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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

To the Editor: Dr Whelton and colleagues1 did not accurately address the role of dietary sodium reduction in the primary prevention of hypertension. They summarized the findings of the TONE trial2 and the DASH-Sodium trial,3 but neither of these can be considered as primary preventive interventions. Participants in these trials had treated hypertension or fulfilled, in most instances, the Joint National Committee VI criteria for blood pressure–lowering treatment.4 Similarly, their description of observational studies (NHANES I Epidemiologic Follow-up Study and Finnish Study), which demonstrated an association between dietary sodium intake and mortality independent of blood pressure, do not seem relevant.