Effects of High- and Low-Sodium Diets on Ambulatory Blood Pressure in Patients With Hypertension Receiving Aliskiren

Dietary sodium reduction and, as necessary, pharmacologic treatment are recommended for hypertension management. This prospective, randomized, open-label, blinded-end point, multicenter, crossover study investigated the effect of dietary sodium intake on mean ambulatory systolic blood pressure (maSBP) in patients with hypertension receiving aliskiren 300 mg once daily Following a 2- to 4-week washout period, patients were randomized to a high- (>= 200 mmol/d) or low- (<= 100 mmol/d) sodium diet and were started on aliskiren, 300 mg/d After 4 weeks, patients were crossed over to the alternate diet for an additional 4 weeks The primary efficacy variable was change in maSBP between diets During treatment with aliskiren maSBP was significantly lower with the low-sodium diet compared with the high-sodium diet (least squares mean difference, 9 4 mm Hg 95% CI 7 5-11 4, P < 0001) The percentage of patients achieving a maSBP response to aliskiren (<130 mm Hg or a >= 20-mm Hg reduction from baseline) was greater with the low- (76 5%) versus the high-sodium diet (42 6%, P < 0001) Overall 40 9% patients had >= 1 adverse event and the rates were similar between groups In this study, aliskiren was well tolerated and a low-sodium diet accentuated its antihypertensive effect