Effectiveness of multidisciplinary lifestyle intervention for hypertension: a randomised controlled trial Hypertension Intervention Pooling Project. Effectiveness of a two-part educational intervention to improve hypertension control: a cluster-randomized trial. Evaluation of a hypertension medication therapy management program in patients with diabetes. The effect of patient education and home monitoring on medication compliance, hypertension management, healthy lifestyle behaviours and BMI in a primary health care setting. The cost-effectiveness of a cardiovascular multiple-risk-factor intervention programme in treated hypertensive men. [Trial of the efficacy of health education programs on therapeutic compliance in arterial hypertension]. Improving hypertension care in a large group-model MCO. Pharmacist intervention in improving hypertension-related knowledge, treatment medication adherence and health-related quality of life: a non-clinical randomized controlled trial. Lifestyle Interventions Reduce Coronary Heart Disease Risk: Results From the PREMIER Trial Effectiveness of a lifestyle intervention led by female community health volunteers versus usual care in blood pressure reduction (COBIN): an open-label, cluster-randomised trial. Hypertension Intervention Nurse Telemedicine Study (HINTS): testing a multifactorial tailored behavioral/educational and a medication management intervention for blood pressure control. Lifestyle Interventions, Insulin Resistance, and Renal Artery Stiffness in Essential Hypertension Lifestyle intervention: results of the Treatment of Mild Hypertension Study (TOMHS). Hypertension Improvement Project: Randomized Trial of Quality Improvement for Physicians and Lifestyle Modification for Patients Community-based Randomized Controlled Trial of Non-pharmacological Interventions in Prevention and Control of Hypertension among Young Adults Lifestyle interventions for hypertension treatment among Iranian women in primary health-care settings: Results of a randomized controlled trial
Lifestyle factors like weight , alcohol consumption , salt intake and physical activity have shown to be important in treating hypertension . There have been made some r and omised trials about the effects of lifestyle interventions , but the numbers of patients have been relatively small and the duration s of follow-ups have been short . No controlled trials assessing the effects of lifestyle intervention in a rehabilitation setting have been reported . In this study , the effects of multidisciplinary lifestyle intervention in rehabilitation centres among middle-aged hypertensive employees were described . A total of 731 hypertensives from 45 worksites were r and omised to lifestyle intervention in a rehabilitation centre or to usual care in an occupational or primary health-care centre for 12 months . St and ard measurements were conducted before the intervention and 1-year later . Blood pressure ( BP ) levels were clearly reduced in the intervention group , while only minor changes were observed in the control group . The net changes between the two groups both for systolic and diastolic BPs were −2.1 mmHg ( 95 % confidence intervals ( CI ) −4.0 to −0.1 ) and −1.5 mmHg ( 95 % CI −2.6 to −0.4 ) , respectively . The net changes were greater among men than women . The multidisciplinary lifestyle intervention in a rehabilitation centre setting produced significant reductions in BP among middle-aged employees with hypertension Data from 12 independently design ed and conducted r and omized trials of behavioral interventions for hypertension , consisting principally of variants of relaxation and biofeedback therapies , were aggregated to assess current progress of research in this area . Meta-analytical methods revealed a statistically significant decrease in diastolic blood pressure for nonmedicated patients at the end of intervention . No significant improvement was detected in medicated patients , but potential differential effectiveness of prescribed medications and differences in compliance among patients prohibits separation of changes due to behavioral treatments alone . The need to devise criteria for selection of patients , and to establish the most appropriate patient-treatment match is emphasized STUDY OBJECTIVE To measure the effectiveness of a multifaceted educational intervention to improve ambulatory hypertension control . DESIGN Cluster-r and omized trial . SETTING Academic