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Lifestyle can rectify some prehypertension.

NEW ORLEANS -- Therapeutic lifestyle changes are effective for lowering blood pressure in individuals with prehypertension, but obese individuals may not derive maximum benefit, according to findings from a prospective study of nearly 2,500 patients who had prehypertension at baseline.

Of the 1,113 obese adults (body mass index greater than 30 kg/[m.sup.2]), 858 overweight adults (BMI 25-29.9 kg/[m.sup.2]), and 506 nonoverweight adults (BMI less than 25 kg/[m.sup.2]) who participated in a community-based therapeutic lifestyle changes (TLC) program, 952 (38%) experienced blood pressure normalization with the TLC program.

The blood pressure reductions were statistically significant in all groups, but the greatest reductions were seen in the nonoverweight subjects (average reduction of 10/8 mm Hg vs. 7/6 mm Hg for overweight subjects and 6/5 mm Hg for obese subjects), Dr. Barry A. Franklin reported in a poster at the annual meeting of the American College of Sports Medicine.

The greatest changes were seen in the nonoverweight group, despite significantly more weight loss in the obese subjects (6 pounds) and the overweight subjects (3 pounds), compared with the nonoverweight subjects (0 pounds), noted Dr. Franklin of William Beaumont Hospital, Royal Oak, Mich.

Overall, the average resting blood pressure of the study population (125/79 mm Hg) decreased by 6/3 mm Hg. Systolic blood pressure decreased by 7 mm Hg in those with a baseline systolic blood pressure of 120-139 mm Hg, and diastolic blood pressure decreased by 6 mm Hg in those with a baseline diastolic blood pressure of 80-89 mm Hg. All the decreases were statistically significant.

The participants, who were not using any type of drug therapy to control blood pressure, were evaluated at baseline and after an average of 6 months of participation in the program, which involved exercise training, nutrition, weight management, stress management, and smoking cessation interventions.

The findings are important, Dr. Franklin said, because although guidelines promote therapeutic lifestyle changes as a cornerstone in the management of prehypertension, recent research that has focused largely on pharmacotherapy for prehypertension suggests that TLC is ineffective or inadequate.

These data show that TLC can be effective for managing prehypertension, which is a precursor of hypertension and a predictor of excessive cardiovascular risk, but they also suggest that there may be BMI-related differences in the responsiveness of blood pressure to TLC, he concluded.


Southeast Bureau
Reduction in Blood Pressure from Therapeutic Lifestyle Changes

 mm Hg
 Systolic BP Diastolic BP

Nonoverweight (n = 506) 10 8
Overweight (n = 858) 7 6
Obese (n = 1,113) 6 5

Note: Based on adults with prehypertension who participated for an
average of 6 months.
Source: Dr. Franklin

Note: Table made from bar graph.
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Article Details
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Title Annotation:Cardiovascular Medicine
Author:Worcester, Sharon
Publication:Internal Medicine News
Article Type:Clinical report
Geographic Code:1USA
Date:Sep 1, 2007
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