Summary
Fifty hypertensive Type 2 (non-insulin-dependent) diabetic patients were allocated, in a controlled trial, to a treatment diet of high fibre, low fat and low sodium composition, or to a control diet by the hospital dietitian. After 3 months treatment, the modified diet-treated group showed a highly significant reduction in mean systolic (180.5±19.0 to 165.0±20.7 mmHg) and diastolic blood pressure (96.6±9.3 to 88.0±10.5 mmHg), accompanied by significant reductions in urinary sodium excretion (183.0±62.1 to 121.7+ 65.8 mmol/day) glycosylated haemoglobin (12.4±3.1 to 10.5±2.9%), weight (74.6s±13.5 to 71.7±12.1 kg) and serum triglyceride levels (p<0.05). The mean values of diastolic pressure (p<0.01), urinary sodium/potassium ratio (p< 0.001), urinary potassium (p<0.01) was significantly reduced at 3 months compared to control. No changes in serum HDL-cholesterol levels were observed. The number of patients with normal blood pressure at 3 months was greater in the modified diet-treated group (ten versus five). Treatment of mild hypertension in diabetic subjects with this form of dietary regimen has a hypotensive response, with improvement in glycaemic control and no side effects. This modified diet may be an attractive alternative to anti-hypertensive drug therapy as a first line treatment.
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Christlieb AR, Warran JH, Krolewski AS, Busick EJ, Ganda OM, Asmal AC, Soeldner JS, Bradley RF (1981) Hypertension: the major risk factor in juvenile onset insulin dependent diabetics. Diabetes 30 (Suppl 2): 90–96
Barrett-Connor E, Criqui MH, Klauber MR, Holdbrook M (1981) Diabetes and hypertension in a community of older adults. Am J Epidemiol 113: 276–284
Pacy PJ, Dodson PM, Beevers M, Fletcher RF, Taylor KG (1983) The ethnic prevalence of hypertension in a diabetic clinic. Postgrad Med J 59: 56–59
Murphy MB, Lewis PJ, Kohner E, Schumer B, Dollery CT (1982) Glucose intolerance in hypertensive patients treated with diuretics; a fourteen year follow-up. Lancet 2: 1293–1295
Waal-Manning HJ (1976) Metabolic effects of beta-adrenoreceptor blockers. Drugs 11 (Suppl 1): 121–126
Gundersen T, Kjekshus J (1983) Timolol treatment after myocardial infarction in diabetic patients. Diabetes Care 6: 285–290
Dodson PM (1982) Lipids and antihypertensive therapy. Br J Clin Pract Suppl 20: 17–20
MacGregor GA, Markandu ND, Best FE, Elder DM, Cam DM, Sagnella GA, Squires M (1982) Double blind randomised crossover trial of moderate sodium restriction. Lancet 1: 351–354
Parijs J, Joossens JV, Van der Linden L, Verstreken G, Amery A (1973) Moderate sodium restriction and diuretics in the treatment of hypertension. Am Heart J 85: 22–34
Morgan T, Gillies A, Morgan G, Adam W, Wilson M, Carney S (1978) Hypertension treated by salt restriction. Lancet 1: 227–230
Puska P, Lancono J, Nissinen A, Korhonen H, Vartiainen E, Pietinen P, Dougherty R, Leino V, Mutanen M, Moisio S, Huttunen J (1983) Controlled randomised trial of the effect of dietary fat on blood pressure. Lancet 1: 1–5
MacGregor GA, Smith SJ, Markandu ND, Banks RA, Sagnella GA (1982) Moderate potassium supplementation in essential hypertension. Lancet 2: 567–570
Rouse IL, Beilin LJ, Armstrong BK, Vandongen R (1983) Blood pressure-lowering effect of a vegetarian diet: controlled trial in normotensive subjects. Lancet 1: 5–9
Wright A, Burstyn PG, Gibney MJ (1979) Dietary fibre and blood pressure. Br Med J 2: 1541–1543
Dodson PM, Humphreys DM (1981) Hypertension and angina. In: Trowell HC, Burkitt DP (eds) Western diseases: their emergence and prevention. Edward Arnold, London, pp 411–420
Beard TC, Cooke HM, Gray WR, Barge R (1982) Randomised controlled trial of a no-added-sodium diet for mild hypertension. Lancet 2: 455–458
Simpson RW, Mann JI, Eaton J, Carter RD, Hockaday TDR (1979) High-carbohydrate diets and insulin-dependent diabetics. Br Med J 2: 523–525
Dodson PM, Stocks J, Holdsworth G, Galton DJ (1981) Highfibre and low-fat diets in diabetes mellitus. Br J Nutr 46: 289–294
Maxwell MH, Waks AV, Schroth PC, Karam M, Dornfield LP (1982) Error in blood pressure measurement due to incorrect cuff size in obese patients. Lancet 2: 33–35
Reisin E, Abel R, Modam M, Silverberg DS, Eliahou HE, Modan B (1978) Effect of weight loss without salt restriction on reduction of blood pressure in overweight hypertensive patients. N Engl J Med 289: 1–6
Multiple Risk Factor Intervention Trial (1982) JAMA 248: 1465–1477
The Australian Therapeutic Trial in Mild Hypertension (1980) Lancet 1: 1261–1267
Pacy P, Dodson PM (1984) Hypertension and wellbeing. Br Med J 288: 327 (Letter)
National Advisory Committee on Nutrition Education (1983) Proposals for nutritional guidelines for health education in Britain. Lancet 2: 719–721,782–785, 835–837, 902–905
Ministry of Agriculture, Fisheries and Food (1979) Household food consumption and expenditure. Her Majestry's Stationary Office, London, p 111
Paul AA, Southgate DAT (1978) In: McCance and Widdowson's, The composition of foods, 4th edn. Her Majesty's Stationary Office, London
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Dodson, P.M., Pacy, P.J., Bal, P. et al. A controlled trial of a high fibre, low fat and low sodium diet for mild hypertension in type 2 (non-insulin-dependent) diabetic patients. Diabetologia 27, 522–526 (1984). https://doi.org/10.1007/BF00290388
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DOI: https://doi.org/10.1007/BF00290388