health system using an ambulatory electronic medical record . SUBJECTS A total of 10,696 patients with a diagnosis of hypertension cared for by 93 primary care providers . INTERVENTION Academic detailing , provision of provider-specific data about hypertension control , provision of educational material s to the provider , and provision of educational and motivational material s to patients . MEASUREMENTS AND MAIN RESULTS The primary outcome was blood pressure control , defined as a blood pressure measurement below 140/90 mm Hg , and was ascertained from electronic medical records over 6 months of follow-up . We determined the adjusted odds ratio for the association between the intervention and the achievement of controlled blood pressure . When we accounted for clustering by provider , this adjusted odds ratio was 1.13 ( 95 % confidence interval 0.87 - 1.47 ) . Adjusted odds ratios were 1.03 ( 95 % confidence interval 0.78 - 1.36 ) in patients whose blood pressure was controlled at baseline and 1.25 ( 95 % confidence interval 0.94 - 1.65 ) in those whose blood pressure was not . These odds ratios were not significantly different ( p=0.11 ) . CONCLUSIONS These results were consistent with no effect or , at best , a relatively modest effect of the intervention among patients with hypertension . Had we not included a concurrent control group , the data would have provided an unduly optimistic view of the effectiveness of the program . The effectiveness of future interventions may be improved by focusing on patients whose blood pressure is uncontrolled at baseline OBJECTIVE To evaluate the effect of a 9-month community pharmacy-based medication therapy management ( MTM ) program on quality of care in patients with diabetes and hypertension . DESIGN R and omized controlled trial . SETTING Tulsa , OK , between November 2005 and July 2007 . PATIENTS 52 patients with diabetes and hypertension who were enrolled in a managed care organization . INTERVENTION During monthly visits , intervention group participants received MTM services for hypertension and diabetes management . MAIN OUTCOME MEASURES Systolic blood pressure ( SBP ) , percentage at goal blood pressure ( < 130/80 mm Hg ) , and antihypertensive medication adherence . RESULTS The mean intervention group SBP decreased 17.32 mm Hg , whereas the mean control group SBP level increased 2.73 mm Hg ( P = 0.003 ) . The percentage of patients at goal blood pressure increased from 16.0 % to 48.0 % in the intervention group and decreased from 20.0 % to 6.67 % in the control group . Intervention group participants were 12.92 times more likely than control group participants to achieve goal blood pressure ( P = 0.021 ) . Although the mean adherence rate in the intervention group increased 7.0 % while remaining fairly constant in the control group ( -0.7 % ) , this group difference was not statistically significant . CONCLUSION A community pharmacy-based hypertension MTM program was effective in improving blood pressure control among managed care enrollees with diabetes and hypertension . Community pharmacists are strategically positioned to provide MTM services and effectively communicate with providers to improve quality of care for patients AIM The aim of this study was to determine the effect of anti-hypertensive patient-oriented education and in-home monitoring for medication adherence and management of hypertension in a primary care setting , by providing education on healthy lifestyle behaviours and medication adherence . BACKGROUND Hypertension is the third most common cause of death worldwide . Prevalence of hypertension in Turkey is approximately 30 % in the general population and 45 - 50 % in population over 50 . DESIGN R and omised controlled study . METHODS This study conducted in Turkey used a study group comprised of 120 subjects ( 40 Group A , 40 Group B , 40 controls ) , all previously diagnosed with hypertension and who started medication therapy at least one year prior to start of study . The study was conducted between February-November 2006 at public primary health care facilities and homes of the study participants . Participants in Group A and B received a total of six monthly education sessions , four times during clinic visits and two home visits . Medication adherence education for Groups A and B and education about healthy lifestyle behaviours for Group B were administered in a structured and individualised format . The