For older patients, a reduction in sodium, which is recommended for blood pressure control, may also help reduce the occurrence of headaches. Findings of this study were published online in the American Journal of Public Health.

Headache accounts for approximately 18 million office visits annually in the U.S. Previous research has shown that both headaches and high sodium intake have been linked to elevated blood pressure, however few studies have examined the relationship between sodium intake and the occurrence of headache.

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In this multicenter study (Trial of Nonpharmacologic Interventions in the Elderly), 975 patients (both men and women; 60–80 years old) with hypertension were randomized to either a sodium-reduction intervention group or control group and were followed for up to 36 months. In these patients, hypertension was managed with a single antihypertensive medication and those with history of heart attack or stroke within the preceding 6 months were excluded.

At each follow-up visit, mean difference in sodium excretion between the two groups was significant, with an average difference of 38.8millimoles/24hrs. Compared with control, the occurrence of headaches was significantly lower in patients in the sodium-reduction intervention group (14.3% vs. 10.5%, respectively; hazard ratio 0.59). There was a significant association between headache risk and average level of sodium excretion during follow-up, independent of other risk factors. A threshold effect was also noted, with headache risk increasing progressively above a sodium excretion of 150millimoles/24hrs.

The findings from this study were consistent with those from the DASH-Sodium trial which included middle-aged patients but used a different approach; whether a reduction in sodium lowers headache risk in other populations is currently unknown.  The authors conclude that “from a policy perspective, these data provide an additional rationale in support of recommendations by the American Heart Association, US federal government, Institute of Medicine, World Health Organization, and others to reduce dietary sodium intake.”

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