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March 24, 1997

Lessons From the Trials of Hypertension Prevention, Phase IIEnergy Intake Is More Important Than Dietary Sodium in the Prevention of Hypertension

Arch Intern Med. 1997;157(6):596-597. doi:10.1001/archinte.1997.00440270014001

PHASE II of the Trials of Hypertension Prevention (TOHP II), the results of which are reported in this issue,1 is the latest in a series of studies designed to investigate the feasibility of preventing hypertension by nonpharmacological interventions.2-4 The rationale of these studies may be summarized as follows. First, hypertension is approximately 50% environmental in origin, with the most likely modifiable risk factors being body weight and sodium intake. Second, treatment of established hypertension is expensive and does not lower cardiovascular morbidity as much as originally hoped; patients being treated for hypertension remain at a higher risk of cardiovascular disease than patients without hypertension with the same level of blood pressure (BP).5 Third, several analyses of population surveys of cardiovascular risk factors have concluded that reductions in BP as small as 2.0 mm Hg should produce a marked reduction in cardiovascular risk of 6% for coronary heart

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