Treatment of hypertensive vascular disease with rice diet

Kempner, Walter

doi:10.1016/0002-9343(48)90441-0

Cited by 450 publications

(59 citation statements)

References 7 publications

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“…Although Tobian, Janecek, and Tomboulian (4) observed no significant increase in the incidence or severity of hypertension in rats with experimental renal hypertension drinking saline solution, the capacity of NaC1 to induce severe vascular disease in the rat is generally well established (8)(9)(10)(11)(12). This toxic effect of NaC1 on vascular structures may be related to Kempner's original observation that among patients with severe hypertension who were treated by the "rice diet," vascular retinopathy could improve markedly without significant change in blood pressure (13). We have confirmed this same phenomenon repeatedly over a period of 15 years, during which time hypertensive patients were cycled on diets high and low in sodium under controlled, metabolic ward conditions.…”

Section: Genetic ]~Actors In Experim2~ntal Hypertensionsupporting

confidence: 56%

Effects of Chronic Excess Salt Ingestion

Dahl

Heine

Tassinari

1963

The Journal of Experimental Medicine

104

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In an earlier study (1, 2) we reported that by using the technique of selective inbreeding~ two strains of rats were evolved which differed markedly in their tendency to develop hypertension from chronic excess salt ingestion: one population was predisposed to develop hypertension (the sensitive or S strain) from the same high salt intake that proved ineffective in producing hypertension in the other population (the resistant or R strain). It was concluded that generic factors played an important role in determining susceptibility to that form of experimental hypertension.Prior to working with these two strains of selectively inbred rats, over a period of about 15 years we had observed the response of hundreds of stock animals to a chronically high sodium intake and had found that only about three-fourths of such animals would develop varying degrees of hypertension. Our experience with a combination of desoxycorticosterone acetate and a high sodium chloride intake (DOCA-salt) was similar. We were intrigued to learn that other investigators had found unilateral renal artery compression in the rat gave roughly similar results, namely ~only about half to two-thirds of animals so treated developed hypertension (3, 4). These several experiences suggested that variations in genetic susceptibility were operating in experimental hypeffension induced by either renal artery compression or DOCA-salt, just as we had observed in that from salt alone.The present paper is a report of experiments which demonstrate that this is true. Depending upon whether animals were derived from the sensitive or resistant strain of rats, susceptibility to experimental hypertension induced by either unilateral renal artery compression or DOCA-salt was found to be significantly different. Thus, variations in genetic substrate clearly influence the development of at least 3 "varieties" of experimental hypertension. It is postulated that this may hold true for other, and conceivably all, means of producing experimental hypertension. If so, it may be possible to develop a general hypothesis that will unify these presently disparate entities.

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Section: Genetic ]~Actors In Experim2~ntal Hypertensionsupporting

confidence: 56%

Effects of Chronic Excess Salt Ingestion

Dahl

Heine

Tassinari

1963

The Journal of Experimental Medicine

104

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“…of fat daily. 2 We have found no evidence that human serum cholesterol concentration has ever been lowered by a diet that restricts cholesterol alone without restricting the total fat simultaneously.…”

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confidence: 81%

Principles of a Low Fat Diet

Hildreth

Mellinkoff

1951

Circulation

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From personal experience on low fat diets and through experience gained treating patients with low fat diets, the authors suggest that when such a diet is prescribed carefully it may be quite palatable and also reduce serum cholesterol concentration. The principles of a low fat diet and methods for making the diet appetizing are presented. Sample diet instruction sheets which can be individualized for different patients are also illustrated.

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“…When the clinical condition is under control, and this may take several months, small amounts of non-leguminous vegetables, potatoes, lean meat and fish, all prepared without salt or fat, may be added. Kempner (1948) demonstrated that with the use of this dietary regimen many patients could achieve normal blood pressure, and objective improvements in ECG changes, heart size and renal function were documented (Figure 2). Published retinal photographs showed resolution of advanced changes, including papilloedema, haemorrhages and exudates.…”

Section: The Rice-fruit-sugar Dietmentioning

confidence: 94%

“…Published retinal photographs showed resolution of advanced changes, including papilloedema, haemorrhages and exudates. Kempner's (1948) results were regarded with scepticism by the profession, but were confirmed by Dahl (1972) under controlled conditions in the metabolic unit at the Rockefeller Hospital. One of the criticisms of Kempner's work was that the mechanism by which the diet worked was uncertain: although it was grossly deficient in salt, containing about 150 mg of sodium, it was also deficient in protein, fat, total calories and probably other nutrients.…”

Section: The Rice-fruit-sugar Dietmentioning

confidence: 95%

“…The first major clinical observations on the role of salt restriction in hypertension were made by Kempner (1948) from Duke University with a series of publications commencing in 1944, and he still has an active programme. The rice diet contains 2000 calories, 300 mg salt, and 250-350 g rice, boiled in either water or fruit juice.…”

Section: The Rice-fruit-sugar Dietmentioning

confidence: 99%

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Salt and Hypertension: Discussion Paper¹

Finn

1983

J R Soc Med

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High blood pressure has perhaps understandably been one of the few subjects in medicine which has caused much controversy. My own early days in academic medicine coincided with the high drama of the Pickering-Platt controversy concerning the mode of inheritance of hypertension. Pickering championed polygenic inheritance with no sharp cut-off between hypertension and normotension (Hamilton et al. 1954), andPlatt (1963) believed that hypertension was a distinct disease whose inheritance was controlled by a single major gene. We in the lower orders waited with bated breath for the next round between these brilliant stars in the medical firmament. They were heady days and emotions ran high. We now know that both proponents held some elements of the truth. Pickering made monumental contributions to the study of hypertension, but felt strongly that salt had no major part to play in the condition. The story is told that when eating in public, he used to smother his food in massive quantities of salt, and then proclaim to his dining companions that he had done this for many years and his blood pressure was still normal, and hence salt had nothing to do with the aetiology of hypertension. Such was his intellectual brilliance and his reputation in the field of hypertension that this view tended to dominate medical circles in the UK and even in the United States. Thus a climate of opinion has existed which opposed the role of salt in hypertension. A recent review in the UK summarized the position of the anti-salt lobby (Swales 1980). Dahl (1972) wrote that Kempner's (1948) work on salt restriction 'for reasons that are difficult to fathom, occasioned much antipathy', and he also wrote that he had become heir to the original antipathies directed to Kempner. The position is now beginning to change, and the role of salt in the causation of hypertension is slowly gaining acceptance.

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Treatment of hypertensive vascular disease with rice diet

Cited by 450 publications

References 7 publications

Effects of Chronic Excess Salt Ingestion

Effects of Chronic Excess Salt Ingestion

Principles of a Low Fat Diet

Salt and Hypertension: Discussion Paper¹

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Treatment of hypertensive vascular disease with rice diet

Cited by 450 publications

References 7 publications

Effects of Chronic Excess Salt Ingestion

Effects of Chronic Excess Salt Ingestion

Principles of a Low Fat Diet

Salt and Hypertension: Discussion Paper1

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Salt and Hypertension: Discussion Paper¹