American Journal of Clinical Nutrition, Vol 1, 7-16, Copyright © 1952 by The American Society for Clinical Nutrition, Inc.

Dietary Treatment of HYPERTENSION

¹ From the Research Division of the Cleveland Clinic Foundation, and the Frank E. Bunts Educational Institute, Cleveland, Ohio

In spite of the belated application of scientific method to the study of low sodium dietotherapy in hypertension, it has now been shown that a minority of patients with established essential hypertension respond favorably to diets containing about 0.2 Gm. sodium in each day's intake. In such diets, protein intake may be sustained by use of sodium-poor milk powder or similar preparations, or it may be sacrificed as in the rice diet. The choice is determined by the needs and possibilities of the patient.

Psychological, social and economic, as well as functional factors powerfully influence the success or applicability of low sodium dietotherapy. Lacking other proven means of speedy selection, the "proof of the pudding is in the eating" of a low sodium diet for at least 6 weeks, during which time the adequacy of sodium restriction is ensured by frequent checks of urinary sodium output. The cation-exchange resins are not as yet adequate substitutes for rigid sodium restriction in the treatment of hypertension.

The combination of low sodium dietotherapy with other modes of treatment is generally deprecated unless it can be shown that the combined treatments have advantageously additive or synergistic effects. To date, the most definitely advantageous combination is the special case of combined hexamethonium, low sodium dietotherapy.