Abstract 18589: Blood Pressure Lowering Persists for 36 Weeks After Lifestyle Interventions: The ENCORE Follow-up Study
Background: Short-term lifestyle modification programs are effective in lowering blood pressure (BP), but the long-term benefits of these interventions have not been extensively studied. We examined the persistence of changes in dietary habits, exercise behavior, body weight, and blood pressure in participants in the ENCORE study at 1 year after enrollment.
Methods: Participants included 144 unmedicated, overweight or obese participants (67% F; 59% Caucasian; mean age = 52 yr) with pre-hypertension or stage 1 hypertension (BP 130-160/80-99 mm Hg). Subjects were randomized to 16 weeks of DASH diet plus behavioral weight management (consisting of supervised exercise and a behavioral modification program) (DASH+WM), DASH diet alone (consisting of nutritional counseling without exercise or caloric restriction) (DASH), or usual care (UC).
Results: Data were available in 124 subjects at 52 weeks (36 weeks following completion of the intervention). At 52 weeks, consumption of sodium was lower and dietary intake of potassium, calcium, and magnesium was higher in the active treatment groups than in UC. The proportion of participants reporting regular vigorous exercise was nearly identical in DASH+WM and DASH, and almost 3 times greater than in UC. Mean changes from baseline weight at 16 and 52 weeks were -8.7 and -6.3 kg for DASH+WM; -0.3 and-1.5 kg for DASH; and +0.9 and -1.6 kg for UC (p<0.001 for DASH+WM vs DASH and DASH+WM vs UC at 52 weeks). BP at 16 and 52 weeks was reduced by 16.1/9.9 and 9.9/4.3 mm Hg in DASH+WM, 11.2/7.5 and 9.7/5.5 mm Hg in DASH, and 3.4/3.8 and 3.7/3.1 mm Hg in UC (p<0.05 for difference in systolic BP for active treatment groups vs. UC).
Conclusions: Significant changes in dietary habits and exercise behaviors, weight, and BP persisted for 36 weeks following completion of 16-week lifestyle intervention programs, although there was 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.
- © 2010 by American Heart Association, Inc.