Journal article
Feasibility and Efficacy of Sodium Reduction in the Trials of Hypertension Prevention, Phase I
Hypertension (Dallas, Tex. 1979), v 22(4), pp 502-512
Oct 1993
PMID: 8406655
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Abstract
Phase I of the Trials of Hypertension Prevention was a multicenter, randomized trial of the feasibility and efficacy of seven nonpharmacologic interventions, including sodium reduction, in lowering blood pressure in 30- to 54 -year-old individuals with a diastolic blood pressure of 80 to 89 mm Hg. Six centers tested an intervention designed to reduce dietary sodium to 80 mmol (1800 mg)/24 h with a total of 327 active intervention and 417 control subjects. The intervention consisted of eight group and two one-to-one meetings during the first 3 months, followed by less-intensive counseling and support for the duration of the study. The mean net decrease in sodium excretion was 43.9 mmol/24 h at 18 months. Women had lower sodium intake at baseline and were therefore more likely to decrease to less than 80 mmol/24 h. Black subjects were less likely to decrease to less than 80 mmol/d, independent of sex or baseline sodium excretion. The mean (95% confidence interval) net decrease associated with treatment was −2.1 (−3.3, −0.8) mm Hg for systolic blood pressure and −1.2 (−2.0, −0.3) mm Hg for diastolic blood pressure at 18 months (both P<.01). Multivariate analyses indicated a larger systolic blood pressure effect in women (−4.44 versus −1.23 mm Hg in men), adjusted for age, race, baseline blood pressure, and baseline 24-hour urinary sodium excretion (P=.02). Dose-response analyses indicated an adjusted decrease of −1.4 mm Hg for systolic blood pressure and −0.9 mm Hg for diastolic blood pressure for a decrease of 100 mmol/24 h in 18-month sodium excretion. These results support the utility of sodium reduction as a population strategy for hypertension prevention and raise questions about possible differences in dose response associated with gender and initial level of sodium intake.
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Details
- Title
- Feasibility and Efficacy of Sodium Reduction in the Trials of Hypertension Prevention, Phase I
- Creators
- Shiriki Kumanyika - Johns Hopkins UniversityPatricia Hebert - Johns Hopkins UniversityJeffrey Cutler - Johns Hopkins UniversityVera Lasser - Johns Hopkins UniversityCarolyn Sugars - Johns Hopkins UniversityLyn Steffen-Batey - Johns Hopkins UniversityAmy Brewer - Johns Hopkins UniversityMary Cameron - Johns Hopkins UniversityLana Shepek - Johns Hopkins UniversityNancy Cook - Johns Hopkins UniversityStephen Miller
- Publication Details
- Hypertension (Dallas, Tex. 1979), v 22(4), pp 502-512
- Publisher
- American Heart Association, Inc
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Dana and David Dornsife School of Public Health
- Web of Science ID
- WOS:A1993MA42800005
- Scopus ID
- 2-s2.0-0027493381
- Other Identifier
- 991019312321104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Peripheral Vascular Disease