Abstract P330: Customization of Low-sodium Diet and Its Efficacy

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2017-09, Vol.70 (suppl_1)
• Main Authors: Kidambi, Srividya, Moosreiner, Andrea, Rubens, Merrill, Obi, Brittaney, Widlansky, Michael, Tyagi, Sudhi, Puppala, Venkata, Beyer, Andreas, Cowley, Allen, Mattson, David, Kotchen, Theodore, Liang, Mingyu
• Format: Article
• Language: English
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/hyp.70.suppl_1.p330

Abstract only Introduction: Lack of adherence with a low-sodium (Na) diet remains a challenge for many patients. Most research studies use standardized diets for subjects which may decrease adherence and hence result in sub-optimal lowering of blood pressure (BP). We hypothesized that adoption of a customized low-Na diet will result in high rates of adherence, lower BP, and improve vascular function. Methods: Post-menopausal women (50-65 years) and men (30-65 years) with baseline BP ≥ 130/80 mm Hg or history of HTN were recruited. Subjects were placed on a 2-week 1200mg Na/day diet (after a 3-day run-in period during which subjects were given 2400 mg of Na/day in addition to their regular diet). Subjects were off all BP medications 1 week prior to the start of the diet and during 2 weeks of study diet. All food was prepared by a bio-nutritionist with a customized menu according to food logs kept by the subjects. Two 24h urine Na measurements were taken to ensure compliance with the diet. In addition to BPs, conduit (brachial artery flow-mediated dilation (FMD)) and micro (~ 200 μm extracted from gluteal adipose tissue biopsies) vessel functions were evaluated before and after the diet period to assess in vivo and in vitro vascular function respectively. Results: Seventeen subjects (9 African-American, 7 Caucasian, and 1 Hispanic) with mean BPs of 145 ± 14/87 ± 6 mm Hg (± SD) before starting the low-Na diet were recruited. During the diet period, subjects consumed an average of 1000 mg of Na/day (66% reduction from baseline Na intake). Excluding 2 subjects in whom the 24h urine Na did not drop (instead increased) after 2-weeks indicating non-adherence, the average SBP/DBP reductions were -11 ± 14 (-7%, p=0.06)/-8 ± 10 mm Hg (-9%, p=0.04). Average urine Na levels were 230 ± 83 (before) and 71 ± 82 (after) mmol/24hr. Brachial artery FMD improved from 7.3 ± 3.2 to 9.6 ± 2.3 % (p=0.04) after 2 weeks. Maximal Arteriolar FMD (endothelial dependent) trended toward an increase from 54 ± 18 to 77 ± 13 % and smooth muscle dependent dilation to papaverine was not effected. Conclusions: The adoption of a customized low-Na diet can result in high rates of dietary adherence (88% in the current study) and lower BPs. In addition, vascular function improves within 2 weeks on a low-Na diet.