4.SODIUM MAGNESIUM AND POTASSIUM INTAKE
There is strong and consistent evidence that reducing sodium intake reduces BP. Adults should be advised to limit their sodium intake to no more than 2,400 mg per day (equivalent to around 5 gm/1 teaspoon of table salt per day). Further reduction of sodium intake to 1,500 mg per day is desirable because it is associated with an even greater reduction in BP. The average BP reduction in patients consuming a sodium‐restricted diet of 2,400 mg per day is 2/1 mm Hg, or 7/3 mm Hg for those restricting sodium to 1,500 mg per day. 33 Reducing baseline sodium intake by at least 1,000 mg per day will lower BP even if the desired daily sodium intake is not yet achieved. Food prepared out of home, canned foods, and prepackaged foods (dry or frozen) tend to contain more sodium than home‐cooked meals or frozen vegetables, so it is best to be avoided. Recent analysis of 15 randomized control trials (RCTs) for potassium supplementation (75‐125 mmol per day) in 917 normotensive and hypertensive patients independent to antihypertensive drugs had a reduction in SBP by 4.7 mmHg and in DBP values by 3.5 mmHg in all patients, an effect that was stronger in hypertensive by 6.8 and 4.6 mmHg for SBP and DBP values, respectively. 34 An analysis of 34 trials involving 2028 normotensive and hypertensive patients showed a positive effect of magnesium supplementation (368 mg/d) for three months, in lowering SBP by 2.0 mmHg and DBP values by 1.78 mmHg. We need more studies to clarify the role of potassium and magnesium supplementation in the management of hypertension. (Table 1)
TABLE 1.
Summarizing the main points/message of the review
1. A reduction of just 5 mm of Hg systolic blood pressure has been found to be associated with mortality reductions of 14% from stroke, 9% from heart disease, and 7% from all‐cause mortality
2. Dietary pattern is a very important part of non‐pharmacologic management of blood pressure as it is influenced by appropriate calorie requirements, personal, cultural food preferences, and nutritional therapy for other medical conditions, such as diabetes mellitus and chronic kidney disease.
3. Both the Mediterranean Diet and the Dietary Approaches to Stop Hypertension diet are relatively easy to adhere to and are palatable, high in fruit, vegetables, whole grains, nuts, and unsaturated oils; moreover, both minimize the consumption of red and processed meat, and are in accordance with dietary recommendations for cardiovascular health.
4. Cardioprotective effects of the alternate‐day fasting diet are associated with a reduction of visceral fat tissue, increased adiponectin, decreased leptin, and low‐density lipoproteins cholesterol. A method of intermittent fasting, like alternate‐day fasting or time restricted meal intake could be adopted by the patient.
5. Adults should be advised to limit their sodium intake to no more than 2,400 mg per day (equivalent to around 5 gm/1 teaspoon of table salt per day).
6. Food prepared out of home, canned foods, and prepackaged foods (dry or frozen) tend to contain more sodium than home‐cooked meals or frozen vegetables, so a hypertensive patient should consciously restrict the intake of such foods.
7. Regular exercise, stopping the use of tobacco, decreased alcohol intake or substitution by non‐alcoholic beverages are helpful in controlling blood pressure.
8. Practising yoga, transcendental meditation, acupuncture, mindfulness‐based stress‐reduction program (MBSRP), Tai chi / taiji / tai chi chuan (origin: China) which combines movement, deep breathing could help in alleviating stress.
9. Home monitoring of blood pressure is highly recommended
10. Quality nutrition, physical activity of few times per week, attaining normal body weight, cessation of alcohol and tobacco, reduction in sodium intake & increasing calcium, magnesium & potassium, stress management and supplementation of certain ingredients may prove beneficial.
Ref
J Clin Hypertens (Greenwich). 2021 Mar 18;23(7):1275–1283. doi: 10.1111/jch.14236SODIUM MAGNESIUM AND POTASSIUM INTAKE
Non‐pharmacological management of
hypertension
Narsingh Verma 1,✉, Smriti Rastogi 1, Yook‐Chin Chia 2, Saulat Siddique 3, Yuda Turana 4, Hao‐min Cheng 5, Guru Prasad Sogunuru 6, Jam Chin Tay 7, Boon Wee Teo 8, Tzung‐Dau Wang 9, Kelvin Kam Fai TSOI
10, Kazuomi Kario 11
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