Deconstructing JNC 7 – Part 4

One thing to note about management of hypertension is the importance of salt in the diet. A regimen called DASH, which means Dietary Approach to Stop Hypertension, is a worthy find on the internet. I would like to discuss it on another thread. Its main approach is to reduce salt intake to 2300 mg or less and also to add fruits and vegetables to the diet. It’s based on a study of three experimental groups: the first with a normal American diet, the second with the same diet plus fruits and vegetables, the third with the DASH plan. Both the diet with fruits and vegetables and DASH plan had reduced blood pressure. But it is with DASH that the reduction was fast and greatest among the three groups.

I highly recommend you download it for your patients and especially your loved ones.

Other factors, besides excess salt intake, that can contribute to high blood pressure are the following:

  • excess body weight
  • reduced physical activity
  • inadequate intake of fruits, vegetables, and potassium
  • excess alcohol intake

As shown in the figure, minor reductions in systolic BP on a population study can bring about a decrease in overall mortality. This is why I think most cardiologist aim for the best regimen for their patients so they can achieve the best results in terms of mortality.

However, this is a strong point I need to reiterate, individualization of the patient’s regimen is still the best course to follow. Here in the Philippines, a 50 pesos drug to be taken once a day is already a big burden to an average patient. If control can be achieved on drugs that are much more cheaper, why not design a regimen that could be afforded by each individual patient.


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