BMJ  2004;329:111-112 (10 July), doi:10.1136/bmj.329.7457.111-c

Letter

Brief lifestyle interventions for hypertension

Authors' reply

The first 150 words of the full text of this article appear below.

EDITOR—Cappuccio's suggestions do not explain the results.

Nurses measured blood pressure by using semiautomated monitors (minimising measurement bias) and gave structured advice in all groups (minimising placebo effect^{1 2}). Any bias is likely to favour the active interventions, and there was no evidence of this.

General practitioners and nurses were asked to refer patients after two to three readings, using appropriate cuff sizes on a single occasion—the group targeted for non-pharmacological advice according to guidelines from the British Hypertension Society. After a few weeks the baseline blood pressure (the mean of three readings on the second occasion) was 153/93 mm Hg, similar to the previous smaller Dutch study (158/91 mm Hg), which indicated that low sodium salt was effective.³ When patients with a baseline diastolic blood pressure above 90 mm Hg (n = 171) were selected the estimate for the low salt group was - 1.16 mm Hg . . . [Full text of this article]

P.Little@soton.ac.uk

University of Southampton, Division of Community Clinical Sciences, Primary Medical Care Group, Southampton SO16 5ST

Public Health Nutrition, University of Southampton, Community Clinical Sciences Division, Southampton General Hospital, Southampton SO16 6YD

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