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To the Editor.—Dr Whelton and colleagues¹ report that weight reduction and dietary sodium restriction can influence blood pressure (BP) and the need for antihypertensive therapy in healthy elderly patients. If our understanding of the methods is correct, the observed modest change in BP in the experimental subjects may have been attributable to either sodium restriction or weight loss or to increased personal contact with dedicated and skilled health care workers. It would be useful to test whether sodium restriction (or level) was related to BP change in an effort to tease out which of the 2 aspects of the intervention was responsible for the observed results.

Confirmation that vigorous interventions may affect a physiologic variable is interesting. However, the critical issues are whether a low-sodium diet can extend or improve life and whether it is safe. This study was not designed to answer these public health questions. In view . . . [Full Text of this Article]