title: Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly.
abstract: To determine the effect of sodium (Na) reduction on occurrence of headaches.
  
  
  
  In the Trial of Nonpharmacologic Interventions in the Elderly, 975 men and woman (aged 60-80 years) with hypertension were randomized to a Na-reduction intervention or control group and were followed for up to 36 months. The study was conducted between 1992 and 1995 at 4 clinical centers (Johns Hopkins University, Wake Forest University School of Medicine, Robert Wood Johnson Medical School, and the University of Tennessee).
  
  
  
  Mean difference in Na excretion between the Na-reduction intervention and control group was significant at each follow-up visit (P < .001) with an average difference of 38.8 millimoles per 24 hours. The occurrence of headaches was significantly lower in the Na-reduction intervention group (10.5%) compared with control (14.3%) with a hazard ratio of 0.59 (95% confidence interval = 0.40, 0.88; P = .009). The risk of headaches was significantly associated with average level of Na excretion during follow-up, independent of most recent blood pressure. The relationship appeared to be nonlinear with a spline relationship and a knot at 150 millimoles per 24 hours.
  
  
  
  Reduced sodium intake, currently recommended for blood pressure control, may also reduce the occurrence of headaches in older persons with hypertension.
authors.affiliation: Liwei Chen is with the Department of Public Health Sciences, Clemson University, Clemson, SC. Zhenzhen Zhang is with the School of Public Health, Oregon Health & Science University, Portland. Wen Chen is with the Department of Pathology, VA Medical Center, Washington, DC. Paul K. Whelton is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. Lawrence J. Appel is with the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Liwei
authors.initials: L
authors.lastname: Chen
authors.affiliation: Liwei Chen is with the Department of Public Health Sciences, Clemson University, Clemson, SC. Zhenzhen Zhang is with the School of Public Health, Oregon Health & Science University, Portland. Wen Chen is with the Department of Pathology, VA Medical Center, Washington, DC. Paul K. Whelton is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. Lawrence J. Appel is with the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Zhenzhen
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Liwei Chen is with the Department of Public Health Sciences, Clemson University, Clemson, SC. Zhenzhen Zhang is with the School of Public Health, Oregon Health & Science University, Portland. Wen Chen is with the Department of Pathology, VA Medical Center, Washington, DC. Paul K. Whelton is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. Lawrence J. Appel is with the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Wen
authors.initials: W
authors.lastname: Chen
authors.affiliation: Liwei Chen is with the Department of Public Health Sciences, Clemson University, Clemson, SC. Zhenzhen Zhang is with the School of Public Health, Oregon Health & Science University, Portland. Wen Chen is with the Department of Pathology, VA Medical Center, Washington, DC. Paul K. Whelton is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. Lawrence J. Appel is with the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Whelton
authors.affiliation: Liwei Chen is with the Department of Public Health Sciences, Clemson University, Clemson, SC. Zhenzhen Zhang is with the School of Public Health, Oregon Health & Science University, Portland. Wen Chen is with the Department of Pathology, VA Medical Center, Washington, DC. Paul K. Whelton is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. Lawrence J. Appel is with the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Appel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D004305:Dose-Response Relationship, Drug; D005260:Female; D006261:Headache / Q000178:diet therapy* / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000178:diet therapy* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D012982:Sodium, Dietary / Q000008:administration & dosage* / Q000652:urine
chemical_list: D012982:Sodium, Dietary