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Effects on left ventricular hypertrophy of long-term nonpharmacological treatment with sodium restriction in
1Social Insurance Institution, Research and Development Unit, Turku, Finland.
Insights
Reducing dietary sodium intake can decrease left ventricular hypertrophy (LVH) in patients with hypertension. This nonpharmacological approach led to significant reductions in blood pressure and left ventricular mass over 12 months.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- Cross-sectional studies indicate a link between high sodium intake and left ventricular hypertrophy (LVH) in hypertensive individuals.
- Left ventricular hypertrophy (LVH) is a significant risk factor for cardiovascular events.
Purpose of the Study:
- To investigate the impact of a nonpharmacological treatment program centered on sodium restriction on LVH.
- To assess changes in left ventricular mass and blood pressure over a 12-month period in hypertensive patients.
Main Methods:
- A 12-month randomized controlled trial involving 76 untreated patients with mild-to-moderate hypertension.
- Serial echocardiography was used to measure left ventricular mass (LVM) and left ventricular mass index (LVMI).
- The treatment group underwent dietary sodium restriction, while the control group did not.
Main Results:
- The treatment group showed a significant reduction in mean daily sodium excretion (from 195 to 109 mmol/day).
- Blood pressure decreased significantly in the treatment group (systolic: 6.7 mm Hg, diastolic: 3.8 mm Hg over 12 months).
- Left ventricular mass (LVM) decreased by 5.4% and LVMI by 4.7% in the treatment group after 12 months; no changes were observed in the control group.
Conclusions:
- Long-term moderate sodium restriction effectively reduces left ventricular hypertrophy (LVH) in patients with hypertension.
- This nonpharmacological intervention offers a viable strategy for managing cardiac remodeling in hypertensive individuals.
Background:
Cross-sectional studies on human hypertension have suggested an association between sodium intake and left ventricular hypertrophy (LVH).
Methods And Results:
The effects on LVH of a nonpharmacological treatment program based mainly on sodium restriction were examined by serial echocardiography in a 12-month controlled, randomized study that included 76 previously untreated subjects with uncomplicated mild-to-moderate hypertension. The mean daily sodium excretion of 38 subjects randomized into the treatment group decreased from 195 +/- 95 to 94 +/- 73 mmol (P < .001) at 6 months and to 109 +/- 74 mmol (P < .001) at 12 months. This was accompanied by a weight decrease from 81.4 +/- 18.0 to 79.2 +/- 17.4 kg (P < .001) at 6 months and to 80.6 +/- 17.5 kg (NS) at 12 months. The net blood pressure decrease (difference in change from baseline between the treatment and control groups) was 8.9 mm Hg (P < .001) in systolic blood pressure and 6.5 mm Hg (P < .001) in diastolic blood pressure during the first 6 months and 6.7 mm Hg (P < .01) in systolic blood pressure and 3.8 mm Hg (P < .01) in diastolic blood pressure during the last 6 months. After 12 months of sodium restriction, left ventricular mass (LVM) had decreased by 5.4% (from 238 +/- 63 to 225 +/- 51 g, P < .01), and LVM index (LVMI) had decreased by 4.7% (from 123 +/- 26 to 117 +/- 22 g/m2, P < .05), whereas no changes occurred in these parameters in the control group. In treated subjects with baseline LVMI of more than the median value of 133 g/m2 in men and 107 g/m2 in women, LVM decreased by 8.6% (from 272 +/- 62 to 249 +/- 51 g, P < .01), and LVMI decreased by 7.1% (from 140 +/- 23 to 130 +/- 22 g/m2, P < .01). LVM and LVMI remained unchanged in treated subjects with LVMI values equal to or less than the median.
Conclusions:
Our data suggest that long-term nonpharmacological treatment with moderate sodium restriction decreases LVH.