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).

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project--Cooperative Agreements (U01)
Project #
1U01HL037904-01
Application #
3552860
Study Section
(SRC)
Project Start
1986-09-30
Project End
1990-06-29
Budget Start
1986-09-30
Budget End
1987-06-29
Support Year
1
Fiscal Year
1986
Total Cost
Indirect Cost
Name
University of California Davis
Department
Type
Schools of Medicine
DUNS #
094878337
City
Davis
State
CA
Country
United States
Zip Code
95618
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Cook, Nancy R; Obarzanek, Eva; Cutler, Jeffrey A et al. (2009) Joint effects of sodium and potassium intake on subsequent cardiovascular disease: the Trials of Hypertension Prevention follow-up study. Arch Intern Med 169:32-40
Cook, Nancy R; Cutler, Jeffrey A; Obarzanek, Eva et al. (2007) Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ 334:885-8
Kumanyika, S K; Cook, N R; Cutler, J A et al. (2005) Sodium reduction for hypertension prevention in overweight adults: further results from the Trials of Hypertension Prevention Phase II. J Hum Hypertens 19:33-45
Cook, N R; Kumanyika, S K; Cutler, J A et al. (2005) Dose-response of sodium excretion and blood pressure change among overweight, nonhypertensive adults in a 3-year dietary intervention study. J Hum Hypertens 19:47-54
Yamamoto, M E; Applegate, W B; Klag, M J et al. (1995) Lack of blood pressure effect with calcium and magnesium supplementation in adults with high-normal blood pressure. Results from Phase I of the Trials of Hypertension Prevention (TOHP). Trials of Hypertension Prevention (TOHP) Collaborative Research Group Ann Epidemiol 5:96-107
Whelton, P K; Buring, J; Borhani, N O et al. (1995) The effect of potassium supplementation in persons with a high-normal blood pressure. Results from phase I of the Trials of Hypertension Prevention (TOHP). Trials of Hypertension Prevention (TOHP) Collaborative Research Group. Ann Epidemiol 5:85-95