control group was routinely monitored in health care facilities . RESULTS Healthy lifestyle behaviours and perception of self-efficacy regarding medication adherence showed improvement after education sessions in Groups A and B. Systolic and diastolic blood pressures of subjects in Group A and B showed a significant decrease compared with those of the control group ; the blood pressure decrease in Group B was greater than in Group A. CONCLUSION Nurses play an important role in uncontrolled hypertension detection and can improve medication adherence and healthy lifestyle behaviours . RELEVANCE TO CLINICAL PRACTICE Patient education medication adherence alone and in combination with healthy lifestyle behaviour teaching is an effective tool for blood pressure reduction in the hypertensive population in primary health care setting OBJECTIVES The aim of this study was to carry out a cost-effectiveness analysis of a multifactorial intervention programme in treated hypertensive patients . DESIGN A cost-effectiveness analysis based on 3 years of follow-up in an open , r and omized , parallel-group study with allocation either to a comprehensive , multiple-risk factor modification programme or to conventional treatment . SETTING An outpatient clinic of a city hospital . SUBJECTS Inclusion criteria were : male sex , age 50 - 72 ( mean 66.4 ) years , treated hypertension and at least one of the following : serum cholesterol > or = 6.5 mmol L-1 , and /or smoking and /or diabetes mellitus . A total of 508 patients were included in the study . INTERVENTIONS Advice given to individuals , and group meetings based on nutritional advice and behavioural treatment principles . If necessary , drug therapy could be instituted to achieve the treatment goals in the intervention group : serum total cholesterol of < 6.0 mmol L-1 , no smoking , HbAlc < 6.0 % and diastolic blood pressure < 90 mmHg in both groups . MAIN OUTCOME MEASURE Incremental cost per life-year gained of the intervention programme . RESULTS The cost per life-year gained was SEK 4000 in an estimation based on the observed risk reduction and ranged between SEK 62,000 and SEK 163,000 in three estimations based on the risk factor changes . CONCLUSIONS The analysis indicates that the intervention programme is cost-effective in the studied patient population OBJECTIVE To analyse by means of a group session and postal support the efficacy of health education ( HE ) on compliance with therapy for light-to-moderate essential Hypertension . DESIGN Controlled clinical trial with r and omised distribution . SETTING Primary Care . PATIENTS 110 hypertense patients with new or uncontrolled Hypertension , for whom treatment with Tr and olapril as a start or change of medication was indicated . INTERVENTIONS The patients were split into two groups at r and om , with observation for six months after inclusion in the study and monthly attendance : 1 ) Control group ( CG ) of 55 patients who received HE from their family doctor ; 2 ) Intervention group ( IG ) of 55 patients controlled . MEASUREMENTS AND RESULTS Patients were defined as compliant if their consumption was 80 - 110 % of what was prescribed . The counting of pills was recorded . Percentages of compliant patients and mean compliance were analysed with the Chi squared and Student 's t tests . 109 people completed , 77 of them women . Neither group differed as to age , sex , length of evolution , number of diseases or doses of drugs consumed . CONCLUSIONS Intervening in HE with a group session and postal follow-up is an efficacious measure to improve therapeutic compliance in Hypertension cases The effectiveness of a quality improvement program for hypertension management practice s and patient health outcomes in a group-model managed care organization was evaluated . Health-system pharmacists analyzed medical and pharmacy cl aims data to identify hypertensive patients . Chart review was conducted on a r and om sample of these patients to vali date a hypertension diagnosis and to obtain blood pressure ( BP ) control rates and prevalence of cardiovascular risk factors and comorbid conditions . The interventions consisted of educating health care providers and recommending appropriate pharmacotherapy for compelling indications . Patient outcomes were compared with baseline hypertension data . After interventions were implemented , medical and pharmacy cl aims identified 30,721 hypertensive patients and chart