A HEALTH PROMOTION PROGRAM INCORPORATING FISH FOR WITHDRAWAL OF ANTIHYPERTENSIVE DRUGS IN OVERWEIGHT, HYPERTENSIVES

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Obesity is the major lifestyle factor predisposing to high blood pressure and abnormal blood fat levels. Weight reduction and omega-3 fatty acids from fish meals and fish oils have been shown independently to reduce blood pressure and improve blood fats in subjects with high blood pressure. We have previously shown that in treated hypertensive patients on a daily fish meal as part of a weight-reducing regimen, substantial blood pressure reduction was achieved over a 4 month period. We now aim to assess in overweight, men and women, who are taking medication for high blood pressure, the effects of a health promotion program which focuses on improved dietary education and includes increased dietary omega-3 fatty acids from fish. The program will also incorporate increased physical activity, quitting smoking and moderation of alcohol consumption. The primary aim is to reduce blood pressure and enable antihypertensive therapy to be withdrawn. It is proposed the program improve blood fats, blood glucose and insulin, and components of the clotting system. The results should have important implications for public health given the high prevalence of hypertensive cardiovascular disease. 190 men and women, 40-70 years, who are receiving treatment for high blood pressure, will be recruited from the general community. Patients will be randomly allocated to either: 1) continue their usual diet and usual care, or 2) commence a health promotion program which includes information on improved dietary habits, increased physical activity, moderation in alcohol consumption, as well as quitting smoking. These subjects will be given an individual dietary program to reduce caloric intake and they will also be asked to include fish meals as part of their diet on at least 4 days of the week. Subjects in the usual care group (control group) will be provided with literature from the National Heart Foundation and will be offered weight control counselling at the end of the study.