Hypertension and Salt Restriction

It is not unusual for obstetricians to make a reflex diagnosis of toxemiaAs-defined-by-the-1997-Merriam-Webster-M... whenever one or more of the “classic” symptoms are present: swelling of the hands and face, excess weight gain, protein in the urine or elevated blood pressure. Your friend is fortunate to have been only diagnosed as “borderline hypertensive”, but her treatment may still CAUSE her to develop toxemia, because she is being treated for a problem she may not actually have. Her blood pressure should be rechecked several times before making a diagnosis, and her diet must not be ignored. Her blood pressure may be high because she’s not eating well - not having enough salt, fluids or protein to expand her blood volume as needed for pregnancy. Quoting again from Brewer, p. 82…

Elevated blood pressure (hypertension) may result from many different causes. “Anxiety” hypertension is engendered by emotional stress of any sort. Many women become anxious during physical examinations or during laboratory testing. Women whose blood pressure has been normal throughout pregnancy may develop hypertension at the time of admission to the hospital for labor and birth. These mothers do not have MTLPMetabolic-Toxemia-of-Late-Pregnancy---th...; the liver is functioning normally and the blood volume is expanded.

“Essential,” chronic, or benign hypertension is most common in women over thirty years of age. However, many black teenagers have already developed the condition and will continue to have it the rest of their lives. These mothers require exactly the same diet as mothers with normal blood pressures — including the use of salt to taste — since their blood volumes must expand, too, as pregnancy advances.

  • Sodium deficiency can trigger hypertension, as mentioned previously.
  • Obese women are often incorrectly diagnosed as hypertensive when a standard-size blood pressure cuff is used to take a reading. When the cuff is too small, additional pressure on the mother’s arm reads on the meter as elevated blood pressure. Using a larger cuff prevents this error.
  • Pheochromocytoma, an exceedingly rare tumor of the adrenal gland, also causes hypertension.
  • Kidney diseases also result in high blood pressure.

Another quote from Dr. Tom Brewer’s Metabolic Toxemia of Late Pregnancy: A Disease of Malnutrition:

In the last fifteen years obstetricians have narrowly focused on the blood pressure of the pregnant woman as being of central concern regardless of her nutritional metabolic status, liver function, blood volume and placental function. If the diastolic blood pressure rises 15 or 20 mm Hg or the systolic rises 20-30 mm Hg, a diagnosis of “pregnancy-induced hypertension” (PIH) is made. All “PIH” is then “managed” the same as if every hypertensive pregnant woman were in jeopardy of convulsions, brain hemorrhage, abruption of the placenta, fetal death, etc. This is simply not true; most hypertension in human pregnancy is physiological or benign, not related to MTLP at all.

British investigators, Mathews et al. have shown the benign nature of hypertension in the well-fed pregnant woman. (British Medical Journal, vol. 2, p. 623, 1978) When these workers abandoned the traditional “therapies” for hypertension in pregnancy, bed rest, low calorie, low salt diets, sodium diuretics, sedatives, pre-term induction, for women with “non-albuminic hypertension” as they termed it, they found that their hypertensive patients achieved the same outcome of pregnancy as in women with normal blood pressures attending their prenatal clinics. Their recommendation for those with hypertension not attributable to any medical disease is simply to refrain from aggressive therapies and have [the patient’s] case followed by the district midwife. In the United States this would translate to having her continue to be followed by her chosen care provider, not to be referred to a “high-risk” perinatal specialist.

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    Copyright  1999-2013 Marci J. Abraham (formerly O'Daffer) and/or Thomas Brewer, M. D. - All Rights Reserved
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