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A 2020 Cochrane systematic review [75] concludes that for white people with hypertension, reducing salt intake results in a decrease of about 4 mmHg (about 3.5%) of their blood pressure; for people with normal blood pressure, the decrease was negligible. Weak evidence indicated that these effects might be a little greater in black and Asian people.
Hydrochlorothiazide is taken by mouth and may be combined with other blood pressure medications as a single pill to increase effectiveness. [4] Hydrochlorothiazide is a thiazide medication which inhibits reabsorption of sodium and chloride ions from the distal convoluted tubules of the kidneys, causing a natriuresis.
Saline (also known as saline solution) is a mixture of sodium chloride (salt) and water. [1] It has a number of uses in medicine including cleaning wounds, removal and storage of contact lenses, and help with dry eyes. [2] By injection into a vein, it is used to treat hypovolemia such as that from gastroenteritis and diabetic ketoacidosis.
Lifestyle changes, including reducing dietary salt, increasing exercise and losing weight can help to reduce blood pressure. [9] Thiazides and thiazide-like diuretics have been in constant use since their introduction in 1958. Decades as a cornerstone of hypertension treatment show how well these drugs perform for most patients. [10]
Loop diuretics are 90% bonded to proteins and are secreted into the proximal convoluted tubule through organic anion transporter 1 (OAT-1), OAT-2, and ABCC4.Loop diuretics act on the Na +-K +-2Cl − symporter (NKCC2) in the thick ascending limb of the loop of Henle to inhibit sodium, chloride and potassium reabsorption.
The well-known effect of sodium on blood pressure can be explained by comparing blood to a solution with its salinity changed by ingested salt. Artery walls are analogous to a selectively permeable membrane, and they allow solutes, including sodium and chloride, to pass through (or not), depending on osmosis. [9]
The choice between the drugs is to a large degree determined by the characteristics of the patient being prescribed for, the drugs' side effects, and cost. Most drugs have other uses; sometimes the presence of other symptoms can warrant the use of one particular antihypertensive. Examples include: Age can affect the choice of medications.
While reduction of sodium intake to less than 2,300 mg per day is recommended by developed countries, [6] one review recommended that sodium intake be reduced to at least 1,200 mg (contained in 3 g of salt) per day, as a further reduction in salt intake led to a greater fall in systolic blood pressure for all age groups and ethnicities. [68]
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