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William H. McMicken, M.D.
Suite 323
2600 Philmont Avenue
Huntingdon Valley, Pennsylvania 19006


The basic principles of non-drug therapy of high blood pressure are salt restriction, adequate intake of potassium and other minerals, restriction of fats and cholesterol in diet, maintaining ideal body weight, regular exercise, avoidance of alcohol and tobacco, and avoidance of stress. These principles can be recognized, in general, as simply controlling known risk factors for arteriosclerotic disease. The principles of non-drug therapy are listed in Table 2., below.


1. Restriction of salt (sodium) intake in diet
2. Adequate dietary intake of potassium, calcium, and magnesium
3. Restriction of saturated fats and cholesterol in diet
4. Maintenance of ideal body weight
5. Regular physical exercise
6. Avoidance of alcoholic beverages
7. No smoking or other use of tobacco products
8. Avoidance of excessive stress

Non-Pharmaceutical Therapy
General Considerations
A comprehensive non drug treatment program for high blood pressure must include the following components:

  • Restriction of dietary sodium to 2,000 to 3,000 mg. daily.
  • Reduce dietary saturated fat and cholesterol.
  • Caloric restrictions to maintain ideal body weigh.
  • Maintain adequate intake of potassium, calcium, and magnesium.
  • Limit alcoholic intake to no more than 2 ounces and preferably one ounce per day (one ounce of alcohol is contained in 2 usual portions of beer, wine, or spirits).
  • Stop smoking. This may not influence the blood pressure directly, but will have a marked beneficial effect on overall cardiovascular and pulmonary health.
  • Aerobic exercise of 20 to 30 minutes at least three times a week.
  • Reduce stress by whatever form of relaxation therapy that is acceptable to the individual.

These components are also recognized as beneficial in preventing coronary heart disease. There is inevitable overlap in the treatment of coronary heart disease (discussed later in this book) and the treatment of high blood pressure. This is understandable, since the two conditions are so closely linked with each other.

Salt (Sodium) Restriction
Even before drug treatment was generally available, the value of dietary salt restriction was observed to help control high blood pressure. An early example was the "Rice Diet" devised by Dr. Walter Kempner in the 1940's which was effective because of its severe sodium restriction to only 150 mg. daily. In milder cases, moderate salt restriction may be the only method necessary for adequate control. Sodium is the mineral element that is involved; ordinary "table salt" or sodium chloride is the predominant source of sodium in our diets. It is necessary in the body for proper transmission of nerve impulses, for regulating blood volume and water balance in body tissues.

Sodium occurs naturally in all foods to varying degrees, so it is impossible to make a diet completely "sodium free". Salt is more harmful to some people than others. The distinction between "sodium" and "salt" is sometimes confusing. Sodium chloride, or "salt", is about 40 percent sodium and 60 percent chloride by weight. Sodium is present in compounds other than common "salt". Some of these compounds are: Monosodium glutamate (MSG), used as a flavor enhancer; Sodium saccharin, used as a non-caloric sweetener; Disodium phosphate; a compound added to some hot cereals to shorten cooking time; Baking Soda (sodium bicarbonate); and baking powder, used as leaving agent in baked goods.

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