A lifestyle program for treated hypertensives improved health-related behaviors and cardiovascular risk factors, a randomized controlled trial.
OBJECTIVE
To assess effects of a cognitively based program on health-related behaviors and cardiovascular risk factors in overweight drug-treated hypertensives.


METHODS
In a clinical trials center, volunteers, recruited by advertisement, were randomized to usual care (N=118) or to a 4-month program (N=123) incorporating weight loss; a low-sodium diet, high in fruit, vegetables, and fish; and increased physical activity. Diet, physical activity, weight, blood lipids, glucose, and insulin were measured at 4 and 16 months.


RESULTS
Ninety-eight usual care and 106 program participants completed the 4-month assessment; 90 and 102, respectively, completed follow-up. Using intention-to-treat analysis, relative to usual care, net changes with the program at 4 months were as follows: dietary fat (-2.6% energy; P<0.001); sodium (-290mg/d; P=0.004); energy (-313mJ/d; P=0.005); fish (+2.1 serves/wk; P<0.001); vegetables (+3.0 serves/wk; P<0.001); physical activity (+37min/wk; P=0.004); weight (-2.8kg; P<0.001); waist girth (-3.1cm; P<0.001); total cholesterol (-0.2mmol/L; P=0.017); and triacylglycerols (-0.12mmol/L; P=0.002). One year later, net changes included dietary fat (-2.2% energy; P<0.001); sodium (-150mg/d; P=0.029); fish (+2.0 serves/wk; P<0.001); vegetables (+4.3 serves/wk; P<0.001); weight (-2.5kg; P=0.001); waist girth (-3.1cm; P<0.001); high-density lipoprotein cholesterol (+0.03mmol/L; P=0.031).


CONCLUSIONS
Improvements in behaviors and risk factors, several maintained long term, suggest the potential for long-term benefits in hypertensives.
Burke
Valerie
V
University of Western Australia, School of Medicine and Pharmacology, Royal Perth Hospital Unit, the Cardiovascular Research Centre and West Australian Institute for Medical Research, Perth, Australia. vburke@cyllene.uwa.edu.au
Beilin
Lawrie J
LJ
Cutt
Hayley E
HE
Mansour
Jacqueline
J
Williams
Amy
A
Mori
Trevor A
TA
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000523:psychology / Q000628:therapy*; D007328:Insulin / Q000097:blood; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids