Despite previous correspondence,1-3 Logan continues, erroneously, to equate the blood pressure effects estimated in his meta-analysis per 100 mmol/d change in sodium excretion4 with the blood pressure effects observed in TOHP II for 24 to 40 mmol/d change in sodium.5 The TOHP II result in fact represents 2.5 to 4.0 times the 1.0—mm Hg effect from the meta-analysis, if one assumes a linear relationship through that range. He further expresses surprise at the range of blood pressure responses, without noting that these occurred over different follow-up periods during which adherence (group differences in sodium excretion) diminished somewhat and may also have become increasingly less well measured. Since all these issues were discussed in the article, we are surprised at his surprise.
Logan then criticizes the main results of TOHP II, as well those of a recent meta-analysis of sodium reduction trials published subsequent to his own,6
Cutler JA, Allender PS, Cook N, Follman D, Hennekens CH, Whelton PK. Salt, Blood Pressure, and Cointervention-Reply. Arch Intern Med. 1997;157(22):2667. doi:10.1001/archinte.1997.00440430148027