title: Stress management and dietary counseling in hypertensive patients: a pilot study of additional effect.
abstract: BACKGROUND
  In Western societies, cardiovascular (CV) disease is the primary cause of mortality, and high blood pressure (BP) is the main reversible factor leading to CV disease. Dietary habits and psychosocial stress contribute to the establishment of hypertension, while its role in the control of high BP is currently examined. In this study, we examined the effect and feasibility of a combined intervention of dietary education and stress management on the control of hypertension.
  
  
  METHODS
  A randomized, controlled pilot study was designed to evaluate the effect of combined education on stress management techniques and dietary habits (Mediterranean diet principle) on office BP after eight weeks.
  
  
  RESULTS
  Of the 45 randomized subjects, 36 were included in the final analysis (control group = 20 (age: 67 ± 12 years, 31.8%, males) and intervention group = 16 (age: 62 ± 12 years, 47%, males)). CV disease risk factors (except smoking), BP, dietary habits, perceived stress and physical activity (all assessed with validated questionnaires) were similar between the two groups at baseline. After eight weeks, office BP (systolic and diastolic) and perceived stress were significantly reduced, whereas the adherence in Mediterranean diet principle was significantly increased, but only in the intervention group.
  
  
  CONCLUSIONS
  A combined intervention of stress management techniques and Mediterranean diet education seems to be beneficial for BP reduction. Such interventions could possibly serve as a complementary treatment along with drug therapy or in the early treatment of high normal BP. A call to action for designing epidemiological studies and evaluating the efficacy of such non-pharmacological treatment strategies is therefore warranted.
authors: 1 Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece.
authors: Alexia L
authors: AL
authors: Katsarou
authors: 1 Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece.
authors: Marios M
authors: MM
authors: Vryonis
authors: 1 Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece.
authors: Athanassios D
authors: AD
authors: Protogerou
authors: 1 Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece.
authors: Evangelos C
authors: EC
authors: Alexopoulos
authors: 1 Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece.
authors: Apostolos
authors: A
authors: Achimastos
authors: 2 1st Department of Propaedeutic and Internal Medicine, Hypertension Center and Cardiovascular Research Laboratory, Laiko Hospital, Athens, Greece.
authors: Dimitrios
authors: D
authors: Papadogiannis
authors: 1 Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece.
authors: George P
authors: GP
authors: Chrousos
authors: 1 Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece.
authors: Christina
authors: C
authors: Darviri
mesh_terms: D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D003376:Counseling / Q000379:methods*; D038441:Diet, Mediterranean; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D012064:Relaxation Therapy / Q000193:education*; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology / Q000628:therapy*