Posted by Michael S. Evers

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Government Panel Says Diet is the Answer to Hypertension
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by Peter Barry Chowka

A federal panel of medical experts went farther than ever in
advocating major dietary changes to control hypertension (high blood
pressure). The Joint National Committee (JNC) on Prevention, Detection,
Evaluation, and Treatment of High Blood Pressure of the National Heart, Lung,
and Blood Institute (NHLBI), one of the Natonal Institutes of Health,
suggested that all Americans, not just people with hypertension, should
follow a strict diet high in fruits and vegetables and low in fats to control
blood pressure and to prevent heart disease, stroke, and end-stage renal
disease, all of which are associated with hypertension.

Patients on such a diet, known as DASH -- Dietary Approaches to Stop
Hypertension -- fared well in a study published April 17, 1997 in The New
England Journal of Medicine. That study concluded, "A diet rich in fruits,
vegetables, and low-fat dairy foods and with reduced saturated and total fat
can substantially lower blood pressure. This diet offers an additional
nutritional approach to preventing and treating hypertension."

It is estimated that 50 million Americans are hypertensive, defined by the
JNC as having blood pressure that is 140 over 90 mm Hg (millimeters of
mercury) or greater. Sheldon Sheps, MD, chairman of the JNC and a professor
emeritus at the Mayo Clinic, noted that as many as three-quarters of
hypertensives don't have adequate control of their blood pressure, either
because they do not comply with suggested lifestyle or dietary changes or
because they stop taking antihypertensive drugs due to their costs or side
effects.

According to the National Health and Nutrition Examination Survey, the number
of hypertensives among those who responded who had achieved blood pressure
control fell from 29 percent in 1988-91 to 27.4 percent in 1991-94. "We're
concerned to see a decrease in awareness and control," commented Claude
Lenfant, MD, director of NHLBI which convened the JNC. Lenfant added that
"people are becoming complacent" when confronting a lifetime of taking pills
or watching their diets.

In the past two decades, there had been a 60% reduction in the incidence of
stroke and a 53% decrease in coronary heart disease incidence nationally. The
most recent government statistics, however, have found a plateau in the rate
of cardiac disease deaths and a slight increase in stroke deaths. Meanwhile,
the incidence rate per million people of end-stage renal disease has risen
from 92 in 1982 to 253 in 1995, and the prevalence of heart failure has risen
for every age group.

To address these problems, the JNC recommended diet and lifestyle changes as
the first approach. The panel suggested that people with slightly elevated
blood pressure and few risk factors for complications try these changes for a
year before starting medication. Previous JNC/NHLBI guidelines had
recommended only 3-6 months of lifestyle or dietary modification before
starting drug treatments.

For further informaton,

A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure N Engl
J Med 1997;336:1117-24. (abstract)
http://www.nejm.org/public/1997/0336/0016/1117/1.htm

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Michael S. Evers, Esq. michael@evers.com
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