The Long-Term Effects of Lifestyle Change on Blood Pressure: One-Year Follow-Up of the ENCORE Study
The Long-Term Effects of Lifestyle Change on Blood Pressure: One-Year Follow-Up of the ENCORE Study
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DOI：
10.1093/ajh/hpt183
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发表时间：
2014-05-01
影响因子：
3.2
通讯作者：
Blumenthal, James A.
中科院分区：
文献类型：
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作者：
Hinderliter, Alan L.;Sherwood, Andrew;Blumenthal, James A.
生活方式干预对健康行为和血压(BP)的持续益处的数据很少。在Encore研究中，我们检验了健康习惯和血压变化的持久性，在这项试验中，144名血压高于正常的超重者被随机分为以下16周干预之一：停止高血压的饮食方法(DASH-A)、DASH饮食加行为体重管理干预(DASH-WM)或日常护理。治疗结束后8个月进行随访，16周时，DASH-WM组、DASH-A组和常规护理组的收缩压分别下降16.1(95%可信区间13.019.2)mm Hg、11.2(95%CI 8.114.3)mm Hg和3.4(95%CI 0.46.4)mm Hg。血压下降持续了8个月，DASH-WM组的收缩压比基线低11.7(95%CI 8.115.3)mm Hg，DASH-A组下降9.5(95%CI 6.712.1)mm Hg，常规护理组下降3.9(95%CI 0.57.3)mm Hg(P<；积极治疗与常规护理相比P<；0.001)。DASH-WM受试者在干预期间减重了8.7公斤，在随访检查中仍减重了6.3公斤。饮食内容的变化在两个DASH干预组都是持续的。然而，在那些参加DASH-WM的人中，卡路里摄入量不再降低，只有21%的人报告在完成干预8个月后仍有规律地锻炼。饮食习惯、体重和血压的变化在16周的安可计划完成后持续了8个月，但益处有所减弱。还需要进行更多的研究，以确定有效的方法，以促进长期保持生活方式改变计划的好处。
There is a paucity of data describing the sustained benefits of lifestyle interventions on health behaviors and blood pressure (BP).We examined the persistence of changes in health habits and BP in the ENCORE study, a trial in which 144 overweight individuals with above-normal BP were randomized to one of the following 16-week interventions: Dietary Approaches to Stop Hypertension (DASH) diet alone (DASH-A), DASH diet plus a behavioral weight management intervention (DASH-WM), or Usual Care. Follow-up assessments were conducted 8 months after the end of treatment.At 16 weeks, systolic BP was reduced by 16.1 (95% confidence interval (CI) 13.019.2) mm Hg in the DASH-WM group, 11.2 (95% CI 8.114.3) mm Hg in the DASH-A group, and 3.4 (95% CI 0.46.4) mm Hg in the Usual Care group. A decrease in BP persisted for 8 months, with systolic BP lower than baseline by 11.7 (95% CI 8.115.3) mm Hg in the DASH-WM group, 9.5 (95% CI 6.712.1) mm Hg in the DASH-A group, and 3.9 (95% CI 0.57.3) mm Hg in the Usual Care group (P < 0.001 for active treatments vs. Usual Care). DASH-WM subjects lost 8.7kg during the intervention and remained 6.3kg lighter on follow-up examination. Changes in diet content were sustained in both DASH intervention groups. Among those who participated in DASH-WM, however, caloric intake was no longer lower, and only 21% reported still exercising regularly 8 months after completing the intervention.Changes in dietary habits, weight, and BP persisted for 8 months after completion of the 16-week ENCORE program, with some attenuation of the benefits. Additional research is needed to identify effective methods to promote long-term maintenance of the benefits of lifestyle modification programs.Clinicaltrials.gov identifier: NCT00571844.