Combining
several lifestyle changes including weight loss, exercise and a healthy
diet can lower blood pressure dramatically and reduce the need to go on
hypertension medications, a new study reveals.
Although such
lifestyle changes have been recommended in the past for lowering high blood
pressure, this is the first study to look at the effects of combining the
approaches.
The reduction
in blood pressure was comparable to what might be achieved on low-doses
of hypertension medication, Patricia Elmer, co-author of the study and
director of Portland's Center for Health Research, told United Press International.
"Our group and
the National Institutes of Health think these are very exciting and very
important results," Elmer said, noting the NIH has agreed to fund a study
to determine if people can sustain this
combination approach over
time.
"I'm very encouraged
by the results from this study," Dr. Daniel W. Jones, associate vice chancellor
for health affairs at the University of Mississippi Medical Center in Jackson
and spokesman on high blood pressure for the American Heart Association,
told UPI.
"Certainly,
there's reason for patients to see this as an effective way to lower their
blood pressure," Jones said. The combination approach not only could help
patients to avoid going on medications in the first place, but it also
could reduce the amount of drugs people with high blood pressure need to
take, he said.
In the study,
which will appear in the April 23 issue of The Journal of the American
Medical Association, Elmer's group enrolled 810 overweight adults who had
elevated blood pressure but were not yet on medication into a study involving
three different treatment strategies.
The first group
received one 30-minute session with a dietitian, who offered advice on
reducing blood pressure. The second group received 18 sessions over a six-month
period involving losing weight, reducing salt intake and increasing exercise.
The third group received the same counseling as the second group, except
they also were given additional advice on the DASH diet, which has been
shown to reduce blood pressure.
The DASH --
or Dietary Approaches to Stop Hypertension -- diet emphasizes increased
intake of fruits, vegetables and low-fat dairy products and calls for a
reduction in fats, red meat and sweets.
The third group
experienced the biggest reductions in blood pressure over the six-month
study. They lowered their systolic blood pressure or the upper number of
a blood pressure reading by 11 millimeters of mercury and their diastolic
blood pressure or the lower number was reduced by 6.4 mmHg.
In addition,
people in the third group with high blood pressure decreased from 37 percent
to 12 percent over the duration of the study, indicating some individuals
brought their blood pressure back within normal levels (below 120 mmHg
systolic and 80 mmHg diastolic) and would not require medication to control
it.
The lifestyle
approach not only allows people to avoid drugs, but it also offers other
benefits, such as a reduction in the risk of developing heart disease,
Elmer said.
Those employing
the lifestyle modifications also lost an average of 13 pounds, improved
their fitness, increased their fruit and vegetable intake and lowered their
intake of fat, particularly heart-clogging saturated fat.
"Our study shows
that people can simultaneously make multiple lifestyle changes that lower
their blood pressure and improve their health," study co-author Dr. Lawrence
J. Appel, professor of medicine, epidemiology and international health
at Johns Hopkins University said in a written statement. "The key issue
now is helping people maintain these changes so they don't revert back
to less healthy behaviors."
That is the
goal of the study the NIH elected to fund, Elmer said. The study, called
Weight Loss Maintenance, will use the combination lifestyle approach in
people at a higher risk for heart disease "and see how we can get people
to stay on these changes for several years, she added.
Staying on the
combination approach could prove difficult for some patients, in particular
when it involves sticking with a healthy diet, Jones said.
The people in
the study were successful but they were very motivated and had access to
some of the best dietary counseling available, he pointed out. Eating a
healthy diet "can be done, but it's challenging in the American environment,"
he said.
--
Copyright 2003 by United
Press International.
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