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Final Report of a Four-Year Randomized Controlled Trial— The Hypertension Control Program

Rose Stamler, MA; Jeremiah Stamler, MD; Richard Grimm, MD, PhD; Flora C. Gosch, MD; Patricia Elmer, MS, RD; Alan Dyer, PhD; Reuben Berman, MD; Joan Fishman, MS, RD; Nancy Van Heel, MS, RD; Jean Civinelli; Arline McDonald, PhD

JAMA. 1987;257(11):1484-1491.

Abstract
A four-year trial assessed whether less severe hypertensives could discontinue antihypertensive drug therapy, using nutritional means to control blood pressure. Randomization was to three groups: group 1—discontinue drug therapy and reduce overweight, excess salt, and alcohol; group 2—discontinue drug therapy, with no nutritional program; or group 3—continue drug therapy, with no nutritional program. In groups 1 and 2 patients resumed drug therapy if pressure rose to hypertensive levels. Loss of at least 4.5 kg (10+ lb) was maintained by 30% of group 1, with a group mean loss of 1.8 kg (4 lb); sodium intake fell 36% and modest alcohol intake reduction was reported. At four years, 39% in group 1 remained normotensive without drug therapy, compared with 5% in group 2. Study findings demonstrated that nutritional therapy may substitute for drugs in a sizable proportion of hypertensives or, if drugs are still needed, can lessen some unwanted biochemical effects of drug treatment.

(JAMA 1987;257:1484-1491)

Author Affiliations
From the Department of Community Health and Preventive Medicine, Northwestern University Medical School, Chicago (Drs J. Stamler, Gosch, Dyer, and McDonald, Prof R. Stamler, and Mss Fishman and Civinelli); the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (Dr Grimm and Ms Elmer); and Clinical Studies, Mount Sinai Hospital, Minneapolis (Dr Berman and Ms Van Heel).

Footnotes
Reprint requests to Northwestern University Medical School, Department of Community Health and Preventive Medicine, Morton Bldg 1-615, Chicago, IL 60611 (Prof R. Stamler).

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