The implementation of lifestyle modifications, home blood pressure (BP) measurement, and optimization of antihypertensive drug therapy have been shown to improve BP control in tightly controlled research settings. Our objective was to determine the effect of these interventions in a primary care setting, with the family practitioners and nurses serving as the interventionists.
Two hundred twenty hypertensive patients were recruited from 2 health centers that operated in the same building and covered similar populations, with the health centers randomized to function as intervention or control sites. Participants in the intervention group received repeated individual and group counseling from the centrally trained staff of the health center on healthy lifestyles. In addition, their antihypertensive drug therapy was guided by home BP measurements performed at 3-month intervals instead of by conventional office measurements.
After 12 months of follow-up, the between-group differences in the changes of lifestyle variables (body mass index, physical activity, dietary recalls, and urinary sodium/potassium) were nonsignificant. Antihypertensive treatment intensity increased in both groups, but the between-group difference was nonsignificant (P = 0.63). Office systolic/diastolic BP decreased significantly in the intervention (8/6 mm Hg; P
Notes
Comment In: Am J Hypertens. 2014 Mar;27(3):291-324363277