Hypertension is a major risk factor for mortality and morbidity in the USA and most of the Western societies. Drug treatment of hypertension, although effective in reducing mortality and morbidity, is associated with untoward side effects. Because of the magnitude of the problem of hypertension and the inherent fallacy in a policy of using drugs to control hypertension, it seems prudent to test the feasibility, safety, and efficacy of nonpharmacologic methods of intervention (including changes in dietary habits and other relevant life style behaviors) in our approach to primary prevention of hypertension. We have attempted to document our capacity of recruiting 200 (or even 250) eligible participants aged 25-49 years for Phase IB of TOHP and have presented methods of intervention we would like to test. These methods include weight reduction, sodium restriction with potassium supplementation, and physical exercise training. Participants will be assigned randomly to each of these three groups and to a control group. Results in each group of approximately 50 participants will be compared with a control group of approximately 50 participants (a total of 200). In addition, we have discussed our competence and willingness to conduct other intervention procedures such as the biofeedback/relaxation or dietary changes dealing with fat intake or other nutrients such as calcium and magnesium. The intervention method for dietary modification modality will include a combination of group sessions and individual counseling. The adherence to the regimen will be monitored by overnight urinary excretion of Na+ and K+ and by review of 24-hour food record. In exercise training group, participants will be trained for a 20 week period for aerobic dynamic exercise program employing simple modalities of exercise to improve heart rate (HR) and blood pressure (BP).
