Cardiovascular outcomes of lifestyle intervention in hypertensive patients with antihypertensive agents.
OBJECTIVE
This study aims to investigate whether changes in lifestyle, added to the antihypertensive treatment, could translate to changes in cardiovascular (CV) morbidity and mortality in hypertensive patients.


METHODS
Between October 2007 and November 2008, men or women (50-79years) were enrolled randomly in this study when their BP was 140/90-179/109mmHg with a 2-weeks run-in stage firstly. All participants had at least one additional CV risk factor, indicated by a history of stroke, myocardial infarction (MI), etc.


RESULTS
12,245 (90.4%) patients were eligible for our analysis. We assigned them to the lifestyle intervention group (5225) or to control group (7020). In the end of the study, weight loss at least 1kg of the participants of the intervention group of accounted for 33.2%, control group was 24.9 (P<0.001). Salt intake more than 6g of the participants accounted for 29.4% in the intervention group, 38.4% in the control group (P<0.001). The composite CV events which include non-fatal stroke, MI and CV death, happened in 133 (2.2%) participants of intervention group and 177 (2.4%) in the control group. However, the improvement of composite CV events reduced 55% (adjusted HR=0.45, 95% CI: [0.32,0.63]), and decreased by 55% (HR=0.45, 95% CI: [0.37,0.63]) for all CV events.


CONCLUSIONS
The effect of advised only lifestyle intervention used in our study is minor for CV prevention. However, the effect of improvement of lifestyle on CV prevention is indisputable even in hypertensives who receive a-hypertension drug treatment.
Department of Cardiac Surgery, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Kun
K
Hua
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China.
Guang
G
Hao
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China. Electronic address: liwei_1266@126.com.
Wei
W
Li
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D040242:Risk Reduction Behavior; D016896:Treatment Outcome
D000959:Antihypertensive Agents
Blood pressure; Cardiovascular; Exercise; Healthy diet; Lifestyle