Facility and Web-based Approaches to Lifestyle Change in Resistant Hypertension
改变顽固性高血压生活方式的设施和基于网络的方法
基本信息
- 批准号:9068412
- 负责人:
- 金额:$ 5.62万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2014
- 资助国家:美国
- 起止时间:2014-12-01 至 2019-06-30
- 项目状态:已结题
- 来源:
- 关键词:AddressAdherenceAdoptedAdultAerobicAffectAmericanAntihypertensive AgentsBaroreflexBehaviorBehavior TherapyBiological MarkersBlood PressureBody WeightBody Weight decreasedCaloric RestrictionCardiac rehabilitationCardiovascular systemCessation of lifeClinicClinical TrialsCountryDASH dietDataDiastolic blood pressureDiet HabitsDiet ModificationDiseaseDiureticsDoseEducationEtiologyEventExerciseExhibitsGoalsHealthHourHyperlipidemiaHypertensionHypertrophyHypotensionIndividualInflammationInsulin ResistanceKidney FailureLeft Ventricular HypertrophyLifeLife StyleLipidsMeasuresMediator of activation proteinMedicalModificationMotivationMyocardial InfarctionObesityOnline SystemsParticipantPatient-Focused OutcomesPatientsPharmaceutical PreparationsPharmacological TreatmentPhysiciansPressoreceptorsPrevalenceProcessPublic HealthQuality of lifeRandomizedRandomized Clinical TrialsRefractoryRegimenResistant HypertensionRiskRisk FactorsStrokeStructureSympathetic Nervous SystemTherapeuticTrainingWomanarterial stiffnessbaseblood pressure reductionblood pressure regulationcardiovascular risk factorclinically significantdesigneditorialexperiencefitnessfollow-upglycemic controlhealthy lifestylehigh riskimprovedinflammatory markerinsulin sensitivity/resistanceintervention programlifestyle interventionmennutritionprogramsresponsesedentarystandard of caretherapy designunhealthy lifestyle
项目摘要
DESCRIPTION (provided by applicant): Hypertension (HTN) is considered to be the single most important risk factor for adverse cardiovascular events, including stroke, myocardial infarction and death. It has been estimated that 70% of the 68 million American adults with HTN receive pharmacological treatment, but only 46% have their blood pressure (BP) adequately controlled. Patients with BP that remains above goal (systolic blood pressure >140 mm Hg and/or diastolic blood pressure >90 mm Hg) despite the concurrent use of 3 or more classes of antihypertensive medications, including a diuretic, are considered to have "resistant hypertension" (RH). With the growing prevalence of HTN in this country, RH is a major public health concern, affecting more than 7.5 million Americans. Patients with RH are at high risk for CVD-related events, and there is a need to develop effective management strategies to help lower BP and reduce risk in these individuals. Surprisingly, there have been no randomized clinical trials (RCTs) evaluating whether an adjunctive lifestyle intervention that combines exercise, weight loss, and optimal nutrition featuring the DASH diet may help control BP and reduce CVD risk in patients with RH. This proposed RCT is designed to evaluate whether RH patients can achieve clinically significant BP lowering and improve other biomarkers of CVD risk through a lifestyle intervention delivered in a center-based cardiac rehabilitation facility (C-LIF) compared to a standardized education and physician advice control condition (SEPA). One hundred fifty men and women with RH will be randomized in a 2:1 design to C-LIFE or SEPA. We hypothesize that C-LIFE participants will (1) exhibit greater improvements in aerobic fitness, greater adherence to the DASH diet, and greater weight loss after 4 months compared to SEPA controls; (2) exhibit lower clinic BP and ambulatory BP after 4 months compared to SEPA controls; (3) exhibit greater regression of LV hypertrophy and greater improvements in CVD risk biomarkers including arterial stiffness, baroreceptor reflex sensitivity, insulin resistance, and inflammatory markers after 4 months compared to SEPA controls; (4) exhibit lower clinic BP and ABP, and improved CVD biomarkers at 1 year follow-up compared to SEPA controls. We also hypothesize that greater aerobic fitness, better adherence to the DASH diet, and greater weight loss will be associated with greater reductions in clinic BP at 4 months and at 1 year follow-up. I successful, the lifestyle intervention described in this application could be adopted by cardiac rehabilitation programs nationwide, and provide a viable non-pharmacologic treatment for managing patients with RH.
