Dietary counselling has no effect on cardiovascular risk factors among Chinese Grade 1 hypertensive patients: a randomized controlled trial.
To evaluate the effectiveness of Dietary Approaches to Stop Hypertension (DASH) by one-off dietary counselling on reducing cardiovascular risk factors among Chinese Grade 1 hypertensive patients in primary care.



A parallel-group, randomized controlled trial (ChiCTR-TRC-13003014) was conducted among patients (40-70 years old) newly diagnosed with Grade 1 hypertension in primary care settings in Hong Kong. Subjects were randomized to usual care (standard education, control) (n = 275), or usual care plus DASH-based dietary counselling (intervention) (n = 281). The study endpoints included blood pressure (BP), lipid profile, and body mass index (BMI) at 6- and 12-months. Outcome data were available for 504 (90.6%) and 485 (87.2%) patients at 6 and 12 months, respectively. Blood pressure levels reduced in both groups at follow-ups. However, the intervention group did not show a significantly greater reduction in either systolic BP (-0.7 mmHg, 95%CI -3.0-1.5 at 6-month; -0.1 mmHg, 95%CI -2.4-2.2 at 12-month) or diastolic BP (-1.0 mmHg, 95%CI -2.7-0.7 at 6-month; -1.1 mmHg, 95%CI -2.9-0.6 at 12-month), when compared with the control group. The improvements in lipid profile and BMI were observed among all subjects, yet no significant differences were detected between intervention and control groups.



The DASH diet by one-off dietitian counselling which resembled the common primary care practice might confer no added long-term benefits on top of physician's usual care in optimizing cardiovascular risk factors. Physicians may still practice standard usual care, yet further explorations on different DASH delivery models are warranted to inform best clinical practice.
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Martin C S
MC
Wong
School of Public Health, Sun Yat-Sen University, Guangzhou 510080, P.R. China General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK haoxiangwang@163.com Haoxiang.Wang@glasgow.ac.uk.
Harry H X
HH
Wang
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Family Medicine and Primary Health Care, Hospital Authority, Hong Kong.
Mandy W M
MW
Kwan
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Brian C Y
BC
Fong
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Wai Man
WM
Chan
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
De Xing
DX
Zhang
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Shannon T S
ST
Li
Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Bryan P
BP
Yan
Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Monash University, Australia and the University of Warwick, UK.
Andrew J S
AJ
Coats
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Sian M
SM
Griffiths
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003376:Counseling; D005260:Female; D006293:Health Promotion / Q000379:methods; D006723:Hong Kong; D006801:Humans; D006973:Hypertension / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome
Cardiovascular risk factors; Chinese patients; DASH; Dietary approaches to stop hypertension; Dietary counselling; Primary care