title: Efficacy of a multicomponent program (patient-centered assessment and counseling for exercise plus nutrition [PACE+ Japan]) for lifestyle modification in patients with essential hypertension.
abstract: With conventional lifestyle modification programs, it can be difficult for hypertensive individuals to modify their lifestyles and maintain the changes. We assessed whether a multicomponent program (patient-centered assessment and counseling for exercise plus nutrition [PACE+ Japan]) based on behavior theory and social cognitive theory would be effective for treating patients with essential hypertension. We examined 57 outpatients aged 62+/-10 years with essential hypertension irrespective of antihypertensive drug treatment. Participants were randomly divided into two groups: 1) a PACE+ Japan follow-up group (n =18), who were given an action-plan sheet and systemic health counseling by a physician and counselor every 4 weeks for 24 weeks, and 2) a PACE+ Japan-only group (n =20), who were given an action-plan sheet but did not receive counseling. An age- and sex-matched control group (n =19) was also selected. The decrease in systolic blood pressure (SBP) (Delta SBP=SBP at 24 weeks minus that at 0 weeks) in the PACE+ Japan follow-up group was significantly greater than that in the control group. In addition, the Delta percentage of Fat (%Fat) and Delta urinary sodium extraction (U-Na) in the PACE+ Japan follow-up group were significantly greater than those in the control group. With regard to changes in total energy expenditure, exercise energy expenditure and total energy intake between 0 weeks and 24 weeks, significant improvements were observed for the PACE+ Japan follow-up group. Delta U-Na was determined to significantly predict Delta SBP as assessed by stepwise selection. In addition, the partial correlation coefficient of Delta SBP with Delta U-Na was 0.361 (p =0.011) as assessed by a multiple regression analysis. Therefore, PACE+ Japan follow-up counseling was associated with a reduction in SBP, which in turn was associated with reduction in U-Na. This new program may be effective for reducing blood pressure in hypertensives.
authors.affiliation: Department of Cardiology, Fukuoka University School of Medicine, Japan. miuras@cis.fukuoka-u.ac.jp
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Miura
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Hidenori
authors.initials: H
authors.lastname: Urata
authors.forename: Yuki
authors.initials: Y
authors.lastname: Himeshima
authors.forename: Noriko
authors.initials: N
authors.lastname: Otsuka
authors.forename: Sayo
authors.initials: S
authors.lastname: Tomita
authors.forename: Kouji
authors.initials: K
authors.lastname: Yamatsu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishida
authors.forename: Keijiro
authors.initials: K
authors.lastname: Saku
mesh_terms: D000368:Aged; D001521:Behavior Therapy; D001794:Blood Pressure; D003376:Counseling / Q000458:organization & administration*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D007564:Japan; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D010045:Outpatients; D010353:Patient Education as Topic / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration; D015397:Program Evaluation; D012044:Regression Analysis; D040242:Risk Reduction Behavior; D012964:Sodium / Q000652:urine
chemical_list: D012964:Sodium