Re: olivier and some crisis

[Guest guest]

Olivier, you are not crazy. All of us here have experienced some of the same

things. I have gone through posts and pulled out member comments about anxiety,

rage, depression and what we're now calling " PA episodes. " I just uploaded my

latest version and sent a notice to the group. Just click on the link and you

can read what others have said. If clicking on the link doesn't work, go to the

home page of the group, click on " Files " and then click on " Member Comments. "

You can print it out and show it to your doctors. I kept telling my doctor

things like you relate. She sent me to a shrink (psychiatrist) when what I

should have had was a cardiologist.

BTW, at the bottom of the paper I listed comments about sweating. Eventually,

I'll break those off into another paper.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of odile debargue

hello everybody,

I discover something interesting and the doctors are very intersted with it

seems that my desease comes some times with crisis :

-eyes cry and no more good visions (i had never any problem with this before)

-headache (to the point i have to go away from my children and i am unable to

answer to anybody)

-sweating (th bed is wet ..)

-any light is becoming a problem and i have to close my eyes

-my BP is going up at this time (no salt diet and high k for 2 months)

-anxious am i anxious because of this or to be anxious is part of it this i can

t say

this can stay fot some hours or many days last week i had it for 4 days and it

disappears.

it looks like the BP is only a symptom but in fact the problem is bigger

did anyone feel the samethings .

Doctors begins to look at me strangely and this make me afraid,

regards

Olivier

[Guest guest]

suspect you are having migraine headaches. Can you tell when one is

coming on? Flashes of lights or wavy lines in vision?

What meds are you taking as in some they may cause headaches.

Ask if you have been tested for a pheochromocytoma.

If not you should be tested.

May your pressure be low!

CE Grim MS, MD

High Blood Pressure Consulting

Clinical Professor of Medicine Medical College of Wisconsin

Board certified in Internal Med, Geriatrics and Hypertension.

Interests: The effect of recent evolutionary forces on high blood

pressure in human populations.

On Jun 14, 2008, at 1:39 AM, odile debargue wrote:

> hello everybody,

>

> I discover something interesting and the doctors are very intersted

> with it seems that my desease comes some times with crisis :

> -eyes cry and no more good visions (i had never any problem with

> this before)

> -headache (to the point i have to go away from my children and i am

> unable to answer to anybody)

> -sweating (th bed is wet ..)

> -any light is becoming a problem and i have to close my eyes

> -my BP is going up at this time (no salt diet and high k for 2 months)

> -anxious am i anxious because of this or to be anxious is part of

> it this i can t say

>

> this can stay fot some hours or many days last week i had it for 4

> days and it disappears.

>

> it looks like the BP is only a symptom but in fact the problem is

> bigger

> did anyone feel the samethings .

> Doctors begins to look at me strangely and this make me afraid,

>

> regards

> Olivier

>

> __________________________________________________________

> Envoyez avec . Une boite mail plus intelligente http://

> mail..fr

>

>

[Guest guest]

more wavy lines and very high light sensibilty not able to see a tv screen and i

don t feel it like a migraine .

Migraine i had before was more hurting me now it is like i am in a cloud  and

any noise any light  any question asked to me is a worry last friday i had to

ask help to come back home by car.

The things who makes me the more afraid is this lose in vision acuity.

yes i have been tested for this and it is negatif.

medecine i take aldactone (75 mg)  rimenidine 2mg iperten (cholirydrate de

manidipine) 20 mg atenolol 50 mg firosemide 40 mg

sadly i asked my doctors what to do when i have these " crisis " and i have a

blank as answer  and they say me that i have to undrstand that what i have is

very rare wich is not so important in my view .

thanks

Olivier

--- En date de : Sam 14.6.08, Clarence Grim <lowerbp2@...> a écrit :

De: Clarence Grim <lowerbp2@...>

Objet: Re: olivier and some crisis

À: hyperaldosteronism

Date: Samedi 14 Juin 2008, 18h27

suspect you are having migraine headaches. Can you tell when one is

coming on? Flashes of lights or wavy lines in vision?

What meds are you taking as in some they may cause headaches.

Ask if you have been tested for a pheochromocytoma.

If not you should be tested.

May your pressure be low!

CE Grim MS, MD

High Blood Pressure Consulting

Clinical Professor of Medicine Medical College of Wisconsin

Board certified in Internal Med, Geriatrics and Hypertension.

Interests: The effect of recent evolutionary forces on high blood

pressure in human populations.

On Jun 14, 2008, at 1:39 AM, odile debargue wrote:

> hello everybody,

>

> I discover something interesting and the doctors are very intersted

> with it seems that my desease comes some times with crisis :

> -eyes cry and no more good visions (i had never any problem with

> this before)

> -headache (to the point i have to go away from my children and i am

> unable to answer to anybody)

> -sweating (th bed is wet ..)

> -any light is becoming a problem and i have to close my eyes

> -my BP is going up at this time (no salt diet and high k for 2 months)

> -anxious am i anxious because of this or to be anxious is part of

> it this i can t say

>

> this can stay fot some hours or many days last week i had it for 4

> days and it disappears.

>

> it looks like the BP is only a symptom but in fact the problem is

> bigger

> did anyone feel the samethings .

> Doctors begins to look at me strangely and this make me afraid,

>

> regards

> Olivier

>

> ____________ _________ _________ _________ _________ _________ _

> Envoyez avec . Une boite mail plus intelligente http://

> mail..fr

>

>

[Guest guest]

How long have you been on the atenolol? I lost vision while on metoprolol.

They are both beta blockers. It would help Dr. Grim if you'd give more

information. For example, why are you on all those meds? How long have you

been on each one? When did the vision problems start? When did the headaches

start?

I question why you're on furosemide. It is a diuretic and can lower your

potassium. Some of what you're experienceing may be low potassium. Do you have

test results you can post? Potassium, aldosterone, renin?

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of odile debargue

more wavy lines and very high light sensibilty not able to see a tv screen and i

don t feel it like a migraine .

Migraine i had before was more hurting me now it is like i am in a cloud and

any noise any light any question asked to me is a worry last friday i had to

ask help to come back home by car.

The things who makes me the more afraid is this lose in vision acuity.

yes i have been tested for this and it is negatif.

medecine i take aldactone (75 mg) rimenidine 2mg iperten (cholirydrate de

manidipine) 20 mg atenolol 50 mg firosemide 40 mg

sadly i asked my doctors what to do when i have these " crisis " and i have a

blank as answer and they say me that i have to undrstand that what i have is

very rare wich is not so important in my view .

thanks

Olivier

--- En date de : Sam 14.6.08, Clarence Grim <lowerbp2@...

<mailto:lowerbp2%40mac.com> > a écrit :

De: Clarence Grim <lowerbp2@... <mailto:lowerbp2%40mac.com> >

Objet: Re: olivier and some crisis

À: hyperaldosteronism

<mailto:hyperaldosteronism%40>

Date: Samedi 14 Juin 2008, 18h27

suspect you are having migraine headaches. Can you tell when one is

coming on? Flashes of lights or wavy lines in vision?

What meds are you taking as in some they may cause headaches.

Ask if you have been tested for a pheochromocytoma.

If not you should be tested.

May your pressure be low!

