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Sodium Reduction and Weight Loss Reduce Hypertension.

There is some evidence that salt restriction can reduce blood pressure. This study explored the impact of weight loss and sodium reduction in 975 elderly patients with mild hypertension controlled (145/85 mm Hg or lower at enrollment) with a single hypertensive agent.

Obese patients were randomized to reduced sodium intake, weight loss, weight loss plus reduced sodium, or usual care. Nonobese patients were randomized only to reduced sodium intake or usual care. After 3 months, investigators withdrew antihypertensive medications. During follow-up that ranged from 15 to 36 months, the risk for recurrence of high blood pressure was 31 percent lower among those assigned to sodium reduction. Of the obese patients, those assigned to weight loss alone had a 30 percent risk reduction. Obese patients assigned to both weight loss and sodium restriction had a 53 percent reduction in risk. Average weight loss was 3.9 kg at 30 months in the weight loss group.

Comment: Hypertension is clearly linked to cardiovascular morbidity in the elderly, and these findings support use of these nonpharmacologic therapies for its control. The data also demonstrate an additive benefit for combined weight loss and salt restriction.

— TH Lee

Published in Journal Watch General Medicine March 24, 1998

Citation(s):

Whelton PK et al. Sodium reduction and weight loss in the treatment of hypertension in older persons: A randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). JAMA 1998 Mar 18 279 839-846.

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