Effect of drug and diet treatment of mild hypertension on diastolic blood pressure. The TAIM Research Group.

Abstract

The Trial of Antihypertensive Interventions and Management is a multicenter randomized trial designed to examine the diastolic blood pressure response of various combinations of pharmacological and dietary interventions in the treatment of mild hypertension (diastolic blood pressure 90-100 mm Hg). Eight hundred and seventy-eight participants at 110-160% of ideal weight were randomly allocated to nine drug/diet treatment groups receiving either a placebo, chlorthalidone (25 mg), or atenolol (50 mg), combined with a usual, a weight loss, or a low sodium/high potassium diet The primary outcome was diastolic blood pressure change from baseline to 6 months. Seven hundred and eighty-seven participants had follow-up data. M ild hypertension is a significant risk factor for cardiovascular mortality and morbidity. 1 Treatment of mild hypertension significantly reduces this mortality and morbidity, 2 -5 but the cost/benefit ratio has been questioned. 6 How best to treat mild hypertension is undecided and remains a controversial point. 7 ' 8 The symptomatic and biochemical side effects, need for long-term use and cost of pharmacological treatment for all hypertensive

Effect of body weight loss and normalization on blood pressure in overweight non-obese patients with stage 1 hypertension

“…Systolic and diastolic reductions in blood pressure were À0.52 and À0.41 mm Hg, respectively, when expressed per kilogram of weight loss. These reductions were similar to those observed by other authors, [38][39][40][41] although lower than those FPG (mg 100 ml À1 ) 9 1 . 3 ± 6.9 88.4 ± 5.7 86.1 ± 4.8 91.5 ± 7.0 88.7 ± 6.0 86.2 ± 4.8 FPI (mU ml À1 ) 8 .…”

Influence of Weight Reduction on Blood Pressure

“…If intermediate measurements were not reported, then the total intervention period was used. [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Different types of weight intervention could have been examined within the same trial, ie, energy restriction, increased physical activity, or the combined intervention. When this was the case, these interventions were analyzed as separate strata.…”

Effectiveness of multidisciplinary lifestyle intervention for hypertension: a randomised controlled trial

“…The group size of the subjects in the intervention periods was. [12][13][14][15][16] A physician, a dietitian, a physiotherapist and a psychologist were responsible for the intervention. The intervention included discussions, tests, group works, practical training and written material.…”

“…10,11 Weight loss is associated with BP reduction and enhanced antihypertensive effects of medication. 12 Weight loss with a fat-modified diet together with increased physical activity has produced favourable long-term effects on BP and plasma lipid fractions in adults with mild hypertension, as well as a change in diet from saturated to polyunsaturated fat has resulted in a significant fall in BP. 13,14 Many clinical guidelines have been issued for the detection and management of hypertension.…”

“…[15][16][17] In several randomised trials the effects of a combination of lifestyle and medication have been compared with the effects of medications alone or lifestyle alone. 12,19,20 Surprisingly, although there has been made several randomised trials about lifestyle interventions for hypertension, no controlled trial assessing the effects of intervention in a rehabilitation centre setting has been reported. The aim of our randomised trial was to assess the effects of multidisciplinary lifestyle guidance and counselling of middle-aged persons with hypertension in a rehabilitation centre setting employing an active rehabilitation concept.…”