Tag Archives: hypertension
FDA Issues Guidance on Dietary Salt
Written by Neil Kurtzman | 14th October 2021The FDA has issued guidance about dietary salt intake. Their advice needs to be taken with a grain of salt – sorry, I couldn’t resist. The summary below conveys their intent and message. The whole report is below and can be downloaded. This guidance supports the goal of reducing sodium intake as recommended by scientific…
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Salt and Cardiovascular Disease
Written by Neil Kurtzman | 19th September 2021We’ve known for a long time that some people are salt sensitive – ie, when salt is ingested in amounts greater than required to maintain homeostasis blood pressure rises as does the likelihood of stroke and other cardiovascular diseases. The remainder of humanity can safely ingest large amounts of salt without hypertension and its associated…
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A Brief History of the Renin-Angiotensin System
Written by Neil Kurtzman | 29th December 2018If you’re here for the music you still might give this piece a glance. It’s on a subject of immense clinical importance that I’ve tried to present in a fashion accessible to layman while still having some content that might interest physicians. Some of the greatest work in medical pathophysiology has contributed to our current…
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The Salinity Obsession
Written by Neil Kurtzman | 13th March 2018Many physicians and those charged with regulating the nation’s health have been obsessed with salt since Lot’s wife was transformed into a pillar of the stuff. On March 7, 2018 the JAMA published online a well performed study of sodium intake, the investigators used 24 hour urinary sodium excretion as a marker of intake, which documents…
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Salt Intake in Chronic Kidney Diease
Written by Neil Kurtzman | 24th January 2017How much salt people should eat continues to be a murky issue. A paper in the February 2017 issue of the American Journal of Kidney Diseases examines the issue of salt (actually sodium) intake on the prevention of cardiovascular disease in patients with chronic kidney diseases (CKD) stages 2-4. It is a commentary on an…
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Salt and More Salt
Written by Neil Kurtzman | 3rd September 2014The August 14, 2014 issue of the New England Journal of Medicine contains three papers on salt intake and health. The third of these is so layered with assumptions that I won’t discuss it. I have previously written about recommendations for optimum dietary intake of salt. In 2011 the American Society of Nephrology endorsed guidelines…
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More on Diabetes and Tight Blood Pressure Control
Written by Neil Kurtzman | 12th July 2010In May I commented on a study in the New England Journal of Medicine that failed to show a benefit in lowering systolic blood pressure below 130 mm Hg. Well, now there’s another such study. This one is in the Journal of the American Medical Association. “Patients were categorized into 3 groups by their average…
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Diabetes and Blood Pressure Control
Written by Neil Kurtzman | 7th May 2010It’s been standard clinical practice for some time to aim for a lower blood pressure in diabetic patients with hypertension compared to hypertensive patients with normal glucose metabolism. Like so much in medicine this approach was based on surmise rather than evidence. The thinking went along these lines. Diabetics are at greatly increased risk for…
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Dietary Salt Reduction and Cardiovascular Disease
Written by Neil Kurtzman | 12th February 2010A paper in the New England Journal of Medicine, Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease, concludes that “Modest reductions in dietary salt could substantially reduce cardiovascular events and medical costs and should be a public health target.” This conclusion is based on the use of a very complicated computer model of…
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Hypertension in the Very Old
Written by Neil Kurtzman | 17th April 2008Virtually all physicians treat their hypertensive patients who are 80 years old or more. The evidence for the effectiveness of this treatment in very old patients has up till now been lacking. The New England Journal of Medicine has published a paper, Treatment of Hypertension in Patients 80 Years of Age or Older, that shows…
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