In the 19th and 20th centuries, before effective pharmacological treatment for hypertension came about, the three main …show more content…
Their emphasis was on chloride. However, in reducing dietary chloride they were also restricting sodium, which is probably more important in hypertension control. Their observations preceded the use of diets extremely low in salt, which became popular in the 1940s. The success of these diets stimulated the development of the thiazide diuretics. Several investigators, such as Watkin and Murphy found that the rice diet of Kempner depended on severe sodium restriction to levels as low as 20 to 30 mEq/day. Moderate salt restriction was ineffective in these patients, possibly because they all had severe hypertension. Whether moderate restriction is effective in milder forms of hypertension remains a controversial question: some investigators claim that it is whereas others claim that it is not. Several investigators of the rice and fruit diet found that the marked sodium restriction leads to a fall in BP because it reduces the extracellular fluid and plasma volume . Extracellular fluid volume was reduced about 2 litres, and plasma volume was reduced by approximately 500 ml. Edward and Dustan independently found a similar reduction of plasma and extracellular fluid volumes during treatment with thiazide diuretics. This suggests that the antihypertensive mechanism in both of these interventions is probably volume-dependent. It also suggests that sodium deprivation will probably not be very …show more content…
Hence there was a lack of prevention for hypertension. Moreover the lack of awareness of the major impact that uncontrolled hypertension has on the development of severe heart problems like stroke and heart attacks is why I think the number of hypertension cases was high in the past. Here you can see that even if some old treatments were quite ineffective some of them like the low salt diet led to developments of new treatments like thiazide diuretics which are still used