OBJECTIVE: To assess effects of a cognitively based program on health-related behaviors and cardiovascular risk factors in overweight drug-treated hypertensives. STUDY DESIGN AND SETTING: In a clinical trials center, volunteers, recruited by advertisement, were randomized to usual care (n = 118) or to a 4-month program (n = 123) incorporating weight loss; a low-sodium diet, high in fruit, vegetables, and fish; and increased physical activity. Diet, physical activity, weight, blood lipids, glucose, and insulin were measured at 4 and 16 months. RESULTS: Ninety-eight usual care and 106 program participants completed the 4-month assessment; 90 and 102, respectively, completed follow-up. Using intention-to-treat analysis, relative to usual care, net changes with the program at 4 months were as follows: dietary fat (-2.6% energy; p < 0.001); sodium (-290mg/d; p = 0.004); energy (-313mJ/d; p = 0.005); fish (+2.1 serves/wk; p < 0.001); vegetables (+3.0 serves/wk; p < 0.001); physical activity (+37min/wk; p = 0.004); weight (-2.8kg; p < 0.001); waist girth (-3.1cm; p < 0.001); total cholesterol (-0.2mmol/L; p = 0.017); and triacylglycerols (-0.12mmol/L; p = 0.002). One year later, net changes included dietary fat (-2.2% energy; p < 0.001); sodium (-150mg/d; p = 0.029); fish (+2.0 serves/wk; p < 0.001); vegetables (+4.3 serves/wk; p < 0.001); weight (-2.5kg; p = 0.001); waist girth (-3.1cm; p < 0.001); high-density lipoprotein cholesterol (+0.03mmol/L; p = 0.031). CONCLUSION: Improvements in behaviors and risk factors, several maintained long term, suggest the potential for long-term benefits in hypertensives.
With permission from Excerpta Medica Inc.

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