Trial reports better 12-week blood pressure control after salt-sensitivity testing
In 210 adults with newly detected stage 1 hypertension in Uzbekistan, a testing-guided strategy was compared with usual medication selection.
Moderate evidenceHuman studySome caution advised
Medical disclaimer: This article summarizes research findings and is for informational purposes only. It is not medical advice.
Editorial illustration — not from the study.
Researchers tested whether a brief salt-sensitivity assessment could help select an initial blood-pressure medicine rather than relying on medication changes over time. Participants were assigned to either a testing-guided group or a conventional-care group, and blood pressure was assessed after 12 weeks.
The testing-guided group had a higher percentage of participants below 140/90 mm Hg and a larger average reduction in systolic blood pressure. The study also reported that fewer participants in this group needed a second medicine. It did not find a statistically significant difference in reported adverse events, and the available results do not give a quantitative measure of psychological stress.
What the review covered
This prospective cluster-randomized trial examined whether identifying salt sensitivity could guide the initial selection of blood-pressure medicines for adults with recently detected stage 1 hypertension. It included 210 participants from three primary care centers in Tashkent and the Fergana Valley region of Uzbekistan between May and November 2025. In the phenotype-guided group, participants underwent an oral salt test. Those classified as salt-sensitive received one medication approach, while those classified as salt-resistant received another; a second medicine could be added if the target was not reached. The conventional-care group received one of several medication types selected by the treating physician according to national guidelines.
Key conclusions
Within the phenotype-guided group, 53.6% of participants were classified as salt-sensitive. After 12 weeks, 78.6% of that group reached the study target of below 140/90 mm Hg, compared with 62.2% in the conventional-care group. The average systolic blood-pressure decrease was 18.9 mm Hg in the phenotype-guided group and 14.7 mm Hg in the conventional-care group. A second medication was reported as necessary for 36.4% versus 51.6% of participants, respectively. These differences were statistically significant in the study. Reported adverse events did not differ statistically between groups. The study's stated goal included reducing psychological stress from medication trial and error, but the provided results do not report a specific psychological-burden measure.
Where this may apply
These findings may be most relevant to adults with recently detected stage 1 hypertension who receive care in settings similar to the three participating primary care centers. They should not be assumed to apply to people with other stages or causes of hypertension, people with major coexisting conditions, or health systems using different testing and prescribing practices. The study is evidence about a group-level comparison, not a determination of which medication or testing strategy is suitable for any individual.
Why it matters
The findings suggest that, in this particular human study, salt-sensitivity testing was associated with better short-term blood-pressure outcomes than the conventional medication-selection approach used for comparison. If similar results were found in larger and more diverse studies, this testing strategy could be of interest for research on how initial medication choices are made. The study does not establish that the approach is appropriate for all people with hypertension or that it reduces psychological burden.
Limitations & evidence assessment
The study included only 210 people, came from three centers in Uzbekistan, and followed participants for just 12 weeks, so the results may not represent longer-term blood-pressure control or other populations. The available abstract and excerpts do not provide detailed information about participant characteristics, adherence, how allocation was implemented, or the completeness of follow-up. The study does not report a quantitative assessment of psychological burden, despite listing it as an aim. It also does not provide enough detail to determine whether the reported adverse-event comparison could identify less common or longer-term harms. The excerpts do not state the authors' own limitations, so additional limitations may not be captured here.
Why this evidence level: This was a relatively small cluster-randomized trial involving 210 people, which provides more informative evidence than an observational study. However, it took place in only three centers, followed participants for 12 weeks, and the available information does not provide enough detail for a full clinical appraisal.
Evidence levels are editorial estimates derived from study metadata — they are not clinical appraisals.
// Source
North American journal of psychology · 2026 · DOI: 10.65696/001c.172488
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