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Lifestyle Interventions Reduce the Need for Guideline-Directed Antihypertensive Medication.

Publication ,  Conference
Hinderliter, AL; Smith, P; Sherwood, A; Blumenthal, J
Published in: Am J Hypertens
October 27, 2021

BACKGROUND: The 2017 ACC-AHA Hypertension Guideline recommends initiation of antihypertensive drug therapy based on blood pressure (BP) and an assessment of global cardiovascular disease (CVD) risk, but intensive lifestyle modification may lower BP to below recommended thresholds for treatment in some patients. METHODS: We examined the effects of lifestyle modification on calculated CVD risk and on the indications for BP-lowering medications in individuals with untreated hypertension. Participants included 144 adults with BP 130-160/80-99 mm Hg who were randomized to 16 weeks of DASH (Dietary Approaches to Stop Hypertension) diet plus behavioral weight management (DASH + WM), DASH diet alone (DASH), or Usual Care. RESULTS: The mean age of the study cohort was 52.0 years; the average baseline BP was 138 ± 9/86 ± 6 mm Hg. The 10-year CVD risk, as calculated by the Pooled Cohort Equations, was 5.7%. The adjusted 10-year risk fell to 4.4% in the DASH + WM group and to 5.0% in the DASH arm, but was not significantly changed (5.7%) in the Usual Care controls. The percentages of participants with guideline-based indications for antihypertensive drugs fell from 51% to 18% in the DASH + WM group and from 48% to 22% in the DASH group; and did not change significantly (49% to 44%) in the Usual Care group (P = 0.010 for the active intervention groups vs. Usual Care; P = 0.042 for DASH + WM vs. DASH). CONCLUSIONS: These data demonstrate that in men and women with mildly elevated BP, lifestyle interventions can lower the calculated CVD risk and dramatically decrease the number of individuals for whom guideline-directed antihypertensive medication is indicated.

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Published In

Am J Hypertens

DOI

EISSN

1941-7225

Publication Date

October 27, 2021

Volume

34

Issue

10

Start / End Page

1100 / 1107

Location

United States

Related Subject Headings

  • Practice Guidelines as Topic
  • Middle Aged
  • Male
  • Life Style
  • Hypertension
  • Humans
  • Female
  • Dietary Approaches To Stop Hypertension
  • Cardiovascular System & Hematology
  • Blood Pressure
 

Citation

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Chicago
ICMJE
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Hinderliter, A. L., Smith, P., Sherwood, A., & Blumenthal, J. (2021). Lifestyle Interventions Reduce the Need for Guideline-Directed Antihypertensive Medication. In Am J Hypertens (Vol. 34, pp. 1100–1107). United States. https://doi.org/10.1093/ajh/hpab090
Hinderliter, Alan L., Patrick Smith, Andrew Sherwood, and James Blumenthal. “Lifestyle Interventions Reduce the Need for Guideline-Directed Antihypertensive Medication.” In Am J Hypertens, 34:1100–1107, 2021. https://doi.org/10.1093/ajh/hpab090.
Hinderliter AL, Smith P, Sherwood A, Blumenthal J. Lifestyle Interventions Reduce the Need for Guideline-Directed Antihypertensive Medication. In: Am J Hypertens. 2021. p. 1100–7.
Hinderliter, Alan L., et al. “Lifestyle Interventions Reduce the Need for Guideline-Directed Antihypertensive Medication.Am J Hypertens, vol. 34, no. 10, 2021, pp. 1100–07. Pubmed, doi:10.1093/ajh/hpab090.
Hinderliter AL, Smith P, Sherwood A, Blumenthal J. Lifestyle Interventions Reduce the Need for Guideline-Directed Antihypertensive Medication. Am J Hypertens. 2021. p. 1100–1107.
Journal cover image

Published In

Am J Hypertens

DOI

EISSN

1941-7225

Publication Date

October 27, 2021

Volume

34

Issue

10

Start / End Page

1100 / 1107

Location

United States

Related Subject Headings

  • Practice Guidelines as Topic
  • Middle Aged
  • Male
  • Life Style
  • Hypertension
  • Humans
  • Female
  • Dietary Approaches To Stop Hypertension
  • Cardiovascular System & Hematology
  • Blood Pressure