Moderate sodium restriction, angiotensin converting enzyme inhibition, and thiazide diuretic in the management of essential hypertension

Abstract

Dietary sodium restriction alone is effective in lowering blood pressure in some, but not all, patients with essential hypertension. Homeostatic mechanisms, including activation of the renin-aldosterone system, may counteract the effects of sodium restriction. Angiotensin converting enzyme (ACE) inhibitors are also effective as sole therapy in many patients with essential hypertension, but may be less effective in those with low-renin hypertension. The combination of dietary sodium restriction with blockade of the renin system by an ACE inhibitor is a particularly effective way to improve blood pressure control. Addition of a thiazide diuretic will reduce pressure further.