title: E-counseling as an emerging preventive strategy for hypertension.
abstract: OBJECTIVE
  Lifestyle counseling that includes exercise training, diet modification, and medication adherence is critical to hypertension management. This article summarizes the efficacy of lifestyle counseling interventions in face-to-face, telehealth, and e-counseling settings. It also discusses the therapeutic potential of e-counseling as a preventive strategy for hypertension.
  
  
  RESULTS
  The recent proliferation of telehealth and e-counseling programs increases the reach of preventive counseling for patients with cardiovascular disorders. Blood pressure reduction following these interventions is comparable to face-to-face interventions. However, the effectiveness of e-counseling varies depending on the design features of the core protocol. An evidence-based guideline needs to be established that identifies e-counseling components which are independently associated with blood pressure reduction. As the Internet becomes more sophisticated, e-counseling is demonstrating a therapeutic advantage in comparison with other telehealth interventions.
  
  
  CONCLUSIONS
  Current evidence supports further development of preventive e-counseling programs for hypertension. A pressing challenge for investigators is to specify key evidence-based components of e-counseling that are essential to the core protocol. In order to achieve this goal, it will be necessary to ensure that e-counseling programs are also clinically organized, in order to guide patients through the process of initiating and sustaining therapeutic behavior change.
authors.affiliation: aCardiac eHealth and Behavioural Cardiology Research Unit, Peter Munk Cardiac Center, University Health Network bFaculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Nolan
authors.forename: Sam
authors.initials: S
authors.lastname: Liu
authors.forename: Ada Y M
authors.initials: AY
authors.lastname: Payne
mesh_terms: D002985:Clinical Protocols; D003376:Counseling / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D020407:Internet; D008019:Life Style; D010353:Patient Education as Topic / Q000379:methods; D010358:Patient Participation / Q000379:methods; D017216:Telemedicine / Q000379:methods*