CE Grim MS, MD

High Blood Pressure Consulting

Clinical Professor of Medicine Medical College of Wisconsin

Board certified in Internal Med, Geriatrics and Hypertension.

Interests: The effect of recent evolutionary forces on high blood

pressure in human populations.

On Jun 14, 2008, at 1:39 AM, odile debargue wrote:

> hello everybody,

>

> I discover something interesting and the doctors are very intersted

> with it seems that my desease comes some times with crisis :

> -eyes cry and no more good visions (i had never any problem with

> this before)

> -headache (to the point i have to go away from my children and i am

> unable to answer to anybody)

> -sweating (th bed is wet ..)

> -any light is becoming a problem and i have to close my eyes

> -my BP is going up at this time (no salt diet and high k for 2 months)

> -anxious am i anxious because of this or to be anxious is part of

> it this i can t say

>

> this can stay fot some hours or many days last week i had it for 4

> days and it disappears.

>

> it looks like the BP is only a symptom but in fact the problem is

> bigger

> did anyone feel the samethings .

> Doctors begins to look at me strangely and this make me afraid,

>

> regards

> Olivier

>

> ____________ _________ _________ _________ _________ _________ _

> Envoyez avec . Une boite mail plus intelligente http://

> mail..fr

>

>

[Guest guest]

May your pressure be low!

CE Grim MS, MD

High Blood Pressure Consulting

Clinical Professor of Medicine Medical College of Wisconsin

Board certified in Internal Med, Geriatrics and Hypertension.

Interests: The effect of recent evolutionary forces on high blood

pressure in human populations.

On Jun 14, 2008, at 12:07 PM, odile debargue wrote:

> more wavy lines and very high light sensibilty not able to see a tv

> screen and i don t feel it like a migraine .

> Migraine i had before was more hurting me now it is like i am in a

> cloud and any noise any light any question asked to me is a worry

> last friday i had to ask help to come back home by car.

> The things who makes me the more afraid is this lose in vision acuity.

This is almost certainly a migraine attach or equivalent. In many

with PA this will get better with Aldact (spiro).

Would talk to your medical team about a couple of possibilities:

increaseing atentolol as it may improve migrainine and BP both.

Stopping furosimide and increasing Aldactone. Furo will cause low K

even on aldact and might be related to the attacks.

>

>

> yes i have been tested for this and it is negatif.

> medecine i take aldactone (75 mg) rimenidine 2mg iperten

> (cholirydrate de manidipine) 20 mg atenolol 50 mg firosemide 40 mg

>

> sadly i asked my doctors what to do when i have these " crisis " and

> i have a blank as answer and they say me that i have to undrstand

> that what i have is very rare wich is not so important in my view .

Whoa--you are the one having this " rare disease " and it is important

in you! unless I misunderstand your English.

You should be tested for a pheo sometime. The only way to Dx this is

to test for it. Most with this adrenal problem have episodes of

severe pounding headaches, spikes in BP, sweating. One of the pts I

have cured of this said her headaches were so bad she wanted to go to

the basement and get a drill and drill a hole in her head and let the

pressure out.

>

>

> thanks

> Olivier

[Guest guest]

thanks  i will talk to them about this i already give them your article so they

know about .

sorry for my english but what i wanted to mean if the fact i dont care if it is

rare i would like them to understand what i feel and not look at me as a crazy

man

thanks a lot

Olivier

--- En date de : Sam 14.6.08, Clarence Grim <lowerbp2@...> a écrit :

De: Clarence Grim <lowerbp2@...>

Objet: Re: olivier and some crisis

À: hyperaldosteronism

Date: Samedi 14 Juin 2008, 19h49

May your pressure be low!

CE Grim MS, MD

High Blood Pressure Consulting

Clinical Professor of Medicine Medical College of Wisconsin

Board certified in Internal Med, Geriatrics and Hypertension.

Interests: The effect of recent evolutionary forces on high blood

pressure in human populations.

On Jun 14, 2008, at 12:07 PM, odile debargue wrote:

> more wavy lines and very high light sensibilty not able to see a tv

> screen and i don t feel it like a migraine .

> Migraine i had before was more hurting me now it is like i am in a

> cloud and any noise any light any question asked to me is a worry

> last friday i had to ask help to come back home by car.

> The things who makes me the more afraid is this lose in vision acuity.

This is almost certainly a migraine attach or equivalent. In many

with PA this will get better with Aldact (spiro).

Would talk to your medical team about a couple of possibilities:

increaseing atentolol as it may improve migrainine and BP both.

Stopping furosimide and increasing Aldactone. Furo will cause low K

even on aldact and might be related to the attacks.

>

>

> yes i have been tested for this and it is negatif.

> medecine i take aldactone (75 mg) rimenidine 2mg iperten

> (cholirydrate de manidipine) 20 mg atenolol 50 mg firosemide 40 mg

>

> sadly i asked my doctors what to do when i have these " crisis " and

> i have a blank as answer and they say me that i have to undrstand

> that what i have is very rare wich is not so important in my view .

Whoa--you are the one having this " rare disease " and it is important

in you! unless I misunderstand your English.

You should be tested for a pheo sometime. The only way to Dx this is

to test for it. Most with this adrenal problem have episodes of

severe pounding headaches, spikes in BP, sweating. One of the pts I

have cured of this said her headaches were so bad she wanted to go to

the basement and get a drill and drill a hole in her head and let the

pressure out.

>

>

> thanks

> Olivier

[Guest guest]

i am with these medecines for 1 month i had to pass 3 weeks in hospital for this

and they give me all these medecines i am going to ask them these questions.

i begin to educate myself about this and see that in some way i have to give

informations to doctor too.

olivier

--- En date de : Sam 14.6.08, Valarie <val@...> a écrit :

De: Valarie <val@...>

Objet: RE: olivier and some crisis

À: hyperaldosteronism

Date: Samedi 14 Juin 2008, 19h47

How long have you been on the atenolol? I lost vision while on

metoprolol. They are both beta blockers. It would help Dr. Grim if you'd give

more information. For example, why are you on all those meds? How long have

you been on each one? When did the vision problems start? When did the

headaches start?

I question why you're on furosemide. It is a diuretic and can lower your

potassium. Some of what you're experienceing may be low potassium. Do you have

test results you can post? Potassium, aldosterone, renin?

Val

From: hyperaldosteronism [mailto:hyperaldosteronism@

groups. com] On Behalf Of odile debargue

more wavy lines and very high light sensibilty not able to see a tv screen and i

don t feel it like a migraine .

Migraine i had before was more hurting me now it is like i am in a cloud and

any noise any light any question asked to me is a worry last friday i had to

ask help to come back home by car.

The things who makes me the more afraid is this lose in vision acuity.

yes i have been tested for this and it is negatif.

medecine i take aldactone (75 mg) rimenidine 2mg iperten (cholirydrate de

manidipine) 20 mg atenolol 50 mg firosemide 40 mg

sadly i asked my doctors what to do when i have these " crisis " and i have a

blank as answer and they say me that i have to undrstand that what i have is

very rare wich is not so important in my view .

thanks

Olivier

--- En date de : Sam 14.6.08, Clarence Grim <lowerbp2mac (DOT) com <mailto:lowerbp2%

40mac.com> > a écrit :

De: Clarence Grim <lowerbp2mac (DOT) com <mailto:lowerbp2% 40mac.com> >

Objet: Re: [hyperaldosteronism ] olivier and some crisis

À: hyperaldosteronism <mailto:hyperaldost eronism%40g

roups.com>

Date: Samedi 14 Juin 2008, 18h27

suspect you are having migraine headaches. Can you tell when one is

coming on? Flashes of lights or wavy lines in vision?

