Trial on control of hypertension by nutritional means: three-year results

Ability to safely withdraw medication from well-controlled mild hypertensives was tested in a 3-group randomized trial. Group I (Intervention): drugs were stopped 2 months after nutrition counseling began. Counselling continued throughout the remaining years of the trial to achieve: a minimum of 10 lb weight loss if overweight; reduction of sodium intake to 1800 mg/day or less; reduction of alcohol intake to not more than 2 drinks per day. Group II (control group 1): drugs were stopped to see if previous long-term blood pressure control had a carryover effect without diet change. Pressure was monitored frequently in both groups with return to treatment if diastolic blood pressure rose to 90 mmHg or above. Group III (control group 2) remained on drugs for comparison of blood pressure and biochemical variables. In Group I mean weight loss at 3 years was 7 lb (3.18 kg) with 39% losing 10 lb (4.55 kg) or more; sodium intake was reduced by 37%. Blood pressure control without drugs was achieved in 44% of Group I patients. This compares with only 15% in Group II. These findings suggest it may be possible after establishing good blood pressure control, to maintain control in a sizeable proportion with less or no medication, when reduction of weight, sodium, and alcohol is achieved.