title: Non-pharmacological treatment of hypertension in primary health care: a 2-year open randomized controlled trial of lifestyle intervention against hypertension in eastern Finland.
abstract: OBJECTIVE
  To assess whether lifestyle counselling is effective in non-pharmacological treatment of hypertension in primary health care.
  
  
  METHODS
  Open randomized controlled trial.
  
  
  METHODS
  Ten municipal primary health care centres in eastern Finland.
  
  
  METHODS
  Seven hundred and fifteen subjects aged 25-74 years with systolic blood pressure 140-179 mmHg and/or diastolic blood pressure 90-109 mmHg or antihypertensive drug treatment.
  
  
  METHODS
  Systematic health counselling given by local public health nurses for 2 years.
  
  
  METHODS
  Blood pressure, lipids and lifestyle data were collected annually.
  
  
  RESULTS
  Among participants with no antihypertensive drug treatment, the net reductions after 1 year both in systolic blood pressure [-2.6 mmHg; 95% confidence interval (CI), -4.7 to -0.5 mmHg] and in diastolic blood pressure (-2.7 mmHg; 95% CI, -4.0 to -1.4 mmHg) were significant in favour of the intervention group. This difference in blood pressure change was maintained during the second year. In participants with antihypertensive drug treatment, no significant difference in blood pressure reduction was seen between the groups during the study.
  
  
  CONCLUSIONS
  A relatively modest, but systematic counselling in primary health care can, at least among untreated hypertensive subjects, produce reductions in blood pressure levels that are modest for the individual, but very important from the public health point of view.
authors.affiliation: Department of Public Health and General Practice, University of Kuopio, Finland. mika.kastarinen@uku.fi
authors.forename: Mika J
authors.initials: MJ
authors.lastname: Kastarinen
authors.forename: Pekka M
authors.initials: PM
authors.lastname: Puska
authors.forename: Maarit H
authors.initials: MH
authors.lastname: Korhonen
authors.forename: Juha N
authors.initials: JN
authors.lastname: Mustonen
authors.forename: Veikko V
authors.initials: VV
authors.lastname: Salomaa
authors.forename: Jouko E
authors.initials: JE
authors.lastname: Sundvall
authors.forename: Jaakko O
authors.initials: JO
authors.lastname: Tuomilehto
authors.forename: Matti I
authors.initials: MI
authors.lastname: Uusitupa
authors.forename: Aulikki M
authors.initials: AM
authors.lastname: Nissinen
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology; D008078:Cholesterol, LDL / Q000097:blood; D003376:Counseling; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011320:Primary Health Care; D012307:Risk Factors; D015431:Weight Loss
chemical_list: D000959:Antihypertensive Agents; D008078:Cholesterol, LDL