描述(由申请人提供):高血压(HTN)被认为是心血管不良事件(包括卒中、心肌梗死和死亡)的最重要的单一风险因素。据估计,6800万美国HTN成年人中有70%接受药物治疗,但只有46%的血压(BP)得到充分控制。尽管同时使用3种或3种以上降压药物(包括利尿剂),但BP仍高于目标值(收缩压>140 mm Hg和/或舒张压>90 mm Hg)的患者被认为患有“顽固性高血压”(RH)。随着HTN在这个国家的日益流行,RH是一个主要的公共卫生问题,影响超过750万美国人。RH患者发生心血管疾病相关事件的风险较高,因此需要制定有效的管理策略来帮助降低血压并降低这些患者的风险。令人惊讶的是,目前还没有随机临床试验(RCT)评估结合运动、减肥和以DASH饮食为特色的最佳营养的辅助生活方式干预是否有助于控制血压并降低RH患者的心血管疾病风险。这项拟议的RCT旨在评价RH患者是否可以通过在中心心脏康复机构(C-LIF)中提供的生活方式干预实现临床显著的BP降低并改善CVD风险的其他生物标志物,与标准化教育和医生建议控制条件(SEPA)相比。150例RH男性和女性患者将以2:1的比例随机分配至C-LIFE或SEPA组。我们假设,C-LIFE参与者将(1)与SEPA对照组相比,在4个月后表现出更大的有氧健身改善,更大的DASH饮食依从性和更大的体重减轻;(2)与SEPA对照组相比,在4个月后表现出更低的门诊血压和动态血压;(3)表现出LV肥大的更大消退和CVD风险生物标志物的更大改善,包括动脉僵硬度、压力感受器反射敏感性,与SEPA对照相比,4个月后显示出较低的临床BP和ABP,以及改善的CVD生物标志物。我们还假设,更好的有氧健身,更好地坚持DASH饮食,以及更大的体重减轻将与4个月和1年随访时门诊血压的更大降低相关。如果成功,本申请中描述的生活方式干预可以被全国范围内的心脏康复计划采用,并为管理RH患者提供可行的非药物治疗。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
James A Blumenthal其他文献
James A Blumenthal的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('James A Blumenthal', 18)}}的其他基金
Improving Lung Transplant Outcomes with Coping Skills and Physical Activity
通过应对技巧和体力活动改善肺移植结果
- 批准号:
10355486 - 财政年份:2019
- 资助金额:
$ 5.62万 - 项目类别:
Exercise and Pharmacotherapy for Anxiety in Cardiac Patients
心脏病患者焦虑的运动和药物治疗
- 批准号:
9751937 - 财政年份:2015
- 资助金额:
$ 5.62万 - 项目类别:
Exercise and Pharmacotherapy for Anxiety in Cardiac Patients
心脏病患者焦虑的运动和药物治疗
- 批准号:
9113594 - 财政年份:2015
- 资助金额:
$ 5.62万 - 项目类别:
Exercise and Pharmacotherapy for Anxiety in Cardiac Patients
心脏病患者焦虑的运动和药物治疗
- 批准号:
8961874 - 财政年份:2015
- 资助金额:
$ 5.62万 - 项目类别:
Facility and Web-based Approaches to Lifestyle Change in Resistant Hypertension
改变顽固性高血压生活方式的设施和基于网络的方法
- 批准号:
9189649 - 财政年份:2014
- 资助金额:
$ 5.62万 - 项目类别:
Facility and Web-based Approaches to Lifestyle Change in Resistant Hypertension
改变顽固性高血压生活方式的设施和基于网络的方法
- 批准号:
8818651 - 财政年份:2014
- 资助金额:
$ 5.62万 - 项目类别:
相似海外基金
I-Corps: Medication Adherence System
I-Corps:药物依从性系统
- 批准号:
2325465 - 财政年份:2023
- 资助金额:
$ 5.62万 - 项目类别:
Standard Grant
Improving Repositioning Adherence in Home Care: Supporting Pressure Injury Care and Prevention
提高家庭护理中的重新定位依从性:支持压力损伤护理和预防
- 批准号:
490105 - 财政年份:2023
- 资助金额:
$ 5.62万 - 项目类别:
Operating Grants
An innovative, AI-driven prehabilitation platform that increases adherence, enhances post-treatment outcomes by at least 50%, and provides cost savings of 95%.
%20创新、%20AI驱动%20康复%20平台%20%20增加%20依从性、%20增强%20治疗后%20结果%20by%20at%20至少%2050%、%20和%20提供%20成本%20节省%20of%2095%
- 批准号:
10057526 - 财政年份:2023
- 资助金额:
$ 5.62万 - 项目类别:
Grant for R&D
CO-LEADER: Intervention to Improve Patient-Provider Communication and Medication Adherence among Patients with Systemic Lupus Erythematosus
共同领导者:改善系统性红斑狼疮患者的医患沟通和药物依从性的干预措施
- 批准号:
10772887 - 财政年份:2023
- 资助金额:
$ 5.62万 - 项目类别:
Nuestro Sueno: Cultural Adaptation of a Couples Intervention to Improve PAP Adherence and Sleep Health Among Latino Couples with Implications for Alzheimer’s Disease Risk
Nuestro Sueno:夫妻干预措施的文化适应,以改善拉丁裔夫妇的 PAP 依从性和睡眠健康,对阿尔茨海默病风险产生影响
- 批准号:
10766947 - 财政年份:2023
- 资助金额:
$ 5.62万 - 项目类别:
Pharmacy-led Transitions of Care Intervention to Address System-Level Barriers and Improve Medication Adherence in Socioeconomically Disadvantaged Populations
药房主导的护理干预转型,以解决系统层面的障碍并提高社会经济弱势群体的药物依从性
- 批准号:
10594350 - 财政年份:2023
- 资助金额:
$ 5.62万 - 项目类别:
Unintrusive Pediatric Logging Orthotic Adherence Device: UPLOAD
非侵入式儿科记录矫形器粘附装置:上传
- 批准号:
10821172 - 财政年份:2023
- 资助金额:
$ 5.62万 - 项目类别:
Antiretroviral therapy adherence and exploratory proteomics in virally suppressed people with HIV and stroke
病毒抑制的艾滋病毒和中风患者的抗逆转录病毒治疗依从性和探索性蛋白质组学
- 批准号:
10748465 - 财政年份:2023
- 资助金额:
$ 5.62万 - 项目类别:
Improving medication adherence and disease control for patients with multimorbidity: the role of price transparency tools
提高多病患者的药物依从性和疾病控制:价格透明度工具的作用
- 批准号:
10591441 - 财政年份:2023
- 资助金额:
$ 5.62万 - 项目类别:
Development and implementation of peer-facilitated decision-making and referral support to increase uptake and adherence to HIV pre-exposure prophylaxis in African Caribbean and Black communities in Ontario
制定和实施同行协助决策和转介支持,以提高非洲加勒比地区和安大略省黑人社区对艾滋病毒暴露前预防的接受和依从性
- 批准号:
491109 - 财政年份:2023
- 资助金额:
$ 5.62万 - 项目类别:
Fellowship Programs