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To the Editor: Dr Whelton and colleagues¹ did not accurately address the role of dietary sodium reduction in the primary prevention of hypertension. They summarized the findings of the TONE trial² and the DASH-Sodium trial,³ but neither of these can be considered as primary preventive interventions. Participants in these trials had treated hypertension or fulfilled, in most instances, the Joint National Committee VI criteria for blood pressure–lowering treatment.⁴ Similarly, their description of observational studies (NHANES I Epidemiologic Follow-up Study and Finnish Study), which demonstrated an association between dietary sodium intake and mortality independent of blood pressure, do not seem relevant.

On the other hand, the authors do not cite the results of the largest and longest randomized controlled trial of dietary sodium restriction in people without hypertension that was specifically designed to assess its effectiveness for primary prevention.⁵ They also did not mention the long-term findings of a trial in . . . [Full Text of this Article]

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