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Letters
February 19, 2003

Lifestyle Modifications to Prevent Hypertension

Author Affiliations
 

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(7):843. doi:10.1001/jama.289.7.843-a

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

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