Introduction:
Lifestyle recommendations are recommended for patients with Stage I hypertension before starting blood pressure-lowering drugs in patients free of cardiovascular disease. The proportion of patients that have blood pressure (BP) controlled with these recommendations was scarcely reported in a clinical context.
Hypothesis:
To investigate the rate of response to a short-term lifestyle intervention (LsI) in the first phase of a randomized clinical trial.
Methods:
PREVER prevention is a double blind, multicenter, randomized clinical trial of effectiveness of drug treatment to control hypertension and target organ damage among individuals with hypertension. It was conducted in 22 centers distributed in 10 Brazilian states. Participants were enrolled in the study if they had hypertension (≥140 of systolic blood pressure or ≥90 mmHg of diastolic blood pressure), confirmed in two visits in the clinics of the study, or if they had normal BP but were using BP-lowering agents. BP measurements were carried out using an oscillometric monitor, and anthropometric measurements were taken in duplicate. All participants were submitted to a lifestyle intervention (LsI) phase, which included detailed recommendations to lose weight, to reduce salt, to adopt a DASH-type diet and to practice physical activities. Blood pressure and control of hypertension were verified after three months. In this analysis, we present the results of blood pressure control and variation in the subsample of participants who had BP higher or equal to 140/90 mmHg.
Results:
4 867 volunteers were screened and 1 835 evaluated for enrollment. From these, 685 (37%) had BP within stage I hypertension. After three months of intensive LsI, 420 (61.3%) remained with uncontrolled BP, 249 (36.4%) had BP in the 120-139/80-89 mmHg range, and 16 (2.3%) had normal BP. Systolic and diastolic BP reduced from 143.8 ±7.1 to 138.7 ±12.2 mmHg and 90.4 ±5.9 to 87.7 ±8.7, respectively.
Conclusion:
Approximately 1/3 of patients with Stage I hypertension have blood pressure controlled after three months of lifestyle recommendations to lose weight, reduce salt intake, adopt a DASH diet and practice physical activities.
A Randomized Clinical Trial of Aggressive Blood Pressure Control in Patients With Acute Cerebral Hemorrhage
