Abstract 19187: Impact of a Tailored Behavioral Intervention on Lowering Sodium Intake in Adults With Uncontrolled Hypertension
Introduction: : Sodium is related to elevated blood pressure (BP) and reducing sodium intake is a key non-pharmacological approach to lowering BP. We conducted a randomized controlled trial testing whether a tailored or non-tailored behavioral intervention would lead to lower BP. Sodium intake was one of the key dietary behaviors targeted.
METHODS: This 3-arm randomized controlled trial evaluated the effectiveness of two active interventions, each compared to the usual care (UC) control group. Participants in the active intervention groups received either a tailored stage-matched intervention (SMI) based on the transtheoretical model (TTM) or a non-tailored health education intervention (HEI) to lower BP through six monthly telephone calls targeting diet, exercise and medication adherence. Participants were adult patients with repeated uncontrolled blood pressure. Urinary sodium levels were measured at baseline and post-intervention (6 months). We indexed sodium intake using urinary sodium-to-creatinine ratio to standardize for time and urine volume since last urination. To compare the two intervention groups with the usual care group at the 6-month follow-up we conducted planned contrasts comparing SMI and HEI with UC in a robust regression model adjusting for baseline sodium-to-creatinine ratio.
RESULTS: At baseline, there were no differences between the groups with the median sodium-to-creatinine ratios being 9.28 for SMI, 10.08 for HEI and 8.99 for UC. At the 6-month follow-up, the median sodium-to-creatinine ratio was 7.99 for SMI, 8.76 for HEI and 9.39 for UC. Participants in the SMI group showed on average lower sodium-to-creatinine ratio than participants in the usual care group (SMI-UC contrast: p = .04). Participants in the HEI group did not differ from participants in the usual care group (HEI-UC contrast: p = .45).
CONCLUSIONS: A TTM-based tailored behavioral intervention leads to lower sodium intake. Such an intervention shows promise for lowering sodium intake in adults with uncontrolled hypertension.
- © 2013 by American Heart Association, Inc.