This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Herbert G. Langford, MD; M. Donald Blaufox, MD, PhD; Albert Oberman, MD; C. Morton Hawkins, ScD; J. David Curb, MD; Gary R. Cutter, PhD; Sylvia Wassertheil-Smoller, PhD; Sara Pressel, MS; Connie Babcock, MS; John D. Abernethy, MB, ChB; Jeanne Hotchkiss, MD; Myra Tyler, MD

JAMA. 1985;253(5):657-664.

Abstract
This study asks whether prolonged antihypertensive therapy will "cure" a substantial percent of rigorously treated hypertensive patients and whether nutritional change will add an antihypertensive effect and reduce the relapse rate. Of 584 eligible patients normotensive while receiving therapy, 496 were randomized into control and discontinued-medication groups with and without dietary intervention. At 56 weeks, 50% of those who were no longer receiving medication remained normotensive by study criteria. Randomization either to weight-loss group (mean loss of 4.5 kg [10 lb]) or to sodium-restriction group (mean reduction of 40 mEq/day) increased the likelihood of remaining without drug therapy, with an adjusted odds ratio of 2.17 for the sodium group and 3.43 for the weight group. Highest success rates were in the nonoverweight mild hypertensives with sodium restriction (78%) and the overweight mild hypertensives who were reducing their weight (72%). These data demonstrate that weight loss or sodium restriction, in hypertensives controlled for five years, more than doubles success in withdrawal of drug therapy.

(JAMA 1985;253:657-664)

Author Affiliations
From the University of Mississippi Medical Center, Jackson (Drs Langford, Abernethy, and Tyler); the Albert Einstein College of Medicine, Bronx, NY (Drs Blaufox, Wassertheil-Smoller, and Hotchkiss); the University of Texas, Houston (Drs Hawkins and Curb and Mss Pressel and Babcock); and the University of Alabama at Birmingham (Drs Oberman and Cutter).

Footnotes
Reprint requests to the University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216 (Dr Langford).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Metabolic Syndrome
Cornier et al.
Endocr. Rev. 2008;29:777-822.
ABSTRACT | FULL TEXT  

Long-term Effects of Weight-Reducing Interventions in Hypertensive Patients: Systematic Review and Meta-analysis
Horvath et al.
Arch Intern Med 2008;168:571-580.
ABSTRACT | FULL TEXT  

Meta-analysis: The Effect of Dietary Counseling for Weight Loss
Dansinger et al.
ANN INTERN MED 2007;147:41-50.
ABSTRACT | FULL TEXT  

2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)
Authors/Task Force Members: et al.
Eur Heart J 2007;0:ehm236v1-75.
FULL TEXT  

Dietary Approaches to Prevent and Treat Hypertension: A Scientific Statement From the American Heart Association
Appel et al.
Hypertension 2006;47:296-308.
ABSTRACT | FULL TEXT  

Trial of Preventing Hypertension: Design and 2-Year Progress Report
Julius et al.
Hypertension 2004;44:146-151.
ABSTRACT | FULL TEXT  

Pharmaceutical Costs in Obese Individuals: Comparison With a Randomly Selected Population Sample and Long-term Changes After Conventional and Surgical Treatment: The SOS Intervention Study
Narbro et al.
Arch Intern Med 2002;162:2061-2069.
ABSTRACT | FULL TEXT  

Effects of Reduced Sodium Intake on Hypertension Control in Older Individuals: Results From the Trial of Nonpharmacologic Interventions in the Elderly (TONE)
Appel et al.
Arch Intern Med 2001;161:685-693.
ABSTRACT | FULL TEXT  

Choose and Prepare Foods with Less Salt: Dietary Advice for All Americans
Loria et al.
J. Nutr. 2001;131:536S-551.
ABSTRACT | FULL TEXT  

Long-Term Weight Loss and Changes in Blood Pressure: Results of the Trials of Hypertension Prevention, Phase II
Stevens et al.
ANN INTERN MED 2001;134:1-11.
ABSTRACT | FULL TEXT  

The Urgent Need to Improve Hypertension Care
Trilling and Froom
Arch Fam Med 2000;9:794-801.
ABSTRACT | FULL TEXT  

Effects of a salt-restricted diet on the intake of other nutrients
Korhonen et al.
Am. J. Clin. Nutr. 2000;72:414-420.
ABSTRACT | FULL TEXT  

Step-Down of Enalapril Treatment for Arterial Hypertension
Gonzalez-Juanatey et al.
Hypertension 1999;34:1287-1292.
ABSTRACT | FULL TEXT  

