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Titolo:
SODIUM REDUCTION AND WEIGHT-LOSS IN THE TREATMENT OF HYPERTENSION IN OLDER PERSONS - A RANDOMIZED CONTROLLED TRIAL OF NONPHARMACOLOGIC INTERVENTIONS IN THE ELDERLY (TONE)
Autore:
WHELTON PK; APPEL LJ; ESPELAND MA; APPLEGATE WB; ETTINGER WH; KOSTIS JB; KUMANYIKA S; LACY CR; JOHNSON KC; FOLMAR S; CUTLER JA;
Indirizzi:
TULANE UNIV,SCH PUBL HLTH & TROP MED,OFF DEAN,DEPT BIOSTAT & EPIDEMIOL,17TH FLOOR,1501 CANAL ST NEW ORLEANS LA 70112 JOHNS HOPKINS UNIV,SCH MED,WELCH CTR PREVENT EPIDEMIOL & CLIN RES BALTIMORE MD 00000 WAKE FOREST UNIV,SCH MED,DEPT PUBL HLTH SCI WINSTON SALEM NC 27109 WAKE FOREST UNIV,SCH MED,DEPT INTERNAL MED WINSTON SALEM NC 27109 UNIV TENNESSEE,DEPT PREVENT MED MEMPHIS TN 00000 UNIV MED & DENT NEW JERSEY,ROBERT WOOD JOHNSON MED SCH,DIV CARDIOVASCDIS & HYPERTENS NEW BRUNSWICK NJ 00000 PENN STATE UNIV,COLL MED,CTR BIOSTAT & EPIDEMIOL HERSHEY PA 17033 NHLBI,CLIN APPLICAT & PREVENT PROGRAM,NIH BETHESDA MD 20892
Titolo Testata:
JAMA, the journal of the American Medical Association
fascicolo: 11, volume: 279, anno: 1998,
pagine: 839 - 846
SICI:
0098-7484(1998)279:11<839:SRAWIT>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY HEART-DISEASE; BLOOD-PRESSURE; MILD HYPERTENSION; RISK; THERAPY; WOMEN; MASS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
37
Recensione:
Indirizzi per estratti:
Citazione:
P.K. Whelton et al., "SODIUM REDUCTION AND WEIGHT-LOSS IN THE TREATMENT OF HYPERTENSION IN OLDER PERSONS - A RANDOMIZED CONTROLLED TRIAL OF NONPHARMACOLOGIC INTERVENTIONS IN THE ELDERLY (TONE)", JAMA, the journal of the American Medical Association, 279(11), 1998, pp. 839-846

Abstract

Context.-Nonpharmacologic interventions are frequently recommended for treatment of hypertension in the elderly, but there is a paucity of evidence from randomized controlled trials in support of this recommendation. Objective.-To determine whether weight loss or reduced sodium intake is effective in the treatment of older persons with hypertension. Design.-Randomized controlled trial. Participants.-A total of 875 men and women aged 60 to 80 years with systolic blood pressure lower than 145 mm Hg and diastolic blood pressure lower than 85 mm Hg while receiving treatment with a single antihypertensive medication. Setting.-Four academic health centers. Intervention.-The 585 obese participantswere randomized to reduced sodium intake, weight loss, both, or usualcare, and the 390 nonobese participants were randomized to reduced sodium intake or usual care, Withdrawal of antihypertensive medication was attempted after 3 months of intervention. Main Outcome Measure.-Diagnosis of high blood pressure at 1 or more follow-up visits, or treatment with antihypertensive medication, or a cardiovascular event duringfollow-up (range, 15-36 months; median, 29 months). Results.-The combined outcome measure was less frequent among those assigned vs not assigned to reduced sodium intake (relative hazard ratio, 0.69; 95% confidence interval [CI], 0.59-0.81; P<.001) and, in obese participants, among those assigned vs not assigned to weight loss (relative hazard ratio, 0.70; 95% CI, 0.57-0.87; P<.001). Relative to usual care, hazard ratios among the obese participants were 0.60 (95% CI, 0.45-0.80; P<.001) for reduced sodium intake alone, 0.64 (95% CI, 0.49-0.85; P=.002) for weight loss alone, and 0.47 (95% CI, 0.35-0.64; P<.001) for reducedsodium intake and weight loss combined. The frequency of cardiovascular events during follow-up was similar in each of the 6 treatment groups. Conclusion.-Reduced sodium intake and weight loss constitute a feasible, effective, and safe nonpharmacologic therapy of hypertension inolder persons.

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Documento generato il 25/11/20 alle ore 18:30:47