Blood Pressure Control in Individuals With Hypertension Who Used a Digital, Personalized Nutrition Platform: Longitudinal Study (Preprint)

Abstract

BACKGROUND While there is a strong association between adhering to a healthy dietary pattern and reductions in blood pressure, adherence still remains low. New technologies aimed to help facilitate behavior change may have an effect on reducing blood pressure among individuals with hypertension. OBJECTIVE To evaluate characteristics of participants with stage 2 hypertension who used Foodsmart and to assess changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP). METHODS We analyzed demographic, dietary, and clinical characteristics collected from 11,934 adults with at least two blood pressure readings who used the Foodsmart platform. Stage 2 hypertension was defined as SBP ≥ 140 mmHg or DBP ≥ 90 mmHg. We calculated mean changes in blood pressure among participants with stage 2 hypertension and stratified by length of follow-up and the covariates associated with achieving blood pressure levels below stage 2 hypertension. We compared changes in diet quality and weight between participants with stage 2 hypertension at baseline who achieved stage 1 hypertension or below and those who did not. RESULTS We found that 47.2% (5,627/11,934) and 10.6% (1,269/11,934) of the participants with at least two SBP and DBP readings had stage 1 and stage 2 hypertension, respectively, at baseline. Among Foodsmart participants with stage 2 hypertension at baseline, SBP and DBP had an absolute reduction, on average, of 5.6 mmHg and 4.0 mmHg, respectively. 33.0% (419/1,269) of participants with stage 2 hypertension at baseline achieved blood pressure levels below stage 2 hypertension (SBP < 140 mmHg and DBP < 90 mmHg). Using a multivariable ordinal logistic regression model, changes in Nutriscore and weight were statistically significantly associated with changes in blood pressure levels for users with stage 2 hypertension at baseline. Using a multivariable logistic regression model, we found that baseline Nutriscore, change in Nutriscore, and change in weight were all associated with the likelihood of users with stage 2 hypertension at baseline to achieve a lower blood pressure category. Among Foodsmart participants with stage 2 hypertension at baseline, systolic blood pressure and diastolic blood pressure had an absolute reduction, on average, of 5.6 mm Hg and 4.0 mm Hg, respectively. 33.0% (419/1,269) of participants with stage 2 hypertension at baseline achieved blood pressure levels of stage 1 hypertension (systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg) in their last blood pressure entry. CONCLUSIONS This study evaluated changes in SBP and DBP among users of the Foodsmart platform with hypertension and found that users with stage 2 hypertension, on average, improved their blood pressure levels over time.