What meds are you taking as in some they may cause headaches.

Ask if you have been tested for a pheochromocytoma.

If not you should be tested.

May your pressure be low!

CE Grim MS, MD

High Blood Pressure Consulting

Clinical Professor of Medicine Medical College of Wisconsin

Board certified in Internal Med, Geriatrics and Hypertension.

Interests: The effect of recent evolutionary forces on high blood

pressure in human populations.

On Jun 14, 2008, at 1:39 AM, odile debargue wrote:

> hello everybody,

>

> I discover something interesting and the doctors are very intersted

> with it seems that my desease comes some times with crisis :

> -eyes cry and no more good visions (i had never any problem with

> this before)

> -headache (to the point i have to go away from my children and i am

> unable to answer to anybody)

> -sweating (th bed is wet ..)

> -any light is becoming a problem and i have to close my eyes

> -my BP is going up at this time (no salt diet and high k for 2 months)

> -anxious am i anxious because of this or to be anxious is part of

> it this i can t say

>

> this can stay fot some hours or many days last week i had it for 4

> days and it disappears.

>

> it looks like the BP is only a symptom but in fact the problem is

> bigger

> did anyone feel the samethings .

> Doctors begins to look at me strangely and this make me afraid,

>

> regards

> Olivier

>

> ____________ _________ _________ _________ _________ _________ _

> Envoyez avec . Une boite mail plus intelligente http://

> mail..fr

>

>

[Guest guest]

As you will note in our archives going back 12000 or so notes this is

a common look that PA patients get.

Also I paste an update on DASH research.

Val: this should go in our files.

1: Br J Nutr. 2008 May 9:1-8. [Epub ahead of print]

Dietary electrolytes are related to mood.

SJ, Nowson CA, Worsley A.

School of Exercise and Nutrition Sciences, Centre for Physical

Activity and

Nutrition, Deakin University, 221 Burwood Highway, Burwood 3125,

Australia.

Dietary therapies are routinely recommended to reduce disease risk;

however,

there is concern they may adversely affect mood. We compared the

effect on mood

of a low-sodium, high-potassium diet (LNAHK) and a high-calcium diet

(HC) with a

moderate-sodium, high-potassium, high-calcium Dietary Approaches to Stop

Hypertension (DASH)-type diet (OD). We also assessed the relationship

between

dietary electrolytes and cortisol, a stress hormone and marker of

hypothalamic-pituitary-adrenal (HPA) axis activity. In a crossover

design,

subjects were randomized to two diets for 4 weeks, the OD and either

LNAHK or HC,

each preceded by a 2-week control diet (CD). Dietary compliance was

assessed by

24 h urine collections. Mood was measured weekly by the Profile of

Mood States

(POMS). Saliva samples were collected to measure cortisol. The change

in mood

between the preceding CD and the test diet (LNAHK or HC) was compared

with the

change between the CD and OD. Of the thirty-eight women and fifty-six

men (mean

age 56.3 (sem 9.8) years) that completed the OD, forty-three

completed the LNAHK

and forty-eight the HC. There was a greater improvement in

depression, tension,

vigour and the POMS global score for the LNAHK diet compared to OD (P

< 0.05).

Higher cortisol levels were weakly associated with greater vigour,

lower fatigue,

and higher levels of urinary potassium and magnesium (r 0.1-0.2, P <

0.05 for

all). In conclusion, a LNAHK diet appeared to have a positive effect

on overall

mood.

PMID: 18466657 [PubMed - as supplied by publisher]

2: Arch Intern Med. 2008 Apr 14;168(7):713-20.

Adherence to a DASH-style diet and risk of coronary heart disease and

stroke in

women.

Fung TT, Chiuve SE, McCullough ML, Rexrode KM, Logroscino G, Hu FB.

Department of Nutrition, College, 300 The Fenway, and

Department of

Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.

fung@...

BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH) diet

has been

shown to lower blood pressure, but little is known about its long-

term effect on

cardiovascular end points. Our objective was to assess the

association between a

DASH-style diet adherence score and risk of coronary heart disease

(CHD) and

stroke in women. METHODS: In this prospective cohort study, diet was

assessed 7

times during 24 years of follow-up (1980-2004) with validated food

frequency

questionnaires. A DASH score based on 8 food and nutrient components

(fruits,

vegetables, whole grains, nuts and legumes, low-fat dairy, red and

processed

meats, sweetened beverages, and sodium) was calculated. Lifestyle and

medical

information was collected biennially with a questionnaire. The

proportional

hazard model was used to adjust for potential confounders. The study

population

comprised 88,517 female nurses aged 34 to 59 years without a history of

cardiovascular disease or diabetes in 1980. The main outcome measures

were the

numbers of confirmed incident cases of nonfatal myocardial

infarction, CHD death,

and stroke. RESULTS: We documented 2129 cases of incident nonfatal

myocardial

infarction, 976 CHD deaths, and 3105 cases of stroke. After

adjustment for age,

smoking, and other cardiovascular risk factors, the relative risks of

CHD across

quintiles of the DASH score were 1.0, 0.99, 0.86, 0.87, and 0.76 (95%

confidence

interval, 0.67-0.85) (P<.001 for trend). The magnitude of risk

difference was

similar for nonfatal myocardial infarction and fatal CHD. The DASH

score was also

significantly associated with lower risk of stroke (multivariate

relative risks

across quintiles of the DASH score were 1.0, 0.92, 0.91, 0.89, and

0.82) (P=.002

for trend). Cross-sectional analysis in a subgroup of women with

blood samples

showed that the DASH score was significantly associated with lower

plasma levels

of C-reactive protein (P=.008 for trend) and interleukin 6 (P=.04 for

trend).

CONCLUSION: Adherence to the DASH-style diet is associated with a

lower risk of

CHD and stroke among middle-aged women during 24 years of follow-up.

Publication Types:

Research Support, N.I.H., Extramural

PMID: 18413553 [PubMed - indexed for MEDLINE]

3: Arch Intern Med. 2008 Feb 11;168(3):308-14.

Deteriorating dietary habits among adults with hypertension: DASH

dietary

accordance, NHANES 1988-1994 and 1999-2004.

Mellen PB, Gao SK, Vitolins MZ, Goff DC Jr.

Hypertension Center of the Hattiesburg Clinic, 5909 US Hwy 49, Ste 30,

Hattiesburg, MS 39402, USA. philip.mellen@...

BACKGROUND: Although the DASH (Dietary Approaches to Stop

Hypertension trial)

diet is among the therapeutic lifestyle changes recommended for

individuals with

hypertension (HTN), accordance with the DASH diet is not known.

