Cheung, BMY

Ho, GYY

Kumana, CR

Lau, CP

Law, CY

Ng, PPY

Hong Kong Medical Journal

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Title Randomised controlled trial of low salt diet in the treatment ofhypertensionAuthor(s) Cheung, BMY; Law, CY; Ho, GYY; Ng, PPY; Kumana, CR; Lau,CPCitationThe 8th Medical Research Conference Abstracts, Hong KongMedical Journal, Hong Kong, China, 25-26 January 2003, v. 9 n. 1Supp 1, p. 23Issued Date 2003URL http://hdl.handle.net/10722/46929Rights Creative Commons: Attribution 3.0 Hong Kong LicenseHKMJ Vol 9 No 1 February 2003 Supplement      23Prevalence of obesity in the Hong Kong Cardiovascular Risk Factor PrevalenceSurvey-2 (CRISPS2)BMY Cheung, YB Man, JLF Lo, DFY Chau, CY Law, KSL Lam, TH Lam,1 NMS Wat, SCF Tam,2 CH Cheng, CR Kumana,CP Lau. University Department of Medicine, Department of Community Medicine,1 The University of Hong Kong; ClinicalBiochemistry Unit,2 Queen Mary Hospital, Hong KongIntroduction: In 1995-6, 2881 randomly chosen Hong Kong men and women were studied in the Hong KongCardiovascular Risk Factor Prevalence Survey. In CRISPS2, those subjects are randomly recalled to assess theprevalence of cardiovascular risk factors. Here, we report the interim findings on obesity.Method: 813 subjects (393 men, 420 women; age 51±12 yrs) were studied. The medical history was obtained andthe subjects were examined with special attention to blood pressure and indices of obesity. Body mass index (BMI)was derived from the weight (kg) divided by height squared (m2). Each subject had an oral glucose tolerance test.Lipid measurements were performed on fasting blood samples.Results: 4.6% of men and 4.5% of women were obese (BMI ≥30). 41% men and 30% women were overweight(BMI≥25). Compared to six years ago, there were no significant changes in body weight and BMI, but the waistcircumference increased from 81.8±1.1 to 84.3±1.2 cm (p<0.001). In men, BMI was related to triglycerides(r=0.37, p<0.001), HDL-cholesterol (r=-0.42, p<0.001), diastolic blood pressure (r=0.31, p<0.001), fastingglucose (r=0.27, p<0.001) and fibrinogen (r=0.11, p=0.04). In women, the BMI also correlated with triglycerides(r=0.35, p<0.001), HDL-cholesterol (r=-0.38, p<0.001), diastolic blood pressure (r=0.34, p<0.001), fasting glucose(r=0.26, p<0.001) and fibrinogen (r=0.16, p=0.002). 126 (16%) and 214 (26%) subjects had diabetes and hypertensionrespectively. In the overweight or obese, the prevalence of diabetes and hypertension is increased to 28% and 40%in men and 25% and 41% in women respectively. BMI≥25 is associated with diabetes (OR 3.5 [2.3-5.1]) andhypertension (OR 3.0 [2.2-4.2]).Conclusions: The prevalence of obesity in the general population is low compared to western countries, but over-weight is common. Overweight is associated with cardiovascular risk factors, so appropriate weight control in thegeneral population seems warranted.Randomised controlled trial of low salt diet in the treatment of hypertensionBMY Cheung, CY Law, GYY Ho, PPY Ng, CR Kumana, CP Lau. University Department of Medicine, University ofHong Kong, Queen Mary Hospital, Hong Kong.Background: Non-pharmacological treatment is the preferred initial step in the management of mild hypertension.We compared its efficacy with drug treatment.Methods: 93 patients (M:F, 45:48; age 44 ± 11 yrs) with untreated mild essential hypertension were recruited.After a placebo run-in phase, 73 eligible patients were randomised to drug treatment (with hydrochlorothiazide 25 mgdaily [n=19] or metoprolol 100 mg daily [n=14]) or non-pharmacological treatment (lifestyle modificationincluding a low-fat, low-salt, high fibre diet, weight control, smoking cessation, moderating alcohol intake andregular exercise) for 6 months. Additional drugs were allowed after 12 weeks if the blood pressure was not controlled.Left ventricular mass index (LVMI) was determined by echocardiography.Results: In the non-pharmacological group, there was a significant decrease in sodium intake (56 ± 14 mmol/day)and body fat (1.7 ± 0.5%), but the decrease in body mass (1.4 ± 0.4Kg) was small.There was a significant decrease in ambulatory systolic and diastolic blood pressure in the drug treatment (16±2 mmHgand 10±2 mmHg) and diet group (10±2 mmHg and 6±1 mmHg). Change in sodium excretion correlated withdiastolic blood pressure (r=0.44, p=0.02) rather than systolic blood pressure (r=0.35, p=0.08).Conclusion: Non-pharmacological treatment reduces blood pressure slightly, but to a lesser extent than antihyper-tensive drugs. It can therefore be used in patients with very mild hypertension. In patients with more severehypertension, non-pharmacological treatment should be implemented in conjunction with antihypertensivemedications.N Diastolic pressure Systolic pressure LVMIbaseline final baseline final baseline finalnon-pharmacological 38 95 ± 1 89 ± 1 142 ± 2 135 ± 3 128 ± 5 119 ± 4pharmacological 35 96 ± 1 83 ± 2* 142 ± 2 122 ± 3* 130 ± 6 123 ± 5 * P < 0.05CVS-09CVS-10

Randomised controlled trial of low salt diet in the treatment of hypertension

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Randomised controlled trial of low salt diet in the treatment of hypertension

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