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Impact of intensive lifestyle treatment (diet plus exercise) on endothelial and vascular function, arterial stiffness and blood pressure in stage 1 hypertension: results of the hintreat randomized controlled trial
Vamvakis A, Gkaliagkousi E, Lazaridis A, Grammatikopoulou MG, Triantafyllou A, Nikolaidou B, Koletsos N, Anyfanti P, Tzimos C, Zebekakis P, Douma S
Nutrients 2020 May;12(5):1326
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Lifestyle modification is an important component of essential hypertension (EH) therapy. The aim of the Hypertension Intensive Nutrition Treatment (HINTreat) parallel, randomized controlled trial was to examine the effect of a 6-month intensive lifestyle treatment (ILT) (diet plus exercise with monthly visits) compared to the usual care. A total of 76 adults with stage 1 EH were randomized (38 in each group). Dietary analysis, anthropometry, physical activity, biochemical and urine profile, blood pressure (BP), asymmetric dimethylarginine (ADMA), central hemodynamics, beta-stiffness index and carotid intima media-thickness were evaluated. The dietary inflammatory index (DII) was calculated for each participant from the intake of 29 nutrients/food components. At the end of the trial, participants in the ILT group reduced their 24 h urinary Na excretion (p <= 0.001), daytime systolic BP (p <= 0.048) and mean carotid beta-stiffness index (p <= 0.005) and ameliorated their lipidemic profile compared to the standard care. Univariate analysis for the total sample showed a strong association between DII and ADMA levels (beta = 0.089, p <= 0.01). ILT is effective in improving the inflammatory components of the diet and selected cardiometabolic parameters, including arterial stiffness.

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