Lifestyle Interventions Reduce the Need for Guideline-Directed Antihypertensive Medication.

Content Provider	Europe PMC
Author	Hinderliter, Alan L Smith, Patrick Sherwood, Andrew Blumenthal, James
Copyright Year	2021
Description	Abstract Background The 2017 ACC-AHA Hypertension Guideline recommends initiation of antihypertensive drug therapy based on blood pressure (BP) and an assessment of global cardiovascular disease (CVD) risk, but intensive lifestyle modification may lower BP to below recommended thresholds for treatment in some patients. Methods We examined the effects of lifestyle modification on calculated CVD risk and on the indications for BP-lowering medications in individuals with untreated hypertension. Participants included 144 adults with BP 130–160/80–99 mm Hg who were randomized to 16 weeks of DASH (Dietary Approaches to Stop Hypertension) diet plus behavioral weight management (DASH + WM), DASH diet alone (DASH), or Usual Care. Results The mean age of the study cohort was 52.0 years; the average baseline BP was 138 ± 9/86 ± 6 mm Hg. The 10-year CVD risk, as calculated by the Pooled Cohort Equations, was 5.7%. The adjusted 10-year risk fell to 4.4% in the DASH + WM group and to 5.0% in the DASH arm, but was not significantly changed (5.7%) in the Usual Care controls. The percentages of participants with guideline-based indications for antihypertensive drugs fell from 51% to 18% in the DASH + WM group and from 48% to 22% in the DASH group; and did not change significantly (49% to 44%) in the Usual Care group (P = 0.010 for the active intervention groups vs. Usual Care; P = 0.042 for DASH + WM vs. DASH). Conclusions These data demonstrate that in men and women with mildly elevated BP, lifestyle interventions can lower the calculated CVD risk and dramatically decrease the number of individuals for whom guideline-directed antihypertensive medication is indicated.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8557445&blobtype=pdf
Page Count	8
ISSN	08957061
Volume Number	34
DOI	10.1093/ajh/hpab090
PubMed Central reference number	PMC8557445
Issue Number	10
PubMed reference number	34107031
Journal	American Journal of Hypertension [Am J Hypertens]
e-ISSN	19417225
Language	English
Publisher	Oxford University Press
Publisher Date	2021-10-01
Publisher Place	US
Access Restriction	Open
Rights License	This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) © The Author(s) 2021. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
Subject Keyword	antihypertensive drugs blood pressure DASH diet hypertension lifestyle modification
Content Type	Text
Resource Type	Article
Subject	Internal Medicine