Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: We agree with Mr McGuffin about the
need for appropriately designed studies to test the efficacy of promising
strategies, such as herbal products, in preventing and treating hypertension.
Dr Logan criticizes our inclusion of the TONE and DASH-Sodium trials
in the section on efficacy of sodium reduction in prevention of hypertension.
Primary prevention was in fact relevant to the majority of the DASH-Sodium
participants, of whom 59% were nonhypertensive; their response to sodium reduction
mirrored the overall experience in the trial. Among the nonhypertensive DASH-Sodium
trial participants who received the control diet (typical of what many people
eat in the United States), assignment to lower (50 mmol sodium/2100 kcal)
vs higher (150 mmol sodium/2100 kcal) sodium intake resulted in blood pressure
being lowered by 7.0 mm Hg (systolic) and 3.8 mm Hg (diastolic) for those
older than 45 years (P<.001) and by 3.7 mm Hg
(systolic) and 1.5 mm Hg (diastolic) for those aged 45 years or younger (P<.05).1
Whelton PK, He J, Appel LJ. Lifestyle Modifications to Prevent Hypertension. JAMA. 2003;289(7):843. doi:10.1001/jama.289.7.843-a