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A pilot study of primary prevention of hypertension in China


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Liu, Su 1993 , 'A pilot study of primary prevention of hypertension in China', Unspecified thesis, University of Tasmania.

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In China stroke is now the leading cause of death. Because of the country's
huge population, the medical approach to hypertension is proving expensive. It
is also not very effective. Population-based primary prevention of hypertension
would be cheaper and probably more effective.
Based on the 1991 WHO/ISH statement on environmental factors and
hypertension, and the distribution of those factors in Chinese society, we assume
1. In the genesis of essential hypertension in Chinese society, a high sodium —
low potassium diet could be a fundamental environmental factor. Salt-induced
hypertension could be a crucial contributor to the total occurrence of essential
2. Reducing sodium intake, increasing potassium intake and reversing the
existing high Na/K ratio to a desirable level (i.e. Na/K 1.0) should greatly
assist in preventing essential hypertension in China.
This thesis describes a preliminary trial undertaken in 1991-92 to test the
feasibility of a proposed study in primary prevention of hypertension. Several
hypotheses were tested. It was thought that a salt-free diet would modify and
maintain users' urinary sodium and potassium excretion in the range of the
Recommended Dietary Intakes (RDI) (adjusted for body weight) and keep the
urinary Na/K ratio at 1.00. In areas prone to Iodine Deficiency Disorders (IDD)
iodised rice was expected to take the place of iodised salt. It was expected that
the new diet would cause no harmful physical and/or psychological problems and
would be accepted and maintained voluntarily by the users after the trial. A total
of 140 students aged 17-23 years joined the trial and 70 (about 20 females and 50
males) dropped out within the first month. The other 70 (26 females and 44
males) completed the trial. The trial procedures brought urinary sodium excretions down to the RDI for
Australia (adjusted for body weight). Urinary Na/K ratios were brought down
from 7.3 and maintained on about 1.3. Urinary iodine analyses showed the iodine
supplement to be effective. With potassium supplementation urinary potassium
excretions in the diet group were significantly higher than in the control group,
however the overall average level did not meet the adjusted RDI. The trial also
showed a gender difference in urinary electrolyte excretion opposite to that
previously reported (more sodium in females) and unreported side effects
including menstrual disorders and increased muscle cramping. The new diet was
not positively accepted by the majority of the diet group and was difficult to
In spite of dietary, managemental, cultural, and socio-economic difficulties,
the author believes that the application of sodium restriction and potassium
supplement to primary prevention of hypertension in Chinese society is a possible
strategy. However people's habits and tastes would prove severe obstacles
requiring the arts of persuasion.

Item Type: Thesis - Unspecified
Authors/Creators:Liu, Su
Keywords: Hypertension
Copyright Holders: The Author
Copyright Information:

Copyright 1993 the Author - The University is continuing to endeavour to trace the copyright
owner(s) and in the meantime this item has been reproduced here in good faith. We
would be pleased to hear from the copyright owner(s).

Additional Information:

Thesis (M.Med.Sc.)--University of Tasmania, 1994. Includes bibliographical references

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