review s were performed on a r and om sample of 417 patients . Pharmacy cl aims revealed a total of 193,311 antihypertensive prescriptions . Approximately 47 % of all hypertensive patients were managed with monotherapy , while 24 % received dual therapy , and 11 % were taking three or more antihypertensive medications per day . Of the patients on monotherapy , 93 % received an angiotensin-converting-enzyme inhibitor ( 27.3 % ) , diuretic ( 26.6 % ) , beta-blocker ( 23.4 % ) , or calcium channel blocker ( 15.4 % ) . The overall level of BP control significantly improved from 37.2 % at baseline to 49.2 % at follow-up ( p = 0.0007 ) . BP control in the follow-up evaluation was 22.2 % in diabetic patients . For treatment of patients with comorbid disease states , provider practice patterns were evaluated at baseline and follow-up . Improving the quality of hypertension management increased BP control from 37.2 % to 49.2 % . Continued efforts to improve hypertension management , particularly in patients with concomitant diabetes and in elderly patients with isolated systolic hypertension , are needed OBJECTIVE The study evaluated whether a pharmaceutical care intervention can result in better underst and ing about hypertension , increase medication adherence to antihypertensive therapy and improve overall health-related quality of life . METHODS A non- clinical r and omized control trial was conducted whereby participants received an educational intervention through hospital pharmacists .  Hypertension knowledge , medication adherence and health-related quality of life were measured by means of self-administered question naires . Descriptive statistics were used to describe the demographic and disease characteristics of the patients . Inferential statistics were used for inter- and intragroup comparisons . SPSS 17 was used for data analysis . RESULTS Three hundred and eighty-five hypertensive patients were r and omly assigned ( 192 in the control group and 193 in the intervention group ) to the study . No significant differences were observed in either group for age , gender , income , locality , education , occupation or duration of disease . There was , however , a significant increase in the participants ' levels of knowledge about hypertension and medication adherence among the interventional group after completing the intervention . Significantly lower systolic and diastolic blood pressure levels were also observed among the interventional group after completion of the intervention . The interventional group , however , reported decreased yet significant health-related quality of life at the end of the interventional programme . CONCLUSION Pharmacist intervention can significantly increase disease-related knowledge , blood pressure control and medication adherence in patients with hypertension . However , further research is needed to address the decreased health-related quality of life after completion of the study Background — Although trials of lifestyle interventions generally focus on cardiovascular disease risk factors rather than hard clinical outcomes , 10-year coronary heart disease ( CHD ) risk can be estimated from the Framingham risk equations . Our objectives were to study the effect of 2 multicomponent lifestyle interventions on estimated CHD risk relative to advice alone and to evaluate whether differences can be observed in the effects of the lifestyle interventions among subgroups defined by baseline variables . Methods and Results — A total of 810 healthy adults with untreated prehypertension or stage I hypertension were r and omized to 1 of 3 intervention groups : An “ advice-only ” group , an “ established ” group that used established lifestyle recommendations for blood pressure control ( sodium reduction , weight loss , and increased physical activity ) , or an “ established-plus-DASH ” group that combined established lifestyle recommendations with the DASH ( Dietary Approaches to Stop Hypertension ) diet . The primary outcome was 10-year CHD risk , estimated from follow-up data collected at 6 months . A secondary outcome was 10-year CHD risk at 18 months . Of the 810 participants , 62 % were women and 34 % were black . Mean age was 50 years , mean systolic/diastolic blood pressure was 135/85 mm Hg , and median baseline Framingham risk was 1.9 % . The relative risk ratio comparing 6-month to baseline Framingham risk was 0.86 ( 95 % confidence interval 0.81 to 0.91 , P<0.001 ) in the established group and 0.88 ( 95 % confidence interval 0.83 to 0.94 , P<0.001 ) in the established-plus-DASH group relative to advice alone . Results were virtually identical in sensitivity analyses , in each major subgroup , and at 18 months . Conclusions — The observed reductions of 12 % to 14 % in estimated CHD risk are substantial and , if achieved , should have important public health benefits INTRODUCTION Elevated blood pressure greatly contributes to cardiovascular deaths in low-income and middle-income countries . We aim ed to investigate the effectiveness of a population -level intervention led by existing community health workers in reducing the burden of hypertension in a low-income population . METHODS We did a community-based , open-label , two-group , cluster-r and omised controlled trial in Nepal . Using computer-generated codes , we r and omly assigned ( 1:1 ) 14 clusters to a lifestyle intervention led by female community health volunteers ( FCHVs ) or usual care ( control group )  . In the intervention group , 43 FCHVs provided  home visits  every 4 months for lifestyle counselling and blood pressure monitoring .  Eligible participants had been involved in a previous population -based survey , were aged 25 - 65 years , did not have plans to migrate outside the study area , and were not severely ill or pregnant . The primary outcome was mean systolic blood pressure at 1 year . We included all participants who remained in the trial at 1 year in the primary analysis . This trial is registered with Clinical Trials.gov , number NCT02428075 . FINDINGS Between April 1 , 2015 , and Dec 31 , 2015 , we recruited 1638 participants ( 939 assigned to intervention ; 699 assigned to control ) . At 1 year , 855 participants remained in the intervention group ( 425 were normotensive , 175 were prehypertensive , and 255 had hypertension ) and 613 remained in the control group ( 305 were normotensive , 128 were prehypertensive , and 180 had hypertension ) . The mean systolic blood pressure at 1 year was significantly lower in the intervention group than in the control group for all cohorts : the difference was -2·28 mm Hg ( 95 % CI -3·77 to -0·79 , p=0·003 ) for participants who were normotensive , -3·08 mm Hg ( -5·58 to -0·59 , p=0·015 ) for participants who were prehypertensive , and -4·90 mm Hg ( -7·78 to -2·00 , p=0·001 ) for participants who were hypertensive . INTERPRETATION A simple , FCHV-led lifestyle intervention coupled with monitoring of blood pressure is effective for reduction of blood pressure in individuals with hypertension and ameliorates age-related increases in blood pressure in adults without hypertension in the general population of Nepal . FUNDING Aarhus University , Jayanti Memorial Trust BACKGROUND Only 31 % of Americans with hypertension have their blood pressure ( BP ) under effective control . We describe a study that tests 3 different interventions in a r and omized controlled trial using home BP telemedicine monitoring . METHODS A sample of hypertensive patients with poor BP control at baseline ( N = 600 ) are r and omized to 1 of 4 arms : ( 1 ) control group -- a group of hypertensive patients who receive usual care ; ( 2 ) nurse-administered tailored behavioral intervention ; ( 3 ) nurse-administered medication management according to a hypertension decision support system ; ( 4 ) combination of the 2 interventions . The interventions are triggered based on home BP values transmitted via telemonitoring devices over st and ard telephone lines . The tailored behavioral intervention involves promoting adherence with medication and health behaviors . Patients r and omized to the medication management or the combined arm have their hypertension regimen changed by the study team using a vali date d hypertension decision support system based on evidence -based hypertension treatment guidelines and individualized to patients ' comorbid illnesses . The primary outcome is BP control : < or = 140/90 mm Hg ( nondiabetic ) and < or = 130/80 mm Hg ( diabetics ) measured at 6-month intervals over 18 months ( 4 total measurements ) . CONCLUSIONS Given the increasing prevalence of hypertension and our inability to achieve adequate BP control using traditional models of care , testing novel interventions in patients ' homes may improve access , quality , and outcomes The study investigates lifestyle and effective anti-hypertensive intervention in overweight-obese patients can influence insulin-resistance ( HOMA-IR ) and US Renal-Resistive-Index ( RRI ) . After a 1-year interventional program ( including a personalized Mediterranean diet , physical activity increase , smoking withdrawal counseling ) , 156 Essential Hypertension ( EH ) patients still have  abnormal HOMA-IR , significantly higher in comparison to 159 control group patients .  