METHODS: Using

data from the National Health and Nutrition Examination Survey

(NHANES) from the

1988-1994 and 1999-2004 periods, DASH accordance among individuals with

self-reported HTN was estimated based on 9 nutrient targets (fat,

saturated fat,

protein, cholesterol, fiber, magnesium, calcium, sodium, and

potassium) (score

range, 0-9). Using data from 1999-2004, we compared the DASH score among

demographic groups in age- and energy-adjusted models and modeled the

odds of a

DASH-accordant dietary pattern (>or=4.5) using multivariable logistic

regression.

The DASH score, DASH accordance, and percentage of participants

achieving

individual targets were compared with estimates from NHANES 1988-1994

data.

RESULTS: Based on 4386 participants with known HTN in the recent

survey period

(1999-2004), the mean (SE) DASH score, after adjustment for age and

energy

intake, was 2.92 (0.05), with 19.4% (1.2%) classified as DASH

accordant. In

multivariable logistic regression models, DASH accordance was

associated with

older age, nonblack ethnicity, higher education, and known diabetes

mellitus.

Accordance with DASH was 7.3% lower in the recent survey period

compared with

NHANES 1988-1994 (26.7% [1.1%]) (P < .001), reflecting fewer patients

with HTN

meeting nutrient targets for total fat, fiber, and magnesium.

CONCLUSION: The

dietary profile of adults with HTN in the United States has a low

accordance with

the DASH dietary pattern, and the dietary quality of adults with HTN has

deteriorated since the introduction of the DASH diet, suggesting that

secular

trends have minimized the impact of the DASH message.

Publication Types:

Comparative Study

PMID: 18268173 [PubMed - indexed for MEDLINE]

4: Am J Hypertens. 2008 Mar;21(3):257-64. Epub 2008 Jan 24.

The association of nephrolithiasis with hypertension and obesity: a

review.

Obligado SH, Goldfarb DS.

Nephrology Section, New York University School of Medicine, New York,

New York,

USA.

Kidney stones affect hypertensive patients disproportionately

compared to

normotensive individuals. On the other hand, some prospective data

suggest that a

history of nephrolithiasis was associated with a greater tendency to

develop

hypertension. Newer epidemiologic data also link obesity and

diabetes, features

of the metabolic syndrome, with nephrolithiasis. In this review, the

association

of hypertension, diabetes, and obesity with nephrolithiasis is

reviewed, and

possible pathogenic mechanisms are discussed. Patients with

hypertension may have

abnormalities of renal calcium metabolism, but data confirming this

hypothesis

are inconsistent. Higher body mass index and insulin resistance

(i.e., the

metabolic syndrome) may be etiologic in uric acid nephrolithiasis as

increasing

body weight is associated with decreasing urinary pH. The possibility

that common

pathophysiologic mechanisms underly these diseases is intriguing, and

if better

understood, could potentially lead to better therapies for stone

prevention. Both

hypertension and stones might be addressed through lifestyle

modification to

prevent weight gain. Adoption of a lower sodium diet with increased

fruits and

vegetables and low-fat dairy products, (for example, the dietary

approaches to

stop hypertension(DASH) diet), may be useful to prevent both stones and

hypertension. In those patients in whom dietary modification and

weight loss are

ineffective, thiazide diuretics are likely to improve blood pressure

control and

decrease calciuria.

PMID: 18219300 [PubMed - in process]

5: Ethn Dis. 2007 Summer;17(3 Suppl 4):S4-7-12.

Modifying soul food for the Dietary Approaches to Stop Hypertension

diet (DASH)

plan: implications for metabolic syndrome (DASH of Soul).

Rankins J, Wortham J, Brown LL.

Department of Nutrition, Food and Exercise Sciences, Florida State

University,

Tallahassee, Florida 32306-1493, USA. jrankins@...

This article presents results of a community-based participatory

study (DASH of

Soul) designed to produce soul food that meets the nutrient criteria

of the DASH

diet plan. DASH of Soul was tested during a 10-month period with two

sub-groups

of low-income African American women: (1) a focus group cooking club

recruited

from among " early adopters " of a previous intervention; and (2) a

broader peer

group dinner club recruited through a health center serving the

neighborhood of

the focus group. Methods for the cooking club included 10 filmed

cooking labs to:

(a) modify traditional soul food (MSF) to reduce food energy, total fat,

saturated fat, sugar, and sodium; ( evaluate and improve upon sensory

acceptability; © integrate acceptable MSF into the DASH diet plan

(MS-DASH);

(d) produce VHS- and DVD-formatted MS-DASH cooking shows. Methods for

the dinner

club included monthly participation in weekly promotional dinner

meetings that

featured the cooking show and a different DASH food group each month

for 8

months. Based on computer software analysis, the nutrient composition

of a sample

MS-DASH menu developed by the cooking club was consistent with

nutrient levels

for the DASH diet plan. The authors concluded from the focus group

interviews and

intercept surveys that, with continued motivation, the potential is

good for the

study population to make MS-DASH a lifestyle choice, reducing their

risks for

diet-related diseases that cluster to comprise metabolic syndrome.

Publication Types:

Research Support, Non-U.S. Gov't

PMID: 17987695 [PubMed - indexed for MEDLINE]

6: J Am Diet Assoc. 2007 Sep;107(9):1530-8.

Acceptability of sodium-reduced research diets, including the Dietary

Approaches

To Stop Hypertension diet, among adults with prehypertension and stage 1

hypertension.

Karanja N, Lancaster KJ, Vollmer WM, Lin PH, Most MM, Ard JD, Swain

JF, Sacks FM,

Obarzanek E.

Kaiser Permanente Center for Health Research, Portland, OR, USA.

OBJECTIVE: Examine the acceptability of sodium-reduced research

diets. DESIGN:

Randomized crossover trial of three sodium levels for 30 days each among

participants randomly assigned to one of two dietary patterns.

PARTICIPANTS/SETTING: Three hundred fifty-four adults with

prehypertension or

stage 1 hypertension who were participants in the Dietary Approaches

to Stop

Hypertension (DASH-Sodium) outpatient feeding trial. INTERVENTION:

Participants

received their assigned diet (control or DASH, rich in fruits,

vegetables, and

low-fat dairy products), each at three levels of sodium (higher,

intermediate,

and lower) corresponding to 3,500, 2,300, and 1,200 mg/day (150, 100,

and 50

mmol/day) per 2,100 kcal. MAIN OUTCOME MEASURES: Nine-item

questionnaire on

liking and willingness to continue the assigned diet and its level of

saltiness

using a nine-point scale, ranging from one to nine. STATISTICAL ANALYSES

PERFORMED: Generalized estimating equations to test participant

ratings as a

function of sodium level and diet while adjusting for site, feeding

cohort,

carryover effects, and ratings during run-in. RESULTS: Overall,

participants

rated the saltiness of the intermediate level sodium as most

acceptable (DASH

group: 5.5 for intermediate vs 4.5 and 4.4 for higher and lower

sodium; control

group: 5.7 for intermediate vs 4.9 and 4.7 for higher and lower

sodium) and rated

liking and willing to continue the DASH diet more than the control

diet by about

one point (ratings range from 5.6 to 6.6 for DASH diet and 5.2 to 6.1

for control

diet). Small race differences were observed in sodium and diet

acceptability.

CONCLUSIONS: Both the intermediate and lower sodium levels of each

diet are at

least as acceptable as the higher sodium level in persons with or at

risk for

hypertension.

