H, Sakamoto M, Suzuki H, Kayama Y, Ohashi K, Hayashi T, et al. Effect of one-week salt restriction on blood pressure variability in hypertensive patients with type 2 diabetes. PLoS One. 2016;11(1):e0144921.
9. Cicero AF, Veronesi M, Fogacci F. Dietary intervention to improve blood pressure control: beyond salt restriction. High Blood Pressure & Cardiovascular Prevention. 2021;28(6):547-53.
10. Bernabe-Ortiz A, Sal y Rosas VG, Ponce-Lucero V, Cárdenas MK, Carrillo-Larco RM, Diez-Canseco F, et al. Effect of salt substitution on community-wide blood pressure and hypertension incidence. Nature medicine. 2020;26(3):374-8.
11. Liu S, Tanaka R, Barr S, Nolan RP. Effects of self-guided e-counseling on health behaviors and blood pressure: Results of a randomized trial. Patient education and counseling. 2020;103(3):635-41.
12. Humalda JK, Klaassen G, de Vries H, Meuleman Y, Verschuur LC, Straathof EJ, et al. A self-management approach for dietary sodium restriction in patients with CKD: a randomized controlled trial. American Journal of Kidney Diseases. 2020;75(6):847-56.
13. Huang L, Trieu K, Yoshimura S, Neal B, Woodward M, Campbell NR, et al. Effect of dose and duration of reduction in dietary sodium on blood pressure levels: systematic review and meta-analysis of randomised trials. bmj. 2020;368.
14. Fu J, Liu Y, Zhang L, Zhou L, Li D, Quan H, et al. Nonpharmacologic interventions for reducing blood pressure in adults with prehypertension to established hypertension. Journal of the American Heart Association. 2020;9(19):e016804.
15. Islamabad I. Hypertension in Pakistan 2023 [Available from: https://www.incpak.com/health/hypertension-in-pakistan/.
16. Schneider H, Sarkis A-L, Sturm L, Britz V, Lechner A, Potzel AL, et al. SALT RESTRICTION COMBINED WITH RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM BLOCKADE IS A POTENT ANTIHYPERTENSIVE STRATEGY IN PATIENTS WITH PRIMARY ALDOSTERONISM. Journal of Hypertension. 2023;41(Suppl 3):e38.
17. Nolan P, McEvoy JW. Salt restriction for treatment of hypertension–current state and future directions. Current Opinion in Cardiology. 2024;39(1):61-7.
18. Hogas M, Statescu C, Padurariu M, Ciobica A, Bilha SC, Haisan A, et al. Salt, not always a cardiovascular enemy? A mini-review and modern perspective. Medicina. 2022;58(9):1175.
19. Aliasgharzadeh S, Tabrizi JS, Nikniaz L, Ebrahimi-Mameghani M, Lotfi Yagin N. Effect of salt reduction interventions in lowering blood pressure: A comprehensive systematic review and meta-analysis of controlled clinical trials. Plos one. 2022;17(12):e0277929.
20. Chen D, Tang J, Gong T, Mu L, Li J, Yu P, et al. Short-term effects of modest salt reduction combined with DASH diet on changing salt eating habits in hypertensive patients with type II diabetes. Clinical and Experimental Hypertension. 2022;44(6):514-22.

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