Persistence of normotension after discontinuation of lifestyle intervention in the Trial of TONE

Background: Weight loss and sodium reduction programs are effective in treating hypertension, but there is little information about the persistence of the benefit after discontinuation of the intervention. Methods: The Trial of Nonpharmacologic Interventions in the Elderly (TONE) was a four-center controlled clinical trial of weight loss, reduced sodium intake, or both in maintaining normotension after withdrawal of antihypertensive drug therapy in older men and women whose hypertension was controlled with a single antihypertensive medication. Information on maintenance of normotension without need for drug therapy was obtained on 222 of 223 participants at the Robert Wood Johnson Medical School clinical center on average of 48.4 months (range 45 to 54 months) after the end of TONE. Results: At the end of TONE follow-up, 43% of participants in the combined intervention group were off medication compared with 25% in the usual care group (P =.011). At 48 months after the end of TONE and discontinuation of contact of the participants with the clinical center, 23% of the combined intervention group v 7% in the usual care group were off medication (P =.012). Conclusions: Some benefits of structured dietary intervention appears to persist long term in a significant number of patients after discontinuation of the intervention.