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To the Editor: Drs Hu and Willett¹ only briefly addressed the role of diet in controlling hypertension. The relationship between hypertension and cardiovascular disease is well established² and the lifetime risk of hypertension is high.³ Providing dietary recommendations to patients for prevention of CHD and not addressing steps to prevent or control hypertension would be a major omission. In view of the generally high salt consumption in the United States and Canada, it is particularly misleading to not discuss salt intake in the face of strong evidence that reduced sodium consumption is associated with reduction in diastolic and systolic blood pressure⁴ and, therefore, reduced morbidity and mortality due to CHD.

Larry Bryan, MD, PhD
University of Calgary
Calgary, Alberta

1. Hu FB, Willett WC. Optimal diets for prevention of coronary heart disease. JAMA. 2002;288:2569-2578. FREE FULL TEXT 2. Stamler J, Stamler R, Neaton JD. Blood pressure, systolic and diastolic, and cardiovascular risks: US population data. Arch Intern Med. 1993;153:598-615. FREE FULL TEXT 3. Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in middle-aged women and men: the Framingham Heart Study. JAMA. 2002;287:1003-1010. FREE FULL TEXT 4. Sacks FM, Svetkey LP, Volmer WM, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001;344:3-10. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289:1509.

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