Document Detail


Effects of reduced sodium intake on hypertension control in older individuals: results from the Trial of Nonpharmacologic Interventions in the Elderly (TONE).
MedLine Citation:
PMID:  11231700     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Few trials have evaluated the effects of reduced sodium intake in older individuals, and no trial has examined the effects in relevant subgroups such as African Americans. PATIENTS AND METHODS: The effects of sodium reduction on blood pressure (BP) and hypertension control were evaluated in 681 patients with hypertension, aged 60 to 80 years, randomly assigned to a reduced sodium intervention or control group. Participants (47% women, 23% African Americans) had systolic BP less than 145 mm Hg and diastolic BP less than 85 mm Hg while taking 1 antihypertensive medication. Three months after the start of intervention, medication was withdrawn. The primary end point was occurrence of an average systolic BP of 150 mm Hg or more, an average diastolic BP of 90 mm Hg or more, the resumption of medication, or a cardiovascular event during follow-up (mean, 27.8 months). RESULTS: Compared with control, mean urinary sodium excretion was 40 mmol/d less in the reduced sodium intervention group (P<.001); significant reductions in sodium excretion occurred in subgroups defined by sex, race, age, and obesity. Prior to medication withdrawal, mean reductions in systolic and diastolic BPs from the reduced sodium intervention, net of control, were 4.3 mm Hg (P<.001) and 2.0 mm Hg (P =.001). During follow-up, an end point occurred in 59% of reduced sodium and 73% of control group participants (relative hazard ratio = 0.68, P<.001). In African Americans, the corresponding relative hazard ratio was 0.56 (P =.005); results were similar in other subgroups. In dose-response analyses, end points were progressively less frequent with greater sodium reduction (P for trend =.002). CONCLUSION: A reduced sodium intake is a broadly effective, nonpharmacologic therapy that can lower BP and control hypertension in older individuals.
Authors:
L J Appel; M A Espeland; L Easter; A C Wilson; S Folmar; C R Lacy
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of internal medicine     Volume:  161     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-20     Completed Date:  2001-05-03     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  685-93     Citation Subset:  AIM; IM    
Affiliation:
Johns Hopkins University, 2024 E Monument St, Suite 2-645, Baltimore, MD 21205-2223, USA. lappel@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group
Aged
Aged, 80 and over
Body Weight
Diet, Sodium-Restricted*
Female
Humans
Hypertension / diet therapy*,  physiopathology
Male
Middle Aged
Sodium, Dietary / metabolism
Treatment Outcome
Grant Support
ID/Acronym/Agency:
AG09771/AG/NIA NIH HHS; AG09773/AG/NIA NIH HHS; AG09799/AG/NIA NIH HHS; HL02642/HL/NHLBI NIH HHS; HL43641/HL/NHLBI NIH HHS; HL48642/HL/NHLBI NIH HHS; HL60197/HL/NHLBI NIH HHS; RR00722/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Sodium, Dietary
Comments/Corrections
Comment In:
ACP J Club. 2001 Sep-Oct;135(2):61
Arch Intern Med. 2001 Nov 26;161(21):2632-3   [PMID:  11718622 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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