Publication Types:

Randomized Controlled Trial

Research Support, N.I.H., Extramural

Research Support, Non-U.S. Gov't

PMID: 17761230 [PubMed - indexed for MEDLINE]

7: Am J Cardiol. 2007 Jul 1;100(1):73-5. Epub 2007 May 11.

Effect of onsite dietitian counseling on weight loss and lipid levels

in an

outpatient physician office.

Welty FK, Nasca MM, Lew NS, Gregoire S, Ruan Y.

Division of Cardiology, Beth Israel Deaconess Medical Center, Boston,

Massachusetts, USA. fwelty@...

We examined the effect of an outpatient office-based diet and

exercise counseling

program on weight loss and lipid levels with an onsite dietitian who

sees

patients at the same visit with the physician and is fully

reimbursable. Eighty

overweight or obese patients (average age 55 +/- 12 years, baseline

body mass

index 30.1 +/- 6.4 kg/m(2)) with > or =1 cardiovascular risk factor

(86%) or

coronary heart disease (14%) were counseled to exercise 30 minutes/

day and eat a

modified Dietary Approaches to Stop Hypertension (DASH) diet

(saturated fat <7%,

polyunsaturated fat to 10%, monounsaturated fat to 18%, low in

glycemic index and

sodium and high in fiber, low-fat dairy products, fruits, and

vegetables).

Weight, body mass index, lipid levels, and blood pressure were

measured at 1

concurrent follow-up visit with the dietitian and physician and > or =1

additional follow-up with the physician. Maximum weight lost was an

average of

5.6% (10.8 lb) at a mean follow-up of 1.75 years. Sixty-four (81%) of

these

patients maintained significant weight loss (average weight loss

5.3%) at a mean

follow-up of 2.6 years. Average decrease in low-density lipoprotein

cholesterol

was 9.3%, average decrease in triglycerides was 34%, and average

increase in

high-density lipoprotein cholesterol was 9.6%. Systolic blood

pressure was

lowered from 129 to 126 mm Hg (p = 0.21) and diastolic blood pressure

from 79 to

75 mm Hg (p = 0.003). In conclusion, having a dietitian counsel patients

concurrently with a physician in the outpatient setting is effective

in achieving

and maintaining weight loss and is fully reimbursable.

Publication Types:

Clinical Trial

PMID: 17599444 [PubMed - indexed for MEDLINE]

8: J Ren Nutr. 2007 May;17(3):218-9.

Notes from the CKD kitchen: a variety of salt-free seasonings.

Sunwold D.

Spokane Community College, Spokane, Washington, USA.

dsunwold@...

<dsunwold@...>

One of the challenges with renal diets is how to make flavorful food

while

maintaining the low sodium restrictions. I have found three spice

companies that

have created seasoning mixtures using a mixture of herbs that do not

add sodium

or potassium chloride in their flavors. The recipe Ginger Roasted

Chicken with an

Asian Slaw is an example of how you can use three different salt-free

seasonings

to create a flavorful meal. I know from personal experience that I

feel better,

have more energy, and sleep better if I restrict my sodium intake. It

is easy to

stop using the salt shaker and replace the garlic salt and onion salt

with garlic

powder and onion powder in the kitchen. It takes a dedicated shopper

to find the

hidden sodium in foods. I find myself reading more and more labels in

the aisles

of the grocery store before I put any foods in my grocery cart. I

also find

myself studying the spice selections looking for salt-free

seasonings. Mrs. Dash

is great and very popular, but there must be more options for us

patients with

chronic kidney disease. After doing some culinary research, I was

pleased to find

a much larger section of salt-free seasonings than I expected. I have

listed a

few of the seasoning combinations below and a table of three major spice

companies along with their contact information for purchasing their

products.

PMID: 17462555 [PubMed - indexed for MEDLINE]

9: Med Clin (Barc). 2006 Nov 4;127(17):673-5.

[Dietary salt in the era of antihypertensive drugs]

[Article in Spanish]

de D, Aller R, Zarzuelo S.

Sección de Endocrinología y Nutrición Clínica, Unidad de Apoyo a la

Investigación, Hospital Universitario Río Hortega, Instituto de

Endocrinología y

Nutrición Clínica, Facultad de Medicina de Valladolid, Valladolid,

España.

dadluis@...

Hypertension has a high prevalence and worldwide distribution,

secondary to

economics, social, cultural and ethnics factors. The prevalence

increases with

the age, over 50 year a 50% of the population has hypertension. No

pharmacological approach is an important device in the treatment of

these

patients, salt restriction is one of the main dietary treatment. A

lot of studies

and designs have been realized in this topic area with controversial

results. In

summary, restriction in salt intake improves blood pressure (BP).

However, other

nutritional interventions such as DASH diet (Dietary Approaches to Stop

Hypertension) have been usefull. This diet is low in saturated fat,

total fat and

cholesterol, and it has high levels of fruit, vegetable, pulses and

semiskimmed

dairy products. In a recent metaanalysis, it has been demonstrated the

improvement in BP with different interventions: aerobic exercise, 4.6

mmHg,

reducing alcohol intake, 3.8 mmHg, decreasing salt intake, 3.6 mmHg

and using

supplements of fish oil, 2.3 mmHg. In conclusion, restriction in salt

intake is

important in the prevention and treatment of hypertension. However

this treatment

has another piece in the integral approach of this entity with weight

reduction

programs, suppression of coffe, alcohol and smoking habit, and a

right source and

type of fats.

Publication Types:

English Abstract

Review

PMID: 17169287 [PubMed - indexed for MEDLINE]

10: Curr Atheroscler Rep. 2006 Nov;8(6):460-5.

The effects of macronutrients on blood pressure and lipids: an

overview of the

DASH and OmniHeart trials.

ER 3rd, Erlinger TP, Appel LJ.

National Institute on Aging, National Institutes of Health, 3001

South Hanover

Street, 5th Floor, Room NM-530, Baltimore, MD 21225, USA.

milleredg@...

Macronutrients are those nutrients (protein, fat, and carbohydrate)

that provide

energy. The purpose of this review is to highlight findings of three

large-scale,

isocaloric feeding studies: the Dietary Approaches to Stop

Hypertension (DASH)

trial, the DASH-Sodium trial, and the Optimal Macro-Nutrient Intake

to Prevent

Heart Disease (OmniHeart) trial. Each of these trials tested the

effects of diets

with different macronutrient profiles on traditional cardiovascular

disease (CVD)

risk factors (ie, blood pressure and blood lipids) in the setting of

stable

weight. The DASH and DASH-sodium trials demonstrated that a

carbohydrate-rich

diet that emphasizes fruits, vegetables, and low-fat dairy products

and that is

reduced in saturated fat, total fat, and cholesterol substantially

lowered blood

pressure and low-density lipoprotein cholesterol. OmniHeart

demonstrated that

partial replacement of carbohydrate with either protein (about half

from plant

sources) or with unsaturated fat (mostly monounsaturated fat) can

further reduce

blood pressure, low-density lipoprotein cholesterol, and coronary

heart disease

risk. Results from these trials highlight the importance of

macronutrients as a

determinant of CVD risk. Furthermore, these results also document

substantial

flexibility that should enhance the ability of individuals to consume a

heart-healthy diet.

