Trials of multifactorial programs in a clinical setting
have met with some success [5] as have, more recently,
cognitively based programs to facilitate behavior change
[6,7]. In the TOPH II trial, participants at risk of hypertension
achieved greater weight loss and lower BP, relative to
usual care, after 6 and 18 months of an intervention that
promoted weight reduction and sodium restriction [8]. Although
weight loss was attenuated after 3 years of followup,
BP remained lower in the weight loss group than in
those receiving usual care. These findings suggest longterm
benefits from weight loss, even if this is modest or
not sustained.