title: The effects of weight loss and salt reduction on visit-to-visit blood pressure variability: results from a multicenter randomized controlled trial.
abstract: OBJECTIVE
  As evidence suggests visit-to-visit variability (VVV) of blood pressure (BP) is associated with cardiovascular events and mortality, there is increasing interest in identifying interventions that reduce VVV of BP. We investigated the effects of weight loss and sodium reduction, alone or in combination, on VVV of BP in participants enrolled in phase II of the Trials of Hypertension Prevention.
  
  
  METHODS
  BP readings were taken at 6-month intervals for 36 months in 1820 participants with high-normal DBP who were randomized to weight loss, sodium reduction, combination (weight loss and sodium reduction), or usual care groups. VVV of BP was defined as the SD of BP across six follow-up visits.
  
  
  RESULTS
  VVV of SBP was not significantly different between participants randomized to the weight loss (7.2 ± 3.1  mmHg), sodium reduction (7.1 ± 3.0  mmHg), or combined (6.9 ± 2.9  mmHg) intervention groups vs. the usual care group (6.9 ± 2.9  mmHg). In a fully adjusted model, no difference (0.0 ± 0.2  mmHg) in VVV of SBP was present between individuals who successfully maintained their weight loss vs. individuals who did not lose weight during follow-up (P = 0.93). Also, those who maintained a reduced sodium intake throughout follow-up did not have lower VVV of SBP compared to those who did not reduce their sodium intake (0.1 ± 0.3  mmHg; P = 0.77). Results were similar for VVV of DBP.
  
  
  CONCLUSIONS
  These findings suggest that weight loss and sodium reduction may not be effective interventions for lowering VVV of BP in individuals with high-normal DBP.
authors.affiliation: aCenter for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York bHypertension, Molecular, and Applied Physiology Laboratory, Department of Kinesiology, Temple University, Philadelphia, Pennsylvania cDepartment of Epidemiology, University of Alabama Birmingham, Birmingham, Alabama dVascular Health Laboratory, Department of Kinesiology & Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Diaz
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Emily B
authors.initials: EB
authors.lastname: Levitan
authors.forename: Michael D
authors.initials: MD
authors.lastname: Brown
authors.forename: Dianne M
authors.initials: DM
authors.lastname: Babbitt
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
mesh_terms: D000328:Adult; D001794:Blood Pressure; D001795:Blood Pressure Determination; D001835:Body Weight; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D017673:Sodium Chloride, Dietary; D015431:Weight Loss
chemical_list: D017673:Sodium Chloride, Dietary