Publication Types:

Review

PMID: 17045071 [PubMed - indexed for MEDLINE]

11: Presse Med. 2006 Jun;35(6 Pt 2):1077-80.

[Nutritional aspects of hypertension]

[Article in French]

Paillard F.

Centre de Prévention Cardiovasculaire, Département de Cardiologie,

CHU de Rennes.

francois.paillard@...

Nutritional factors may explain 30-75% of cases of hypertension,

depending on the

population. Overweight alone can explain 11-25%. Nutritional measures

are

effective in reducing blood pressure or delaying the onset of

hypertension.

Globally, their impact is close to that of antihypertensive treatment

with a

single drug and they potentiate the drug's efficacy. The Dash diet, in

particular, has been shown to be effective in lowering blood

pressure. It is low

in saturated fat and sodium, rich in fruit, vegetables and nonfat

dairy products.

Publication Types:

English Abstract

Review

PMID: 16783276 [PubMed - indexed for MEDLINE]

12: Curr Atheroscler Rep. 2005 Nov;7(6):446-54.

Influence of the DASH diet and other low-fat, high-carbohydrate diets

on blood

pressure.

Delichatsios HK, Welty FK.

Division of Cardiology, Beth Israel Deaconess Medical Center, Boston,

MA 02215,

USA.

The Dietary Approaches to Stop Hypertension (DASH) and DASH-sodium

trials were

controlled feeding dietary trials that lowered blood pressure in the

absence of

weight loss. The beneficial aspect of DASH appears to be the low

saturated fat

content (< 7%). Sodium restriction added additional blood pressure

lowering to

the low saturated fat DASH diet. Sodium restriction was more

effective with

increasing age and more effective than increasing fruit and vegetable

content.

When achievement of sodium restriction, exercise, and weight loss

goals were

reached in the outpatient setting with subjects making their own food

choices (as

in the PREMIER study), adding the DASH diet with an average fruit and

vegetable

intake of 7.8 servings daily had no additional benefit in those

younger than 50

years of age or in ethnic/gender subgroups, but did have a benefit

for the total

group older than age 50 years. Because many hypertensive subjects are

overweight,

hypocaloric versions of DASH geared toward weight loss are appropriate.

Mechanisms for dietary beneficial effects are related to inflammation

and insulin

sensitivity.

Publication Types:

Comparative Study

Review

PMID: 16256002 [PubMed - indexed for MEDLINE]

13: J Nutr Educ Behav. 2005 Sep-Oct;37(5):259-64.

Dietary Approaches to Stop Hypertension (DASH) intervention reduces

blood

pressure among hypertensive African American patients in a

neighborhood health

care center.

Rankins J, Sampson W, Brown B, -Salley T.

Department of Nutrition, Food and Exercise Sciences, Florida State

University,

Tallahassee, Florida, USA. jrankins@...

The purpose of this study was to pilot-test DASH-Dinner with Your

Nutritionist, a

university-neighborhood health care center intervention to promote

the Dietary

Approaches to Stop Hypertension (DASH) diet. Study participants were

low-income

African American adults (N = 82) with poorly controlled blood

pressure. Six

groups, each consisting of 12 to 15 participants taking antihypertensive

medications, met for 1 to 2 hours per week for 8 weeks. The

intervention followed

constructs of Social Cognitive Theory and featured dinners based on

the DASH diet

plan. Blood pressure was significantly lowered (P < .05) among

participants who

missed no more than 2 of 8 sessions. Extension of the DASH-Dinner

model could

improve blood pressure control among low-income hypertensive African

Americans

and reduce health disparities.

Publication Types:

Research Support, Non-U.S. Gov't

PMID: 16053815 [PubMed - indexed for MEDLINE]

14: Cleve Clin J Med. 2004 Sep;71(9):745-53.

Comment in:

Cleve Clin J Med. 2004 Sep;71(9):682. Cleve Clin J Med. 2004

Sep;71(9):755-6.

The DASH diet for high blood pressure: from clinical trial to dinner

table.

Karanja N, Erlinger TP, Pao-Hwa L, ER 3rd, Bray GA.

Kaiser Permanente Center for Health Research, Portland, OR 97227, USA.

njeri.karanja@...

Three recent studies show that a diet rich in fruits, vegetables,

whole grains,

and lowfat dairy products and low in fat, refined carbohydrates, and

sodium can

lower blood pressure either alone or in combination with other

lifestyle changes.

These studies have greatly expanded our knowledge of nonpharmacologic

interventions to prevent and manage hypertension. They also

underscore the need

for diet and lifestyle counseling in the primary care setting.

Publication Types:

Research Support, U.S. Gov't, P.H.S.

Review

PMID: 15478706 [PubMed - indexed for MEDLINE]

15: J Nutr. 2004 Sep;134(9):2322-9.

Blood pressure response to dietary modifications in free-living

individuals.

Nowson CA, Worsley A, Margerison C, Jorna MK, Frame AG, SJ,

Godfrey SJ.

Centre for Physical Activity and Nutrition, School of Health

Sciences, Deakin

University, Burwood, Australia. nowson@...

A diet rich in fruits, vegetables, and low-fat dairy foods has been

shown to

lower blood pressure (BP) when all foods are provided. We compared

the effect on

BP (measured at home) of 2 different self-selected diets: a low-sodium,

high-potassium diet, rich in fruit and vegetables (LNAHK) and a high-

calcium diet

rich in low-fat dairy foods (HC) with a moderate-sodium, high-potassium,

high-calcium DASH-type diet, high in fruits, vegetables and low-fat

dairy foods

(OD). Subjects were randomly allocated to 2 test diets for 4 wk, the

OD and

either LNAHK or HC diet, each preceded by a 2 wk control diet (CD).

The changes

in BP between the preceding CD period and the test diet period (LNAHK

or HC) were

compared with the change between the CD and the OD periods. Of the 56

men and 38

women that completed the OD period, 43 completed the LNAHK diet

period and 48 the

HC diet period. The mean age was 55.6 +/- 9.9 (+/-SD) years. There

was a fall in

systolic pressure between and the CD and OD [-1.8 +/- 0.5 mm Hg (P <

0.001)].

Compared with OD, systolic and diastolic BPs fell during the LNAHK

diet period

[-3.5 +/- 1.0 (P < 0.001) and -1.9 +/- 0.7 (P < 0.05) mmHg,

respectively] and

increased during the HC diet period [+3.1 +/- 0.9 (P < 0.01) and +0.8

+/- 0.6 (P

= 0.15) mm Hg, respectively]. A self-selected low-sodium, high-

potassium diet

resulted in a greater fall in BP than a multifaceted OD, confirming the

beneficial effect of dietary intervention on BP in a community setting.

Publication Types:

Clinical Trial

Randomized Controlled Trial

Research Support, Non-U.S. Gov't

PMID: 15333723 [PubMed - indexed for MEDLINE]

16: Am J Cardiol. 2004 Jul 15;94(2):222-7.

A further subgroup analysis of the effects of the DASH diet and three

dietary

sodium levels on blood pressure: results of the DASH-Sodium Trial.

Bray GA, Vollmer WM, Sacks FM, Obarzanek E, Svetkey LP, Appel LJ; DASH

Collaborative Research Group.

