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Cutting Down On Salt To Prevent Stroke LONDON -- September 19, 1997 -- An increase in blood pressure is the major risk factor for the development of stroke. The blood pressure of older patients with hypertension (high blood pressure) can be lowered by a moderate reduction in salt intake. However, there have been no studies of normotensive (normal blood pressure) older patients -- surprising, given most strokes occur in these people. In this week's The Lancet, Dr. Francesco Cappuccio and colleagues from London, England, report a small restriction of salt intake lowers blood pressure in both hypertensive and normotensive older people. The researchers used 47 untreated older people (24 men, 23 women) with a broad range of blood pressures in a double-blind randomised study. For one month, patients were given either sodium tablets to give a salt intake of 10 grams (equivalent to the normal daily amount for the UK. population) or placebo to keep their salt intake, after dietary restrictions, at five grams. For the second month, sodium and placebo tablets were administered in reverse. After one month on the normal salt intake, mean blood pressure was 163/90 mmHg with mean urinary sodium excretion of 177 mmol/day. With sodium restriction, however, blood pressure fell to 156/87 mmHG with a urinary sodium excretion of 94 mmol/day. A reduction in sodium intake of 83 mmol/day was associated with a reduction of 7.2/3.2 mm Hg. Importantly, there was no significant difference in the blood-pressure fall between 18 normotensive and 29 hypertensive patients. "Since the majority of strokes in older people occur below the current definition of hypertension our results have important implications for the prevention of stroke," Dr. Cappuccio and colleagues concluded. In his commentary, Dr. Paul Elliott of Imperial College, London, England, puts their results in context, arguing they reinforce growing evidence of the adverse effect of salt on blood pressure. E-mail this page to a friend or colleague! To print, use this version