Body mass index ( BMI ) and cholesterol-high-density-lipoprotein improvement are the best predictors of a HOMA-IR decrease ; RRI improves in EH according to lifestyle interventions , but no predictor to RRI is identified . Persistence of IR can be tentatively assumed as a steady sign , persistent also after extended lifestyle intervention in EH , further warranting more intensive dietary interventions BACKGROUND Questions regarding the efficacy of nonpharmacologic approaches for the treatment of stage 1 hypertension were addressed as part of the Treatment of Mild Hypertension Study ( TOMHS ) , a 4-year , r and omized clinical trial ( N = 902 ) . This report describes the lifestyle intervention program used in TOMHS , presents data on the lifestyle changes observed , and focuses on the effect of weight loss on blood pressure and blood lipid levels . METHODS Participants were r and omly assigned to receive either placebo or one of five different antihypertensive medications . All took part in a lifestyle intervention program to reduce weight and sodium and alcohol intake  and to increase physical activity .  RESULTS Substantial changes from baseline levels were achieved for all lifestyle intervention variables . Mean weight change was -10.5 lb ( -5.6 % ) at 1 year , -8.5 lb ( -4.5 % ) at 2 years , -7.4 lb ( -4.0 % ) at 3 years , and -5.7 lb ( -3.0 % ) at 4 years . At 4 years , 70 % of participants remained below baseline weight and 34 % maintained a weight loss of 10 lb or greater . Mean change in urinary sodium excretion was -12.5 mmol/8 hr ( -23 % ) at 1 year , -10.7 mmol/8 hr ( -20 % ) at 2 years , -8.4 mmol/8 hr ( -16 % ) at 3 years , and -4.6 mmol/8 hr ( -9 % ) at 4 years . Alcohol intake declined by 1.6 drinks/week among drinkers at 4 years . Reported leisure physical activity increased by 86 % at 1 year and remained 50 % above baseline at 4 years . Beneficial changes in blood pressure and serum lipids were associated with these changes . CONCLUSIONS These results support a role for lifestyle interventions as the initial treatment for stage 1 hypertension and demonstrate that such interventions can be successfully implemented in the clinical setting Despite widely publicized hypertension treatment guidelines for physicians and lifestyle recommendations for patients , blood pressure control rates remain low . In community-based primary care clinics , we performed a nested , 2 × 2 r and omized , controlled trial of physician intervention versus control and /or patient intervention versus control . Physician intervention included internet-based training , self-monitoring , and quarterly feedback reports . Patient intervention included 20 weekly group sessions followed by 12 monthly telephone counseling contacts and focused on weight loss , Dietary Approaches to Stop Hypertension dietary pattern , exercise , and reduced sodium intake . The primary outcome was change in systolic blood pressure at 6 months . Eight primary care practice s ( 32 physicians ) were r and omized to physician intervention or control groups . Within those practice s , 574 patients were r and omized to patient intervention or control groups . Patient mean age was 60 years , 61 % were women , and 37 % were black . Blood pressure data were available for 91 % of patients at 6 months . The main effect of physician intervention  on systolic blood pressure at 6 months , adjusted for baseline pressure , was 0.3 mm Hg ( 95 % CI : −1.5 to 2.2 ; P=0.72 ) . The main effect of the patient intervention was −2.6 mm Hg ( 95 % CI : −4.4 to −0.7 ; P=0.01 ) . The interaction of the 2 interventions was significant ( P=0.03 ) ; the largest impact was observed with the combination of physician and patient intervention ( −9.7±12.7 mm Hg ) . Differences between treatment groups did not persist at 18 months . Combined physician and patient interventions  lowers blood pressure ; future research should focus on enhancing effectiveness and sustainability of these interventions Context : Hypertension is a major chronic lifestyle disease . Several non-pharmacological