Pennington Biomedical Research Center, Baton Rouge, Lousiana, USA.

brayga@...

This study presents an extensive analysis of the effects on blood

pressure (BP)

of changes in sodium intake over a wide array of subgroups, including

joint

subgroups defined by age and hypertension status, race or ethnicity and

hypertension status, and gender and race or ethnicity. Participants

were given 3

levels of sodium (50, 100, and 150 mmol/2,100 kcal) for 30 days while

consuming

the Dietary Approaches to Stop Hypertension (DASH) diet (rich in fruits,

vegetables, and low-fat dairy) or a more typical American diet.

Within each diet

and subgroup, there was a general pattern such that the lower the

sodium level,

the greater the mean reduction in BP. Sodium reduction from 100 to 50

mmol/2,100

kcal generally had twice the effect on BP as reduction from 150 to

100 mmol/2,100

kcal. Age had a strong and graded influence on the effect of sodium

within the

typical and DASH diets, respectively: -4.8 and -1.0 mm Hg systolic

for 23 to 41

years, -5.9 and -1.8 mm Hg for 42 to 47 years, -7.5 and -4.3 mm Hg

for 48 to 54

years, and -8.1 and -6.0 mm Hg for 55 to 76 years. The influence of

age on the

effect of sodium reduction was particularly strong in nonhypertensive

patients:

-3.7 mm Hg systolic for <45 years and -7.0 mm Hg for >45 years with

the typical

diet and -0.7 and -2.8 mm Hg with the DASH diet. Reduced sodium

intake and the

DASH diet should be advocated for the prevention and treatment of

high BP,

particularly because the benefits to BP strengthen as subjects enter

middle age,

when the rate of cardiovascular disease increases sharply.

Publication Types:

Clinical Trial

Controlled Clinical Trial

Research Support, U.S. Gov't, P.H.S.

PMID: 15246908 [PubMed - indexed for MEDLINE]

17: Asia Pac J Clin Nutr. 2003;12 Suppl:S19.

Dietary approaches to reduce blood pressure in a community setting: a

randomised

crossover study.

Nowson CA, Worsley T, Margerison C, Jorna MK, Frame AG, SJ,

Godfrey SG.

School of Health Sciences, Deakin University, Burwood, VIC, 3215.

Objective - A diet combining increased fruits, vegetables, low-fat

dairy foods,

fish and nuts etc (DASH) has been shown to lower blood pressure (BP) in

controlled intervention studies with all food provided. The aim of

this study was

to determine the effect on BP of three different self-selected diets:

a " DASH "

type diet high in fruit, vegetables and low-fat dairy foods (OD), a

high dairy

diet (HID) and a low sodium, high potassium diet (LNAHIK). Design -

Ninety-four

subjects (56 men and 38 women, 55 normotensives (with BP >or =120/80

mmHg), 39

hypertensives (on anti-hypertensive therapy)) following a one-week

run-in period,

completed a 12-week study, which consisted of a two-week control

diet, after

which subjects were randomised to one of the diets for four weeks

followed by a

second control diet phase, which was followed by the second diet. All

subjects

completed the OD diet. Home BP was measured daily for the last two

weeks in each

phase. Results - Ninety-four subjects completed the OD diet, 43 the

LNAHIK diet

and 48 the HID diet. The mean age was 55.6 (9.9) years and run-in

home BP (mean

(SD)) was 129 (11.3) / 80.6(8.6)mmHg. The changes (mean +/-SEM) in BP

between the

control diet and dietary phases were: OD: -1.8 +/-0.5/ -0.4 +/- 0.3 mmHg

(P<0.001, ns respectively); LNAHIK: -4.4 +/-0.8/-2.0 +/- 0.6 mmHg

(both P<0.001);

HID +0.6 +/-0.4/ +0.3 +/-0.3 (both ns). Urinary sodium (24-hour) fell

in OD by

33.0 +/-7.4 mmol/day and by 73.4 +/-10.1 mmol/day in the LNAHIK diet

(both

P<0.001).Conclusions - In a community setting, a LNAHIK diet resulted

in a

greater fall in blood pressure than a self-selected DASH type diet

and confirms

the positive effect of reducing Na and increasing K on blood pressure.

Publication Types:

Clinical Trial

Randomized Controlled Trial

PMID: 15023613 [PubMed - in process]

18: Climacteric. 2003 Oct;6 Suppl 3:36-48.

Potassium: more beneficial effects.

He FJ, MacGregor GA.

Blood Pressure Unit, St. 's Hospital Medical School, London, UK.

Over 70 years ago, potassium was found to have a natriuretic effect

and was used

in patients with heart failure. However, it took many years for its

role in the

control of blood pressure to be recognized. Recently, epidemiological

and

clinical studies in man and experimental studies in animals have

shown that

increasing potassium intake towers blood pressure and that

communities with a

high potassium intake tend to have lower population blood pressures.

Several

studies have shown an interaction between salt intake and potassium

intake.

However, the recent DASH-Sodium (Dietary Approaches to Stop

Hypertension) study

demonstrates an additive effect of a low salt and high potassium diet

on blood

pressure. Increasing potassium intake may have other beneficial

effects, for

example, reducing the risk of stroke and preventing the development

of renal

disease independent of its effect on blood pressure. A high potassium

intake

reduces calcium excretion and could play an important role in the

management of

hypercalciuria and kidney stone formation, as well as bone

demineralization.

Potassium intake may also play an important role in carbohydrate

intolerance. A

reduced serum potassium increases the risk of lethal ventricular

arrhythmias in

those at risk, i.e. patients with ischemic heart disease, heart

failure or left

ventricular hypertrophy, and increasing potassium intake may prevent

this. In

this article, we address the evidence for the important role of

potassium intake

in regulating blood pressure and other beneficial effects of

potassium which may

be independent of and additional to its effect on blood pressure.

Publication Types:

Review

PMID: 15018247 [PubMed - indexed for MEDLINE]

19: Diabetes Care. 2004 Feb;27(2):340-7.

The effect of the PREMIER interventions on insulin sensitivity.

Ard JD, Grambow SC, Liu D, Slentz CA, Kraus WE, Svetkey LP; PREMIER

study.

Duke Hypertension Center, Duke University Medical Center, and Center

for Health

Services Research in Primary Care, VA Medical Center, Durham, North

Carolina,

USA. jamy.ard@...

OBJECTIVE: This ancillary study of PREMIER sought to determine the

effects on

insulin sensitivity of a comprehensive behavioral intervention for

hypertension

with and without the Dietary Approaches to Stop Hypertension (DASH)

dietary

pattern. RESEARCH DESIGN AND METHODS: Participants were assigned to

one of three

nonpharmacologic interventions for blood pressure (group A, advice

only; group B,

established; and group C, established plus DASH). The established

intervention

included weight loss, reduced sodium intake, increased physical

activity, and

moderate alcohol intake; the DASH dietary pattern was added to the

established

intervention for those in group C. The DASH dietary pattern is high

in fruits,

vegetables, and low-fat dairy products while being lower in total

fat, saturated

fat, and cholesterol. It is abundant in nutrients such as magnesium,

calcium, and

protein, which have been associated with improved insulin

sensitivity. Insulin

sensitivity was measured at baseline and at 6 months using the

frequently sampled

intravenous glucose tolerance test with minimal model analysis.

