Hypertension.

Salt Restriction

The low-salt, low-fat DASH diet failed to remedy the blunting of the nocturnal decline in blood pressure that has been observed in blacks, Dr. Lawrence J. Appel reported at the annual conference of the American Heart Association's Council for High Blood Pressure Research.

Sustained nocturnal blood pressure levels explain in part why blacks carry an excess burden of cardiovascular disease, said Dr. Appel of Johns Hopkins University in Baltimore.

Most studies of blacks' blunted nighttime drop in blood pressure haven't adequately controlled for diet, weight, level of physical activity, and socioeconomic status. In contrast, his analysis of data from the Dietary Approaches to Stop Hypertension (DASH) study did control for these factors, Dr. Appel said in a poster presentation.

When 198 black and 156 nonblack subjects (mean 131/85 mm Hg in both groups) adhered to the same salt-restricted DASH diet for 3 weeks, only the black subjects showed a blunted nocturnal decline in blood pressure. Nocturnal blood pressure dipped normally in nonblack subjects who had the same blood pressure levels and had followed the same diet.

Calcium Channel Blockers

Long-acting calcium channel blockers are significantly less effective than other antihypertensive agents in reducing the disease's major cardiovascular complications, ...