1. Introduction
disability, deaths, hypertensive
HIGH BLOOD PRESSURE
Current Institution: Department of Nutrition, Harvard T.H. Chann School of Public Health, Boston, MA 02115, USA.There is sound evidence showing the efficacy of non-pharmacological interventions in lowering blood pressure (BP); however, adherence is usually poor. Interventions to induce behavioral changes aim to improve the ability to read labels, choose foods, and eat low-sodium meals, reinforcing adherence to sodium restriction. In this randomized parallel-controlled trial, we assessed the effectiveness of an educational intervention using the Dietary Sodium Restriction Questionnaire (DSRQ) scores. A follow-up period of 6 months was conducted. Participants were randomized into (1) an educational intervention provided by a registered dietitian on individual visits and dietary planning; (2) a control group with the usual care and dietary recommendations. Patients underwent 24-h ambulatory BP monitoring, 12-h fasting blood tests, spot urine collection, and assessment using DSRQ. We randomized 120 participants (67.5% women and 68.3% Caucasians), and 25 participants were lost to follow-up. The 24-h sodium urinary excretion changed in the control (Δ −1610 mg/day; 95% confidence interval [CI] −1800 to −1410) and intervention groups (Δ −1670 mg/day; 95% CI −1800 to −1450) over time. There was no significant difference in the 24-h estimated sodium between groups. In hypertensive patients, DSRQ-based educational intervention is effective for improving the ability to detect and overcome obstacles to a low-sodium restriction diet but is as effective as dietary recommendations for lowering sodium.High blood pressure (BP) is the primary preventable cause of mortality and disability worldwide, resulting in over 10.4 million deaths and 218 million disability-adjusted life-years [Despite recommendations to cook with low sodium and prefer fresh foods, the average Brazilian population consumes 4700 milligrams of sodium per day [The TPB emphasizes that a person’s behavioral intention is the most crucial factor, with attitude, subjective norm, and perceived behavioral control being the determinants of behavioral intention. The validation of the Dietary Sodium Restriction Questionnaire (DSRQ) as a valuable tool [