Abstract
Objective: To examine the effects of reduction in dietary sodium intake on cardiovascular events using data from two completed randomised trials, TOHP I and TOHP II. Design: Longterm follow-up assessed 10-15 years after the original trial. Setting: 10 clinic sites in 1987-90 (TOHP I) and nine sites in 1990-5 (TOHP II). Central follow-up conducted by post and phone. Participants: Adults aged 30-54 years with prehypertension. Intervention: Dietary sodium reduction, including comprehensive education and counselling on reducing intake, for 18 months (TOHP I) or 36-48 months (TOHP II). Main outcome measure: Cardiovascular disease (myocardial infarction, stroke, coronary revascularisation, or cardiovascular death). Results: 744 participants in TOHP I and 2382 in TOHP II were randomised to a sodium reduction intervention or control. Net sodium reductions in the intervention groups were 44 mmol/24 h and 33 mmol/24 h, respectively. Vital status was obtained for all participants and follow-up information on morbidity was obtained from 2415 (77%), with 200 reporting a cardiovascular event. Risk of a cardiovascular event was 25% lower among those in the intervention group (relative risk 0.75, 95% confidence interval 0.57 to 0.99, P=0.04), adjusted for trial, clinic, age, race, and sex, and 30% lower after further adjustment for baseline sodium excretion and weight (0.70, 0.53 to 0.94), with similar results in each trial. In secondary analyses, 67 participants died (0.80, 0.51 to 1.26, P=0.34). Conclusion: Sodium reduction, previously shown to lower blood pressure, may also reduce long term risk of cardiovascular events.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 885-888 |
| Number of pages | 4 |
| Journal | BMJ (Online) |
| Volume | 334 |
| Issue number | 7599 |
| DOIs | |
| State | Published - Apr 28 2007 |
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ASJC Scopus subject areas
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Long term effects of dietary sodium reduction on cardiovascular disease outcomes : Observational follow-up of the trials of hypertension prevention (TOHP). / Cook, Nancy R.; Cutler, Jeffrey A.; Obarzanek, Eva; Buring, Julie E.; Rexrode, Kathryn M.; Kumanyika, Shiriki K.; Appel, Lawrence; Whelton, Paul K.
In: BMJ (Online), Vol. 334, No. 7599, 28.04.2007, p. 885-888.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long term effects of dietary sodium reduction on cardiovascular disease outcomes
T2 - Observational follow-up of the trials of hypertension prevention (TOHP)
AU - Cook, Nancy R.
AU - Cutler, Jeffrey A.
AU - Obarzanek, Eva
AU - Buring, Julie E.
AU - Rexrode, Kathryn M.
AU - Kumanyika, Shiriki K.
AU - Appel, Lawrence
AU - Whelton, Paul K.
PY - 2007/4/28
Y1 - 2007/4/28
N2 - Objective: To examine the effects of reduction in dietary sodium intake on cardiovascular events using data from two completed randomised trials, TOHP I and TOHP II. Design: Longterm follow-up assessed 10-15 years after the original trial. Setting: 10 clinic sites in 1987-90 (TOHP I) and nine sites in 1990-5 (TOHP II). Central follow-up conducted by post and phone. Participants: Adults aged 30-54 years with prehypertension. Intervention: Dietary sodium reduction, including comprehensive education and counselling on reducing intake, for 18 months (TOHP I) or 36-48 months (TOHP II). Main outcome measure: Cardiovascular disease (myocardial infarction, stroke, coronary revascularisation, or cardiovascular death). Results: 744 participants in TOHP I and 2382 in TOHP II were randomised to a sodium reduction intervention or control. Net sodium reductions in the intervention groups were 44 mmol/24 h and 33 mmol/24 h, respectively. Vital status was obtained for all participants and follow-up information on morbidity was obtained from 2415 (77%), with 200 reporting a cardiovascular event. Risk of a cardiovascular event was 25% lower among those in the intervention group (relative risk 0.75, 95% confidence interval 0.57 to 0.99, P=0.04), adjusted for trial, clinic, age, race, and sex, and 30% lower after further adjustment for baseline sodium excretion and weight (0.70, 0.53 to 0.94), with similar results in each trial. In secondary analyses, 67 participants died (0.80, 0.51 to 1.26, P=0.34). Conclusion: Sodium reduction, previously shown to lower blood pressure, may also reduce long term risk of cardiovascular events.
AB - Objective: To examine the effects of reduction in dietary sodium intake on cardiovascular events using data from two completed randomised trials, TOHP I and TOHP II. Design: Longterm follow-up assessed 10-15 years after the original trial. Setting: 10 clinic sites in 1987-90 (TOHP I) and nine sites in 1990-5 (TOHP II). Central follow-up conducted by post and phone. Participants: Adults aged 30-54 years with prehypertension. Intervention: Dietary sodium reduction, including comprehensive education and counselling on reducing intake, for 18 months (TOHP I) or 36-48 months (TOHP II). Main outcome measure: Cardiovascular disease (myocardial infarction, stroke, coronary revascularisation, or cardiovascular death). Results: 744 participants in TOHP I and 2382 in TOHP II were randomised to a sodium reduction intervention or control. Net sodium reductions in the intervention groups were 44 mmol/24 h and 33 mmol/24 h, respectively. Vital status was obtained for all participants and follow-up information on morbidity was obtained from 2415 (77%), with 200 reporting a cardiovascular event. Risk of a cardiovascular event was 25% lower among those in the intervention group (relative risk 0.75, 95% confidence interval 0.57 to 0.99, P=0.04), adjusted for trial, clinic, age, race, and sex, and 30% lower after further adjustment for baseline sodium excretion and weight (0.70, 0.53 to 0.94), with similar results in each trial. In secondary analyses, 67 participants died (0.80, 0.51 to 1.26, P=0.34). Conclusion: Sodium reduction, previously shown to lower blood pressure, may also reduce long term risk of cardiovascular events.
UR - http://www.scopus.com/inward/record.url?scp=34247863975&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34247863975&partnerID=8YFLogxK
U2 - 10.1136/bmj.39147.604896.55
DO - 10.1136/bmj.39147.604896.55
M3 - Article
C2 - 17449506
AN - SCOPUS:34247863975
VL - 334
SP - 885
EP - 888
JO - British Medical Journal
JF - British Medical Journal
SN - 0959-8146
IS - 7599
ER -