Middle aged men with high blood pressure don’t get treatment started in time said a recent study, while another said that by adopting a low salt diet, high blood pressure could be controlled. The first study, on timely treatment of high blood pressure, was conducted by Dr. Joseph Ravenell, who did the study at the University of Texas Southwestern Medical Center at Dallas; he is now an assistant professor of medicine at New York University.
The study findings were presented Friday at the American Heart Association's Council for High Blood Pressure Research annual meeting, in Atlanta and were based on 891 black men in Dallas County, most of them being treated by primary-care physicians. 22 community doctors were also interviewed and only 36 % of them said they would start treatment for a 45-year-old black man with an office blood pressure of 145/92 and an out-of-office pressure of 154/95, both well above the recommended 120/80 level. None of the 22 doctors were familiar with the national guidelines calling for treatment of blood pressure at such levels.
Ravenell said the results though surprising were in tune with other earlier results which said that the guidelines aren't adhered to by physicians nearly as well as the guideline creators would like them to be. As all the men in the study were black Ravenell is not sure if the results would have been any different if they were white, though evidence does suggest that often blacks suffer more from poor guideline adherence by physicians.
As black men were at a high risk of death from hypertension, Ravenell felt physicians ought to be particularly careful handling them and should ensure that they are appropriately applying the guidelines to all patients.
Dr. Daniel Jones, vice chancellor for health affairs at the University of Mississippi, and a past president of the American Heart Association said that people who are seen by doctors need to be aware of the guidelines. They should know their blood pressure readings and initiate a discussion with the doctor if the reading point to high blood pressure. Jones said patients can influence doctors' choices by initiating discussions. He further added that national health surveys have shown that Americans are clued in about the dangers of high blood pressure and it being a major risk factor for heart attacks as well as strokes and that drug therapy can control the problem.
Another study conducted on high blood pressure was presented at the American Heart Association's 62nd Annual Fall Conference of the Council for High Blood Pressure Research in Atlanta. Dr. Eduardo Pimenta from the Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil, told Reuters Health that regulating your salt intake could help control high blood pressure that was not getting controlled despite medication.
"A high-salt diet contributes importantly to treatment-resistant hypertension (high blood pressure)," said Dr. Pimenta. The study measured the impact of a low salt diet on 13 adults with treatment-resistant hypertension who wore a 24 hour blood pressure reader continuously for 24 hours. Low- and high-salt diets were tested for seven days separated by a two-week "washout" period, after which the subjects switched groups.
Pimenta and colleagues found that the amount of sodium excreted in the urine over a 24 hour time span reduced drastically when they were on a low salt diet as compared to readings from the high salt diet. They also found that the systolic blood pressure -- the top number in blood pressure readings that represent pressure while the heart contracts reduced by 22.6 mmHg and the diastolic blood pressure - the bottom number that gives the pressure when the heart relaxes between beats - was lower by 9.2 mmHg while on a low salt diet.
"We were expecting blood pressure reduction with low-salt diet but the reduction was larger than we expected," Pimenta said. He added that a high salt diet can impair blood vessel function and cause water retention "despite diuretic therapy," while healthy reductions in fluid volumes were seen during the low salt diet.
All in all the team concluded that a high salt diet causes a lot of harm to people with stubborn hypertension and the simple solution of lowering their salt intake could reduce many health problems related to high blood pressure.