RESULTS: Both

intervention groups decreased total calories, percentage of calories

from fat,

and sodium intake to similar levels, with similar amounts of energy

expenditure

and weight loss. Covariate differences seen only in group C included

increased

intake of protein, potassium, calcium, and magnesium. Compared with

control

subjects, insulin sensitivity improved significantly only in group C,

from 1.96

to 2.95 (P = 0.047). Group B did have a significant decrease in

fasting insulin

and glucose, but the changes in insulin sensitivity did not reach

statistical

significance when compared with control subjects. CONCLUSIONS: These

results

suggest that including the DASH dietary pattern as part of a

comprehensive

intervention for blood pressure control enhances insulin action

beyond the

effects of a comprehensive intervention that does not include DASH.

Publication Types:

Multicenter Study

PMID: 14747211 [PubMed - indexed for MEDLINE]

20: Hypertension. 2004 Feb;43(2):393-8. Epub 2004 Jan 5.

Effect of dietary sodium intake on blood lipids: results from the

DASH-sodium

trial.

Harsha DW, Sacks FM, Obarzanek E, Svetkey LP, Lin PH, Bray GA, Aickin

M, Conlin

PR, ER 3rd, Appel LJ.

Pennington Biomedical Research Center, Baton Rouge, La, USA.

We evaluated the effect on serum lipids of sodium intake in 2 diets.

Participants

were randomly assigned to a typical American control diet or the Dietary

Approaches to Stop Hypertension (DASH) diet, each prepared with 3

levels of

sodium (targeted at 50, 100, and 150 mmol/d per 2100 kcal). The DASH

diet is

increased in fruits, vegetables, and low-fat dairy products and is

reduced in

saturated and total fat. Within assigned diet, participants ate each

sodium level

for 30 days. The order of sodium intake was random. Participants were

390 adults,

age 22 years or older, with blood pressure of 120 to 159 mm Hg

systolic and 80 to

95 mm Hg diastolic. Serum lipids were measured at baseline and at the

end of each

sodium period. Within each diet, sodium intake did not significantly

affect serum

total cholesterol, LDL cholesterol, HDL cholesterol, or

triglycerides. On the

control diet, the ratio of total cholesterol-to-HDL cholesterol

increased by 2%

from 4.53 on higher sodium to 4.63 on lower sodium intake (P=0.04).

On the DASH

diet, sodium intake did not affect this ratio. There was no dose-

response of

sodium intake on serum lipids or the cholesterol ratio in either

diet. At each

sodium level, total cholesterol, LDL cholesterol, and HDL cholesterol

were lower

on the DASH diet versus the typical American diet. There were no

significant

interactions between the effects of sodium and the DASH diet on serum

lipids. In

conclusion, changes in dietary sodium intake over the range of 50 to

150 mmol/d

did not affect blood lipid concentrations.

Publication Types:

Clinical Trial

Multicenter Study

Randomized Controlled Trial

Research Support, U.S. Gov't, P.H.S.

PMID: 14707154 [PubMed - indexed for MEDLINE]

On Jun 14, 2008, at 1:06 PM, odile debargue wrote:

> thanks i will talk to them about this i already give them your

> article so they know about .

>

> sorry for my english but what i wanted to mean if the fact i dont

> care if it is rare i would like them to understand what i feel and

> not look at me as a crazy man

>

> thanks a lot

> Olivier

>

> --- En date de : Sam 14.6.08, Clarence Grim <lowerbp2@...> a

> écrit :

> De: Clarence Grim <lowerbp2@...>

> Objet: Re: olivier and some crisis

> À: hyperaldosteronism

> Date: Samedi 14 Juin 2008, 19h49

>

> May your pressure be low!

>

> CE Grim MS, MD

>

> High Blood Pressure Consulting

>

> Clinical Professor of Medicine Medical College of Wisconsin

>

> Board certified in Internal Med, Geriatrics and Hypertension.

>

> Interests: The effect of recent evolutionary forces on high blood

>

> pressure in human populations.

>

> On Jun 14, 2008, at 12:07 PM, odile debargue wrote:

>

> > more wavy lines and very high light sensibilty not able to see a tv

>

> > screen and i don t feel it like a migraine .

>

> > Migraine i had before was more hurting me now it is like i am in a

>

> > cloud and any noise any light any question asked to me is a worry

>

> > last friday i had to ask help to come back home by car.

>

> > The things who makes me the more afraid is this lose in vision

> acuity.

>

> This is almost certainly a migraine attach or equivalent. In many

>

> with PA this will get better with Aldact (spiro).

>

> Would talk to your medical team about a couple of possibilities:

>

> increaseing atentolol as it may improve migrainine and BP both.

>

> Stopping furosimide and increasing Aldactone. Furo will cause low K

>

> even on aldact and might be related to the attacks.

>

> >

>

> >

>

> > yes i have been tested for this and it is negatif.

>

> > medecine i take aldactone (75 mg) rimenidine 2mg iperten

>

> > (cholirydrate de manidipine) 20 mg atenolol 50 mg firosemide 40 mg

>

> >

>

> > sadly i asked my doctors what to do when i have these " crisis " and

>

> > i have a blank as answer and they say me that i have to undrstand

>

> > that what i have is very rare wich is not so important in my view .

>

> Whoa--you are the one having this " rare disease " and it is important

>

> in you! unless I misunderstand your English.

>

> You should be tested for a pheo sometime. The only way to Dx this is

>

> to test for it. Most with this adrenal problem have episodes of

>

> severe pounding headaches, spikes in BP, sweating. One of the pts I

>

> have cured of this said her headaches were so bad she wanted to go to

>

> the basement and get a drill and drill a hole in her head and let the

>

> pressure out.

>

> >

>

> >

>

> > thanks

>

> > Olivier

>

>

[Guest guest]

suspect you are having migraine headaches. Can you tell when one is

coming on? Flashes of lights or wavy lines in vision?

What meds are you taking as in some they may cause headaches.

Ask if you have been tested for a pheochromocytoma.

If not you should be tested.

May your pressure be low!

CE Grim MS, MD

High Blood Pressure Consulting

Clinical Professor of Medicine Medical College of Wisconsin

Board certified in Internal Med, Geriatrics and Hypertension.

Interests: The effect of recent evolutionary forces on high blood

pressure in human populations.

On Jun 14, 2008, at 1:39 AM, odile debargue wrote:

> hello everybody,

>

> I discover something interesting and the doctors are very intersted

> with it seems that my desease comes some times with crisis :

> -eyes cry and no more good visions (i had never any problem with

> this before)

> -headache (to the point i have to go away from my children and i am

> unable to answer to anybody)

> -sweating (th bed is wet ..)

> -any light is becoming a problem and i have to close my eyes

> -my BP is going up at this time (no salt diet and high k for 2 months)

> -anxious am i anxious because of this or to be anxious is part of

> it this i can t say

>

> this can stay fot some hours or many days last week i had it for 4

> days and it disappears.

>

> it looks like the BP is only a symptom but in fact the problem is

> bigger

> did anyone feel the samethings .

> Doctors begins to look at me strangely and this make me afraid,

>

> regards

> Olivier

>

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