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Reduced sodium intake lowered blood pressure and need for antihypertensive medication

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 QUESTION: In older adults with hypertension, is a reduced dietary sodium (RS) intervention more effective than usual lifestyle (UL) in controlling blood pressure and preventing cardiovascular events?


Randomised {allocation concealed*}, blinded (outcome assessors),* controlled trial with 30 months follow up.


4 clinical centres in the US.


681 patients who were 60–80 years of age (mean age 66 y, 53% men) and had systolic blood pressure (SBP) <145 mm Hg and diastolic blood pressure (DBP) <85 mm Hg while taking 1 antihypertensive medication (AM). Exclusion criteria were use of AM for conditions other than hypertension, myocardial infarction (MI) or stroke in the previous 6 months, angina pectoris, congestive heart failure (CHF), serum creatinine concentration >176.8 μmol/l, blood glucose concentration >14.4 mmol/l, or average alcohol intake >14 drinks per week. Follow …

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  • Source of funding: National Institutes of Health.

  • For correspondence: Dr L J Appel, Johns Hopkins University, 2024 East Monument Street, Suite 2-645, Baltimore, MD 21205-2223, USA.

  • * See glossary.

  • Information provided by the author.

  • Whelton PK, Appel LJ, Espeland MA, et al. JAMA 1998;279:839–46.