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Effects of high- and low-sodium diets on ambulatory blood pressure in patients with hypertension receiving aliskiren.

Author(s): Weir MR, Yadao AM, Purkayastha D, Charney AN

Affiliation(s): Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD 21201, USA. MWEIR@medicine.umaryland.edu

Publication date & source: 2010-12, J Cardiovasc Pharmacol Ther., 15(4):356-63. Epub 2010 Sep 27.

Publication type: Multicenter Study; Randomized Controlled Trial

Dietary sodium reduction and, as necessary, pharmacologic treatment are recommended for hypertension management. This prospective, randomized, open-label, blinded-end point, multicenter, crossover study investigated the effect of dietary sodium intake on mean ambulatory systolic blood pressure (maSBP) in patients with hypertension receiving aliskiren 300 mg once daily. Following a 2- to 4-week washout period, patients were randomized to a high- (>/= 200 mmol/d) or low- (</= 100 mmol/d) sodium diet and were started on aliskiren, 300 mg/d. After 4 weeks, patients were crossed over to the alternate diet for an additional 4 weeks. The primary efficacy variable was change in maSBP between diets. During treatment with aliskiren, maSBP was significantly lower with the low-sodium diet compared with the high-sodium diet (least squares mean difference, 9.4 mm Hg; 95% CI, 7.5-11.4; P < .0001). The percentage of patients achieving a maSBP response to aliskiren (<130 mm Hg or a >/= 20-mm Hg reduction from baseline) was greater with the low- (76.5%) versus the high-sodium diet (42.6%; P < .0001). Overall, 40.9% patients had >/= 1 adverse event and the rates were similar between groups. In this study, aliskiren was well tolerated and a low-sodium diet accentuated its antihypertensive effect.

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