Effect of lifestyle modifications on blood pressure by race, sex, hypertension status, and age

Svetkey, Laura P.; Erlinger, Thomas P.; Vollmer, William M.; Feldstein, Adrianne C.; Cooper, L. S.; Appel, Lawrence J.; Ard, Jamy D.; Elmer, Patricia J.; Harsha, David W.; Stevens, Victor J.

doi:10.1038/sj.jhh.1001770

Cited by 162 publications

(182 citation statements)

References 25 publications

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“…In the absence of a control group, it could be argued that the greater fall in blood pressure in those with higher starting values simply reflected regression to the mean. Nevertheless, the greater fall in those with high values is a common feature of blood pressure studies (Appel et al, 1997(Appel et al, , 2003Sacks et al, 1999;Chobanian et al, 2003;Svetkey et al, 2005). Age, as previously demonstrated (Svetkey et al, 2005), related positively to blood pressure reduction; however, sex appeared to be without effect.…”

Section: Discussionmentioning

confidence: 91%

“…Nevertheless, the greater fall in those with high values is a common feature of blood pressure studies (Appel et al, 1997(Appel et al, , 2003Sacks et al, 1999;Chobanian et al, 2003;Svetkey et al, 2005). Age, as previously demonstrated (Svetkey et al, 2005), related positively to blood pressure reduction; however, sex appeared to be without effect. Our study was not sufficiently ethnically diverse to allow an assessment on this basis for comparison with other studies (Svetkey et al, 2005).…”

Section: Discussionmentioning

confidence: 91%

“…As with the major diet and lifestyle blood pressure studies, the main effect was seen in those with the higher blood pressure (Appel et al, 1997(Appel et al, , 2003Sacks et al, 1999;Chobanian et al, 2003;Svetkey et al, 2005). Dividing the group into those with blood pressures above or below 130/ 85 mm Hg gave systolic blood pressure reductions of 13.271.7 versus 1.871.4 mm Hg, respectively.…”

Section: Discussionmentioning

confidence: 98%

“…The success of diet and lifestyle modification in reducing blood pressure has renewed interest in non-pharmacological approaches to control hypertension (Appel et al, 1997(Appel et al, , 2003Sacks et al, 1999;Svetkey et al, 2005). Before the publication of the benefits of the DASH diet (Appel et al, 1997;Dwyer et al, 1998;Sacks et al, 1999;Lin et al, 2003), rapid growth in the number of effective drugs developed for the control of hypertension had been a major factor resulting in a relative lack of enthusiasm for employing dietary approaches for blood pressure control.…”

Section: Introductionmentioning

confidence: 99%

“…Before the publication of the benefits of the DASH diet (Appel et al, 1997;Dwyer et al, 1998;Sacks et al, 1999;Lin et al, 2003), rapid growth in the number of effective drugs developed for the control of hypertension had been a major factor resulting in a relative lack of enthusiasm for employing dietary approaches for blood pressure control. However, the demonstration that application of diet could result in blood pressure reductions similar to the starting dose of drug monotherapy renewed interest in diet as an important component of hypertension control (Appel et al, 1997(Appel et al, , 2003Sacks et al, 1999;Svetkey et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

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Long-term effects of a plant-based dietary portfolio of cholesterol-lowering foods on blood pressure

et al. 2007

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Objective: To determine the effect on blood pressure of dietary advice to consume a combination of plant-based cholesterollowering foods (dietary portfolio). Methods: For 1 year, 66 hyperlipidemic subjects were prescribed diets high in plant sterols (1.0 g/1000 kcal), soy protein (22.5 g/1000 kcal), viscous fibers (10 g/1000 kcal) and almonds (22.5 g/1000 kcal). There was no control group. Seven-day diet record, blood pressure and body weight were monitored initially monthly and later at 2-monthly intervals throughout the study. Results: Fifty subjects completed the 1-year study. When the last observation was carried forward for non-completers (n ¼ 9) or those who changed their blood pressure medications (n ¼ 7), a small mean reduction was seen in body weight 0.770.3 kg (P ¼ 0.036). The corresponding reductions from baseline in systolic and diastolic blood pressure at 1 year (n ¼ 66 subjects) were À4.271.3 mm Hg (P ¼ 0.002) and À2.370.7 mm Hg (P ¼ 0.001), respectively. Blood pressure reductions occurred within the first 2 weeks, with stable blood pressures 6 weeks before and 4 weeks after starting the diet. Diastolic blood pressure reduction was significantly related to weight change (r ¼ 0.30, n ¼ 50, P ¼ 0.036). Only compliance with almond intake advice related to blood pressure reduction (systolic: r ¼ À0.34, n ¼ 50, P ¼ 0.017; diastolic: r ¼ À0.29, n ¼ 50, P ¼ 0.041). Conclusions: A dietary portfolio of plant-based cholesterol-lowering foods reduced blood pressure significantly, related to almond intake. The dietary portfolio approach of combining a range of cholesterol-lowering plant foods may benefit cardiovascular disease risk both by reducing serum lipids and also blood pressure.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-term effects of a plant-based dietary portfolio of cholesterol-lowering foods on blood pressure

et al. 2007

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Trial of Family and Friend Support for Weight Loss in African American Adults

Kumanyika

Wadden²,

Shults³

et al. 2009

Arch Intern Med

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Obesity Treatment for Socioeconomically Disadvantaged Patients in Primary Care Practice

Warner¹

2012

Arch Intern Med

161

176

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Background Few evidence-based weight loss treatment options exist for medically vulnerable patients in the primary care setting. Methods We conducted a 2-arm, 24-month randomized effectiveness trial in 3 Boston community health centers (from February 1, 2008, through May 2, 2011). Participants were 365 obese patients receiving hypertension treatment (71.2% black, 13.1% Hispanic, 68.5% female, and 32.9% with less than a high school educational level). We randomized participants to usual care or a behavioral intervention that promoted weight loss and hypertension self-management using eHealth components. The intervention included tailored behavior change goals, self-monitoring, and skills training, available via a website or interactive voice response; 18 telephone counseling calls; primary care provider endorsement; 12 optional group support sessions; and links with community resources. Results At 24 months, weight change in the intervention group compared with that in the usual care group was −1.03 kg (95% CI, −2.03 to −0.03 kg). Twenty-four-month change in body mass index (calculated as weight in kilograms divided by height in meters squared) in the intervention group compared with that in the usual care group was −0.38 (95% CI, −0.75 to −0.004). Intervention participants had larger mean weight losses during the 24 months compared with that in the usual care group (area under the receiver operating characteristic curve, −1.07 kg; 95% CI, −1.94 to −0.22). Mean systolic blood pressure was not significantly lower in the intervention arm compared with the usual care arm. Conclusion The intervention produced modest weight losses, improved blood pressure control, and slowed systolic blood pressure increases in this high-risk, socioeconomically disadvantaged patient population.

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Effect of lifestyle modifications on blood pressure by race, sex, hypertension status, and age

Cited by 162 publications

References 25 publications

Long-term effects of a plant-based dietary portfolio of cholesterol-lowering foods on blood pressure

Long-term effects of a plant-based dietary portfolio of cholesterol-lowering foods on blood pressure

Trial of Family and Friend Support for Weight Loss in African American Adults

Obesity Treatment for Socioeconomically Disadvantaged Patients in Primary Care Practice

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