Summary
A moderate restriction of salt intake is recommended as a nonpharmacological approach to reducing high blood pressure, and can be used as an adjuvant to antihypertensive drug treatment. Noncompliance with a salt-restricted diet is the main limitation to this therapeutic approach. Evidence to date has shown that hypertensive patients treated with a calcium antagonist may not require a salt-restricted diet to achieve target blood pressure reductions. Further long term studies are required to confirm this.
Similar content being viewed by others
References
Beard TC, Cooke HM, Gray WR, Barge R. Randomized controlled trial of a no-added-sodium diet for mild hypertension Lancet 2: 455–458, 1982
Blaustein MP. Sodium ions, calcium ions, blood pressure regulation and hypertension: a reassessment and a hypothesis. American Journal of Physiology 232: C165–C173, 1977
Cappuccio FP, Markandu ND, MacGregor GA. Calcium antagonists and sodium balance: effect of changes in sodium intake and the addition of a thiazide diuretic on the blood pressure lowering effect of nifedipine. Journal of Cardiovascular Pharmacology 10(Suppl. 10): S57–S60, 1987
Cappuccio FP, Markandu ND, Sagnella GA, Singer DRJ, Miller MA, et al. Acute and sustained changes in sodium balance during nifedipine treatment in essential hypertension. American Journal of Medicine 91: 233–238, 1991
Carney SL, Gillies AH, Smith AJ, Smitham S. Increased dietary sodium chloride in patients treated with antihypertensive drugs. Clinical and Experimental Hypertension A 13: 401–407, 1991
Carney SL, Gillies AH, Smith AJ, Waga S. Effect of dietary sodium restriction on patients receiving antihypertensive medications. Clinical and Experimental Hypertension 6: 1095–1105, 1984
Cutler JA, Follmann D, Elliot P, Suh I. An overview of randomized trials of sodium reduction and blood pressure. Hypertension 17(Suppl. I): I–127–I–133, 1991
De Wardener HE, MacGregor GA, Clarkson EM, Alaghband-Zadeh J, Bitensky L, et al. Effect of sodium intake on ability of human plasma to inhibit renal Na+-K+-adenosine triphosphatase in vitro. Lancet 1: 411–412, 1981
Elmer P, Grimm Jr RH, Flack J, Laing B. Dietary sodium reduction for hypertension prevention and treatment. Hypertension 17(Suppl. 1): 1182–1189, 1991
Galletti F, Strazullo P, Cappuccio FP, Barba G, Giorgone M, et al. Calcium channel blockers and sodium intake: a controlled study in patients with essential hypertension. Journal of Cardiovascular Drugs and Therapy 3: 135–140, 1989
Garthoff B, Bellemann P. Effects of salt loading and nitrendipine on dihydropyridine receptors in hypertensive rats. Journal of Cardiovascular Pharmacology 10(Suppl. 10): S36–S38, 1987
Grimm Jr RH, Neaton JD, Elmer PJ, Svendsen KH, Levin J, et al. The influence of oral potassium chloride on blood pressure in hypertensive men on a low-sodium diet. New England Journal of Medicine 322: 569–574, 1990
Intersalt Cooperative Research Group. Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. British Medical Journal 297: 319–328, 1988
Joint National Committee. The 1988 report of the Joint National Committee on detection, evaluation and treatment of high blood pressure. Archives of Internal Medicine 148: 1023–1038, 1988
Law MR, Frost CD, Wald NJ. By how much does dietary salt reduction lower blood pressure? III. Analysis of data from trials of salt reduction. British Medical Journal 302: 819–824, 1991
Luque-Otero M, Fernandez Pinilla C, Catalan P, Nartell-Claros N, Fernandez-Cruz A, et al. Acute antihypertensive effect of nifedipine on high and low salt diet. Journal of Cardiovascular Pharmacology 10(Suppl. 10): S142–S148, 1987
Morgan T. Interaction of pharmacological and nonpharmacological therapy. Hypertension 17: 804–805, 1991
Morgan T, Anderson A, Wilson D, Myers J, Murphy J, et al. Paradoxical effect of sodium restriction on blood pressure in people on slow-channel calcium blocking drugs. Correspondence. Lancet 1: 793, 1986
Nicholson JP, Resnick LM, Laragh JH. The antihypertensive effect of verapamil at extremes of dietary sodium intake. Annals of Internal Medicine 107: 329–334, 1987
Rissanen A, Pietinen P, Siljamaki-Ojansuu U, Piirainen H, Reissel P. Treatment of hypertension in obese patients: efficacy and feasibility of weight and salt reduction programs. Acta Medica Scandinavica 218: 149–156, 1985
Ritz E, Schmid M, Ji-Zhen G, Mann J. Salt and the action of calcium antagonist. Journal of Cardiovascular Pharmacology 12(Suppl. 6): S53–S56, 1987
Salvetti A. The antihypertensive effect of nitrendipine and its interaction with sodium intake: a multicentric cross-over trial Proceedings 4th European Meeting in Hypertension, Milan, 1991
Waal-Manning HJ, Paulin JM. Sodium supplements, blood pressure, and calcium channel blocking drugs. Correspondence. Lancet 1: 1370, 1987
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Redon, J. Is Salt Restriction Necessary in Hypertensive Patients Treated with Calcium Antagonists?. Drugs 44 (Suppl 1), 61–65 (1992). https://doi.org/10.2165/00003495-199200441-00011
Published:
Issue Date:
DOI: https://doi.org/10.2165/00003495-199200441-00011