Abstract
One hundred patients with essential hypertension were placed for periods of several weeks to 12 months on a diet of 2200 calories containing approximately 200 mg of sodium, 2.2 g potassium, 70 g protein, 80 to 175 g fat, 130 to 230 g carbohydrate, and vitamin supplements. A daily fluid intake of 3 liters was maintained. All were outpatients. Blood pressure readings were taken with the subject reclining, sitting and standing. They were made by one observer usually at the same time of day. No pretreatment blood pressure was below 170/100. Medical and dietary checks were ordinarily made once or twice a month.
There was a significant lowering of pressure (to or below 155/95) in approximately 20%, and of the diastolic pressure (to or below 95) in an additional 15% of the cases. A number of the patients who improved on this regime had failed to respond satisfactorily to a previous bilateral supradiaphragmatic splanchnicectomy and lower dorsal sympathetic ganglionectomy. The majority with symptoms typical of essential hypertension and hypertensive heart disease showed moderate improvement or were completely relieved of their discomfort. In most of these with angina pectoris the frequency and severity of the seizures were diminished. In all cases in which it was utilized orthodiography demonstrated a definite and progressive decrease in the size of the heart when it was enlarged. The inverted T waves frequently seen in hypertensive heart disease have in some cases become upright. Papilledema diminishes. Peripheral edema and pulmonary congestion invariably disappear. Relief of symptoms and the above described objective changes were not uniformly associated with a significant fall in blood pressure.
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