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Taking a new TONE

Nearly one in three adults has high blood pressure, according to the American Heart Association. While gaining control over high blood pressure can be as easy as taking one pill a day, for older folks even that can be a challenge. Many forget or encounter difficulty with side effects. Can nondrug options help seniors eliminate or reduce the need for high blood pressure medication?

That was the question the National Heart, Lung, and Blood Institute and the National Institute on Aging sought to answer with their Trial of Nonpharmacologic Interventions in the Elderly (TONE). Researchers studied 975 people ages 60 to 80 with hypertension. The 585 overweight subjects were divided into four groups. In the first group, subjects were restricted to 1,800 mg of sodium a day. (Most Americans consume about 4,000 mg a day— about 1,600 more than the American Heart Association recommends.) The second group followed an eating plan designed to help them shed 10 or more pounds. The third group restricted salt and followed the weight-loss plan, and the fourth continued with “usual care,” getting no special help in making lifestyle changes. The 390 normal-weight subjects, meanwhile, were assigned to either a sodium-restricted or usual-care group. During the trial, all participants tried tapering off medication with their doctor’s guidance.

At the nine-month mark, more than a third of the sodium-restricted group had successfully reduced their intake, compared with only 11 percent in the usual-care group. And nearly half of those in the weight-loss group had shed 10 pounds or more, compared with only 13 percent in the usual-care group.

At the 30-month mark, 38 percent of those in the low-sodium group managed to control their blood pressure—without medication. In the weight-loss group, 39 percent were able to do so.

What’s striking is that moderate change was able to bring about such positive results. Cutting back on daily sodium intake by 900 mg (about the amount in three slices of bologna) and maintaining a weight loss of 7 1/2 pounds were enough to reduce the overall need for medication by 30 percent. Better yet, participants felt better thanks to their new, healthier habits.