Effects of a lifestyle programme on ambulatory blood pressure and drug dosage in treated hypertensive patients: a randomized controlled trial
Effects of a lifestyle programme on ambulatory blood pressure and drug dosage in treated hypertensive patients: a randomized controlled trial
复制标题
DOI：
10.1097/01.hjh.0000170388.61579.4f
复制
发表时间：
2005-06-01
影响因子：
4.9
通讯作者：
Mori, TA
中科院分区：
文献类型：
--
作者：
Burke, V;Beilin, LJ;Mori, TA
目的 评估多因素生活方式改变对治疗高血压患者抗高血压药物需求的影响。设计随机对照试验。设置研究单位。参与者通过广告招募接受一种或两种抗高血压药物的超重高血压患者，并随机分配到常规护理组（对照组；n = 118）或生活方式改变组（方案组；n = 123). 干预 为期 4 个月的减肥计划、低钠“控制高血压的饮食方法”型饮食，添加鱼类、体力活动和适量饮酒。 4个月后，如果平均24小时动态血压（ABP）低于135/85 mmHg，则在4周内停用抗高血压药物，并开始长期家庭血压监测。主要结局指标4个月和1年随访时的抗高血压药物需求量、ABP、体重、腰围。结果 90名对照组和102名项目组参与者完成了研究。 4 个月后，对照组的平均 24 小时 ABP 变化为 -1.0/-0.3 +/- 0.5/0.4 mmHg，生活方式计划的平均 24 小时 ABP 变化为 -4.1/-2.1 +/- 0.7/0.5 mmHg（P < 0.01）。随访时，两组的变化没有显着差异（对照组为 4.1/1.3 +/- 1.1/1.0 mmHg；项目组为 2.5/-0.1 +/- 1.1/0.8 mmHg；P = 0.73）。 4 个月时，男性（对照组 44%；方案 66%）的药物戒断情况在各组之间存在显着差异（P = 0.038），但女性（分别为 65% 和 64%；P = 0.964）则没有显着差异。随访时，性别相关差异不显着，对照组有 41% 的人、项目组有 43% 的人维持戒断状态。通过该计划，4 个月时净体重减轻 3.3 公斤（P < 0.001），随访时净体重减轻 3.0 公斤（P < 0.001）；腰围净减少分别为 3.3 厘米（P < 0.001）和 3.5 厘米（P < 0.001）。 结论 接受治疗的高血压患者进行 4 个月的多因素生活方式改变可短期内降低血压。一年后中心性肥胖持续减少，可以降低总体心血管风险。 (c) 2005 年利平科特·威廉姆斯和威尔金斯。
Objective To assess effects of multifactorial lifestyle modification on antihypertensive drug needs in treated hypertensive individuals.Design Randomized controlled trial.Setting Research studies unit.Participants Overweight hypertensive patients, receiving one or two antihypertensive drugs, were recruited by advertising, and allocated randomly to a usual care group (controls; n = 118) or a lifestyle modification group (programme group; n = 123).Intervention A 4-month programme of weight loss, a low-sodium 'Dietary Approaches to Stop Hypertension'-type diet with added fish, physical activity and moderation of alcohol intake. After 4 months, if mean 24-h ambulatory blood pressure (ABP) was less than 135/85 mmHg, antihypertensive drugs were withdrawn over 4 weeks and long-term home blood pressure monitoring was begun.Main outcome measures Antihypertensive drug requirements, ABP, weight, waist girth at 4 months and 1-year follow-up.Results Ninety control group and 102 programme group participants completed the study. Mean 24-h ABP changed after 4 months by -1.0/-0.3 +/- 0.5/0.4 mmHg in controls and -4.1/-2.1 +/- 0.7/0.5 mmHg with the lifestyle programme (P < 0.01). At follow-up, changes in the two groups were not significantly different (4.1/1.3 +/- 1.1/1.0 mmHg in controls; 2.5/-0.1 +/- 1.1/0.8 mmHg in the programme group; P = 0.73). At 4 months, drug withdrawal differed significantly between the groups (P = 0.038) in men (control 44%; programme 66%) but not in women (65 and 64%, respectively; P = 0.964). At follow-up, sex-related differences were not significant, and 41% in the control group and 43% in the programme group maintained drug-withdrawal status. With the programme, net weight loss was 3.3 kg (P < 0.001) at 4 months and 3.0 kg (P < 0.001) at follow-up; respective net decreases in waist girth were 3.3 cm (P < 0.001) and 3.5 cm (P < 0.001).Conclusions A 4-month multifactorial lifestyle modification in patients with treated hypertension reduced blood pressure in the short-term. Decreased central obesity persisted 1 year later and could reduce overall cardiovascular risk. (c) 2005 Lippincott Williams & Wilkins.