interventions are effective in bringing down the blood pressure ( BP ) . This study focuses on the effectiveness of such interventions among young adults . Aims : To measure the efficacy of physical exercise , reduction in salt intake , and yoga , in lowering BP among young ( 20 - 25 ) pre-hypertensives and hypertensives , and to compare their relative efficacies . Setting s and Design : The study was done in the urban service area of JIPMER . Pre-hypertensives and hypertensives , identified from previous studies , constituted the universe . The participants were r and omized into one control and three interventional groups . Material s and Methods : A total of 113 subjects : 30 , 28 , 28 and 27 in four groups respectively participated for eight weeks : control ( I ) , physical exercise ( II ) - brisk walking for 50 - 60 minutes , four days/week , salt intake reduction ( III ) - to at least half of their previous intake , and practice of yoga ( IV ) - for 30 - 45 minutes/day on at least five days/week . Statistical Analysis Used : Efficacy was assessed using paired t test and ANOVA with Games Howell post hoc test . An intention to treat analysis was also performed . Results : A total of 102 participants ( 29 , 27 , 25 and 21 in groups I , II , III and IV ) completed the study . All three intervention groups showed a significant reduction in BP ( SBP/DBP : 5.3/6.0 in group II , 2.6/3.7 in III , and 2.0/2.6 mm Hg in IV respectively ) . There was no significant change ( SBP/DBP : 0.2/0.5 mmHg ) of BP in control group ( I ) . Physical exercise was most effective ( considered individually ) ; salt intake reduction and yoga were also effective . Conclusions : Physical exercise , salt intake reduction , and yoga are effective non-pharmacological interventions in significantly reducing BP among young hypertensives and pre-hypertensives . These can therefore be positively recommended for hypertensives . There is also a case to deploy these interventions in the general population Background : Lifestyle factors such as weight , salt intake , and physical activity have shown to be important in treating hypertension . The object of this study was to describe feasibility and to assess the effectiveness of a multicomponent lifestyle intervention on high blood pressure ( BP ) of Iranian women . Material s and Methods : This r and omized controlled trial was conducted in four health centers by recruiting 161 women aged 35 - 65 years with high BP and r and omizing them to a 4-week lifestyle modification ( n = 80 ) or control group ( n = 81 ) . BP level and other health behavioral factors were assessed before and after the 4-week intervention and also after 6 months . Results : The mean systolic BP changed from 158.8 ( ±8.1 ) mmHg to 153.2 ( ±6.4 ) mmHg during 4-week and to 145.5 ( ±4.6 ) ) mmHg after 6 months in the intervention group ( P < 0.001 ) . There was a significant difference between two groups of study after 4-week mean = 5.6 ( confidence interval [ CI ] = 5.1 - 6.6 ) and 6 months follow mean ( CI = 12.3 - 14.6).(P < 0.001 ) A significant correlation was detected between systolic BP ( SBP ) and diastolic BP ( DBP ) with weight , body mass index , waist circumference , salt intake , and physical activity level ( P < 0.001 ) . Stepwise regression analyses indicated that the weight , dietary salt intake , and physical activity level were significant predictors of SBP and DBP . Conclusion : The results of this study suggest that lifestyle modification program is associated with improvements in BP level in Iranian women
Robust statistically significant effects were found for improved diet , aerobic exercise , alcohol and sodium restriction , and fish oil supplements : mean reductions in systolic blood pressure of 5.0 mmHg [ 95 % confidence interval ( CI ) : 3.1 - 7.0 ] , 4.6 mmHg ( 95 % CI : 2.0 - 7.1 ) , 3.8 mmHg ( 95 % CI : 1.4 - 6.1 ) , 3.6 mmHg ( 95 % CI : 2.5 - 4.6 ) and 2.3 mmHg ( 95 % CI : 0.2 - 4.3 ) , respectively , with corresponding reductions in diastolic blood pressure .
Relaxation significantly reduced blood pressure only when compared with non-intervention controls .
We found no robust evidence of any important effect on blood pressure of potassium , magnesium or calcium supplements .
Available evidence does not support relaxation therapies , calcium , magnesium or potassium supplements to reduce blood pressure
PURPOSE To quantify effectiveness of lifestyle interventions for hypertension .