Abstract 17858: An Intervention to Reduce Sodium Intake can Lower Blood Pressure in Adults With Multiple Cardiovascular Risk Factors Living in a Rural Austere Environment
Background: Studies demonstrating that reduction in dietary sodium intake resulted in decreased blood pressure (BP) were conducted under tightly controlled conditions. There is little evidence that interventions to reduce dietary sodium can produce sufficient reductions in sodium intake to lower BP in individuals with multiple cardiovascular disease (CVD) risk factors living in a rural austere environment.
Objective: To determine effects of a self-care CVD risk reduction intervention that included strategies for reducing dietary sodium in rural Appalachians at high risk for CVD on 24-hour urine sodium excretion and BP.
Methods: BP and 24-hour urine sodium excretion were measured in a subsample of 200 adults (77% women; mean age 58 ± 15yrs) enrolled in the HeartHealth study at baseline and following a 12-week self-care CVD risk reduction program focused on reducing environmental and personal barriers to CVD risk reduction including strategies to decrease dietary sodium. Half were randomized to receive the intervention immediately and half to a 3-month wait-list control group that received the intervention 3 months later. Within-subjects baseline and post-intervention urine sodium excretion and BP were compared by repeated measures ANOVA. The interaction between urine sodium and BP over time was also tested.
Results: There was no change in 24-hour sodium excretion levels or BP in the wait-list control group during the 3 month waiting period. Both groups had a significant decrease from pre-intervention to post-intervention in urine sodium excretion, mg/day (3605±1483 down to 3267±1137, p =.038), systolic BP (130±17 to 125±15p < .001), and diastolic BP (78±9 to 75±8, p< .001) . There was a significant (p = .043) urine sodium by BP interaction indicating changes in these two variables over time were related.
Conclusion: These results are among the first to demonstrate that a self-care CVD risk reduction intervention can reduce dietary sodium intake sufficiently to reduce BP in adults living in an austere environment with limited access to heart healthy foods. They indicate individuals living in austere environments are both willing and able to change behaviors to improve cardiovascular health.
- © 2013 by American Heart Association, Inc.