Long-term follow-up of participants in a health promotion program for treated hypertensives (ADAPT).
OBJECTIVE
Improvements in a lifestyle modification program for hypertensives were maintained 1 year later. Longer follow-up in such studies is limited; we therefore re-assessed participants after an additional 2 years in which there was no contact with program facilitators.


RESULTS
Participants randomised to usual care (N=118) or a 4-month lifestyle program (N=123) were previously assessed after 4 months and 1 year. After a further 2 years, diet, alcohol intake, physical activity, weight, waist girth, ambulatory blood pressure (BP), blood lipids, glucose and insulin were measured (usual care N=64; program N=76). Statistically significant net changes, relative to usual care, included blood cholesterol (-0.2 mmol/L, 95% CI 0.1-0.4); physical activity (53 min/week, 95% CI 15-91); dietary saturated fat (-1.9% energy, 95% CI -0.1 to -3.8); fish (3.2 serves/month, 95% CI 0.7-5.7); vegetables (9.1 serves/month, 95% CI 3.2-15.1); and sweet foods (-6.2 serves/month, 95% CI -1.1 to -11.3). Between-group changes in weight (-0.7 kg, 95% CI -1.8-0.4), BP (systolic 1.4 mmHg, 95% CI -0.7-3.5)/diastolic 1.0 mmHg, 95% CI -0.3-2.4) and Framingham risk (usual care: men 12.1%, women 3.7%; program: men 12.2%; women 3.5%) did not differ significantly.


CONCLUSIONS
Continued reinforcement with long-term follow-up is needed in lifestyle modification programs.
Burke
Valerie
V
University of Western Australia, School of Medicine and Pharmacology, The Cardiovascular Research Centre and West Australian Institute for Medical Research, Perth, Australia. vburke@cyllene.uwa.edu.au
Mansour
Jacqueline
J
Beilin
Lawrie J
LJ
Mori
Trevor A
TA
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control*; D004032:Diet; D015444:Exercise / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000628:therapy*; D007328:Insulin / Q000097:blood; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control; D017063:Outcome Assessment, Health Care; D013997:Time Factors; D016896:Treatment Outcome
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids