Whelton P, Appel L, Espeland M, et al. 1998

9515998

Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group.

Whelton P, Appel L, Espeland M, Applegate W, Ettinger W, Kostis J, Kumanyika S, Lacy C, Johnson K, Folmar S,C utler J

Journal of the American Medical Association

1998

279

11

839-846

Randomized Controlled Trial

Some concerns

Trial participants were men and women 60 to 80 years of age who had an average systolic BP less than 145 mmHg and diastolic BP less than 85 mmHg (mean of 9 measurements, 3 at each of 3 visits) while taking a single antihypertensive medication or a single combination regimen consisting of a diuretic agent and a nondiuretic agent.

Exclusion criteria included history of a heart attack or stroke within the preceding 6 months, current angina pectoris, congestive heart failure, insulin dependent diabetes mellitus, serious mental or physical illness, unexplained or involuntary weight loss of 4.5 kg or greater during the previous year, a body mass index less than 21 kg/m2 in men or women or greater than 33 kg/m2 in men or greater than 37 kg/m2 in women, presumed inability to comply with the protocol, hypercreatinemia (.152 ?mol/L .2.0mg/dL]), hyperkalemia(.5.5mmol/L), hyperglycemia (nonfasting level.14.4 mmol/L [.260 mg/dL]), and anemia (hemoglobin level ,110 g/L).

To determine whether weight loss or reduced sodium intake is effective in the treatment of older persons with hypertension.

See Risk of Bias.

United States

Government

This study was supported by grants from the National Institute on Aging and the National Heart, Lung, and Blood Institute, and by General Clinical Research Center grant 5MO1RR00722 from the National Center for Research Resources, National Institutes of Health.