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(Hypertension. 2000;35:544.)
© 2000 American Heart Association, Inc.
Scientific Contributions |
Long-Term Effects of Weight Loss and Dietary Sodium Reduction on Incidence of Hypertension
From the Department of Epidemiology (J.H., P.K.W.), the Tulane University School of Public Health and Tropical Medicine, New Orleans, La; and the Welch Center for Prevention, Epidemiology, and Clinical Research (M.J.K., L.J.A.), Department of Medicine (M.J.K., L.J.A.) and Department of Epidemiology (M.J.K., L.J.A., J.C.), the Johns Hopkins Medical Institutions, Baltimore, Md.
Correspondence to Jiang He, MD, PhD, Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Ave SL18, New Orleans, LA 70112-2699. E-mail jhe{at}mailhost.tcs.tulane.edu
Abstract—To examine the long-term
effects of weight loss and dietary sodium reduction on the incidence of
hypertension, we studied 181 men and women who participated in the
Trials of Hypertension Prevention, phase 1, in Baltimore, Md. At
baseline (1987 to 1988), subjects were 30 to 54 years old and had a
diastolic blood pressure (BP) of 80 to 89 mm Hg and
systolic BP <160 mm Hg. They were randomly assigned to
one of two 18-month lifestyle modification interventions aimed at
either weight loss or dietary sodium reduction or to a usual care
control group. At the posttrial follow-up (1994 to 1995), BP was
measured by blinded observers who used a random-zero sphygmomanometer.
Incident hypertension was defined as systolic BP 
160
mm Hg and/or diastolic BP 90 mm Hg and/or
treatment with antihypertensive medication during follow-up. Body
weight and urinary sodium were not significantly different among the
groups at the posttrial follow-up. After 7 years of follow-up, the
incidence of hypertension was 18.9% in the weight loss group and
40.5% in its control group and 22.4% in the sodium reduction group
and 32.9% in its control group. In logistic regression
analysis adjusted for baseline age, gender, race, physical
activity, alcohol consumption, education, body weight, systolic
BP, and urinary sodium excretion, the odds of hypertension was reduced
by 77% (odds ratio 0.23; 95% confidence interval 0.07 to 0.76;
P=0.02) in the weight loss group and by 35% (odds ratio
0.65; 95% confidence interval 0.25 to 1.69; P=0.37) in
the sodium reduction group compared with their control groups. These
results indicate that lifestyle modification such as weight loss may be
effective in long-term primary prevention of hypertension.
Key Words: diet, sodium-restricted • blood pressure • hypertension, incidence • weight loss
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