Predictors and Mediators of Successful Long-term Withdrawal From Antihypertensive Medications
Espeland et al.
Arch Fam Med 1999;8:228-236.
ABSTRACT | FULL TEXT  

Setting the TONE for Ending the Hypertension Epidemic
Stamler
JAMA 1998;279:878-879.
FULL TEXT  

Nutritional Factors and Hypertension
Lardinois
Arch Fam Med 1995;4:707-713.
ABSTRACT  

The Primary Prevention of Coronary Heart Disease in Women
Rich-Edwards et al.
NEJM 1995;332:1758-1766.
FULL TEXT  

Effect of Administration and Withdrawal of Doxazosin on Ambulatory Blood Pressure in Patients with Essential Hypertension
Takata et al.
ANGIOLOGY 1995;46:11-18.
ABSTRACT  

Reduction in Long-term Antihypertensive Medication Requirements: Effects of Weight Reduction by Dietary Intervention in Overweight Persons With Mild Hypertension
Davis et al.
Arch Intern Med 1993;153:1773-1782.
ABSTRACT  

Weight Loss Intervention in Phase 1 of the Trials of Hypertension Prevention
Stevens et al.
Arch Intern Med 1993;153:849-858.
ABSTRACT  

National High Blood Pressure Education Program Working Group Report on Primary Prevention of Hypertension
Arch Intern Med 1993;153:186-208.
ABSTRACT  

Nonpharmacologic Intervention to Reduce Blood Pressure in Older Patients With Mild Hypertension
Applegate et al.
Arch Intern Med 1992;152:1162-1166.
ABSTRACT  

The Trial of Antihypertensive Interventions and Management (TAIM) Study: Adequate Weight Loss, Alone and Combined With Drug Therapy in the Treatment of Mild Hypertension
Wassertheil-Smoller et al.
Arch Intern Med 1992;152:131-136.
ABSTRACT  

Increasing the Dietary Potassium Intake Reduces the Need for Antihypertensive Medication
Siani et al.
ANN INTERN MED 1991;115:753-759.
ABSTRACT  

The Treatment of Mild Hypertension Study: A Randomized, Placebo-Controlled Trial of a Nutritional-Hygienic Regimen Along With Various Drug Monotherapies
The Treatment of Mild Hypertension Research Group
Arch Intern Med 1991;151:1413-1423.
ABSTRACT  

Antihypertensive Therapy: To Stop or Not to Stop?
Schmieder et al.
JAMA 1991;265:1566-1571.
ABSTRACT  

Pharmacologic and Nutritional Treatment of Mild Hypertension: Changes in Cardiovascular Risk Status
Oberman et al.
ANN INTERN MED 1990;112:89-95.
ABSTRACT  

Primary Prevention of Hypertension by Nutritional-Hygienic Means: Final Report of a Randomized, Controlled Trial
Stamler et al.
JAMA 1989;262:1801-1807.
ABSTRACT  

Hypertension in Elderly Patients
Applegate
ANN INTERN MED 1989;110:901-915.
ABSTRACT  

The Purdue Stepped Approach Model: A Heuristic Application to Health Counseling
Black and Hultsman
The Counseling Psychologist 1988;16:647-667.
ABSTRACT  

Dietary Sodium Restriction as Adjunctive Treatment of Hypertension
Weinberger et al.
JAMA 1988;259:2561-2565.
ABSTRACT  

Persistence of Reduction in Blood Pressure and Mortality of Participants in the Hypertension Detection and Follow-up Program
Hypertension Detection and Follow-up Program Coope et al.
JAMA 1988;259:2113-2122.
ABSTRACT  

Remission of Hypertension: The 'Natural' History of Blood Pressure Treatment in the Framingham Study
Dannenberg and Kannel
JAMA 1987;257:1477-1483.
ABSTRACT  

Nutritional Therapy for High Blood Pressure: Final Report of a Four-Year Randomized Controlled Trial-- The Hypertension Control Program
Stamler et al.
JAMA 1987;257:1484-1491.
ABSTRACT  

Antihypertensive Drug Therapy Withdrawal in a General Population
Alderman et al.
Arch Intern Med 1986;146:1309-1311.
ABSTRACT  

Slowing the Return of Hypertension After Stopping Medication
Finnerty
JAMA 1985;254:503-503.
ABSTRACT  

The Decision to 'Unmedicate'
Flamenbaum and Cohen
JAMA 1985;253:687-688.
ABSTRACT