DIETARY TREATMENT OF HYPERTENSION. CLINICAL AND METABOLIC STUDIES OF PATIENTS ON THE RICE-FRUIT DIET

Abstract

Of 6 patients with relatively uncomplicated hypertension, treated with Kempner''s rice-fruit diet during a 6-mo. residence on the metabolic ward, 5 showed significant reduction in mean blood pressures, associated decrease in heart sizes, improvement in fundi and return to normal of low or inverted T waves. Restriction of Na, but not of chloride, appeared to be necessary for the clinical effect. An investigation was made of the sufficiency of the diet for maintenance as shown by the attainment of steady weight, balance with respect to N, Na, K and chloride, and normal serum electrolyte concns. The 5 patients with normal renal function appeared to reach, or to approach closely, equilibrium with the diet. The 6th, who had impaired kidneys, achieved the first 2 of the criteria but probably became slowly depleted of body Na, despite apparent balance, since her serum concns. were reduced. With the added burden of NH4Cl admn. she developed severe dehydration and acidosis. Adaptation proceeded slowly. Three months were required for attainment of steady wt. by the smallest subjects and a little more than 5 mos. would have been required by the largest. Since the clinical benefit of the diet did not appear to be associated with depletion but, on the contrary, with successful adaptation, it was suggested that the therapeutic effect is a consequence of the steady state adaptive response to limitation of Na intake.