Abstract P337: Blood Pressure And Retina Responses Of Malignant Hypertension Patients In The Rice Diet Program

Abstract

Introduction: The residential Rice Diet Program at Duke (RDP) has been shown to be effective in treating patients with malignant hypertension (MH) using a low salt (5 meq/d), low protein (5% kcal), and low fat (5% kcal) diet with no anti-hypertensive medications. Our team examined the RDP medical records and further clarified the identification of 710 MH patients by limiting the criteria of an averaged systolic blood pressure (SBP)>170 mmHg to be met ±7 and a documented non-diabetic hemorrhrage and/or papilledema to be met ± 30 days of starting RDP, respectively. Methods: Wilcoxon ranked-sum was used to compare baseline and week-4 blood pressures (BPs), weight, and urine chloride (uCl, a measure of low-salt diet adherence). Linear regression was used to examine the association between baseline age, gender, SBP, last weight measure and uCl change with SBP change at week-4. Retina evaluation were compared between baseline and last measure using Chi-Square and Fisher’s Exact tests. Results: Male patients (p=.048) and those with a greater change in uCl (p=.001) had a greater reduction in SBP at week-4 ( Table ). Those with a higher baseline SBP had a lower reduction in SBP (p<.001), while baseline age and last weight measure had no effect. The proportion of MH patients with either hemorrhage alone, papilledema alone or both, reduced during RDP participation (p<.001). Conclusion: The RDP significantly lowered BPs, weight and uCl in MH patients within 4-week of starting RDP. The proportion of patients with documented retinal hemorrhage and/or papilledema also reduced significantly during participation in RDP. The mechanisms of the diet’s impact merit further investigation.