The effects of nonpharmacologic interventions on blood pressure of persons with high normal levels. Results of the Trials of Hypertension Prevention, Phase I
Autor: | Arlene W. Caggiula, Bernard Rosner, Connie Brinkmann, N. Carole Milas, Merwyn R. Greenlick, Pat Kennedy, Erica Brittain, Jean MacFadyen, Sheila Hamill, Lewis H. Kuller, Frank M. Sacks, Roland Weinsier, Jerome D. Cohen, Patricia A. Borhani, Neil Rappaport, Kim Eberlein, Jeanne Charleston, David M. Batey, Joseph T. Murphy, Mary Ellen Keough, Nemat O. Borhani, Vera I. Lasser, Jack F. Hollis, Ed Lakatos, Nancy King Wright, Delores Kaidy, Lyn Steffen, Monica E. Yamamoto, Edmund Bernauer, Martha Clare Morris, Liz Peel, William B. Applegate, Patricia R. Hebert, Arlene Taylor Dalcin, Craig K. Ewart, Peter G. Kaufmann, Ellen O'Connor, Stephen T. Miller, B.J. Kremen Goldman, Elaine Blethen, David Gordon, Linda P. Fried, Amy Brewer, Carolyn Sugars, Wade Lovelace, Jay M. Sullivan, Katherine Roth, Martin Van Denburgh, Andrew Ertl, Peggy Neibling, Michael J. Klag, W. Gordon Walker, Ellie Danielson, Suzanne Satterfield, Eva Obarzanek, Mildred Mattfeldt-Beman, Norman L. Lasser, James M. Raczynski, Denis A. Evans, Sheila Corrigan, Charles H. Hennekens, Marshall Lee, Doug Heustis, Albert Oberman, Carlos de la Cruz, Judy Randle, Heidi Hataway, Lawrence J. Appel, Ivan Mills, Sherry L. Mayrent, Nancy R. Cook, Thomas M. Vogt, Paul K. Whelton, James O. Taylor, Heather Tosteson, Julie E. Buring, Lana Shepek, Karen Counts, Mary Cameron, Victor J. Stevens, Lee Dolan, Marilyn Farrand, Jeffrey A. Cutler, Margo Woods, Andrea Dommeyer, Beth Walker Corkery, Laretha Goodwin, John Belcher, Eleanor Pistorino, Shiriki K. Kumanyika |
---|---|
Rok vydání: | 1992 |
Předmět: |
Adult
Male medicine.medical_specialty Nonpharmacologic interventions Psychological intervention Blood Pressure Placebo Weight loss Behavior Therapy Stress Physiological Weight Loss Medicine Humans Life Style business.industry Sodium Dietary General Medicine Middle Aged Hypertension prevention Compliance (physiology) Blood pressure Anesthesia Normal diastolic blood pressure Hypertension Physical therapy Female medicine.symptom business Follow-Up Studies |
Zdroj: | JAMA. 267(9) |
ISSN: | 0098-7484 |
Popis: | To test the short-term feasibility and efficacy of seven nonpharmacologic interventions in persons with high normal diastolic blood pressure.Randomized control multicenter trials.Volunteers recruited from the community, treated and followed up at special clinics.Of 16,821 screenees, 2182 men and women, aged 30 through 54 years, with diastolic blood pressure from 80 through 89 mm Hg were selected. Of these, 50 did not return for follow-up blood pressure measurements.Three life-style change groups (weight reduction, sodium reduction, and stress management) were each compared with unmasked nonintervention controls over 18 months. Four nutritional supplement groups (calcium, magnesium, potassium, and fish oil) were each compared singly, in double-blind fashion, with placebo controls over 6 months.Primary: change in diastolic blood pressure from baseline to final follow-up, measured by blinded observers. Secondary: changes in systolic blood pressure and intervention compliance measures.Weight reduction intervention produced weight loss of 3.9 kg (P less than .01), diastolic blood pressure change of -2.3 mm Hg (P less than .01), and systolic blood pressure change of -2.9 mm Hg (P less than .01). Sodium reduction interventions lowered urinary sodium excretion by 44 mmol/24 h (P less than .01), diastolic blood pressure by 0.9 mm Hg (P less than .05), and systolic blood pressure by 1.7 mm Hg (P less than .01). Despite good compliance, neither stress management nor nutritional supplements reduced diastolic blood pressure or systolic blood pressure significantly (P greater than .05).Weight reduction is the most effective of the strategies tested for reducing blood pressure in normotensive persons. Sodium reduction is also effective. The long-term effects of weight reduction and sodium reduction, alone and in combination, require further evaluation. |
Databáze: | OpenAIRE |
Externí odkaz: |