News - Hypertension Week of April 27, 2003/ Vol. 2 No. 17

Study: Weight Loss, Exercise, Less Salt, Healthy Diet Lower Blood Pressure

Losing weight, exercising, consuming less salt and eating healthy foods can dramatically lower blood pressure, according to a study reported in the April 23 issue of the Journal of the American Medical Association.

The study involved 810 overweight and sedentary participants with an average age of 50 who were counseled on weight loss, improved exercise and a low-salt diet and given specific dietary instructions.

Over a six-month period, the participants lowered their systolic blood pressure by an average of 11 points and their diastolic blood pressure by an average of 6.4 points.

The number of people with uncontrolled hypertension dropped from 37 percent to just 12 percent. The percentage of participants with optimal blood pressure (systolic blood pressure less than 120 and diastolic blood pressure less than 80) increased from zero to 35. Only a few required blood pressure medications.

"Our study shows that people can simultaneously make multiple lifestyle changes that lower their blood pressure and improve their health," said study chairman Dr. Lawrence J. Appel, a professor at Johns Hopkins University. "The key issue now is helping people maintain these changes so they don't revert back to less healthy behaviors."

The group that had the best outcomes received counseling on the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables and low-fat dairy products. It includes whole grains, poultry, fish and nuts, and is reduced in fats, red meat, sweets and sugar-containing beverages. This group also was advised to exercise, lose weight and reduce salt intake.

Appel acknowledged that adopting multiple changes can sometimes be a challenge. "For people who have a hard time with this, start with one change, like exercising, and then add others as you can." Before starting or increasing their exercise, people should check with their physician, he said.

Participants were assigned randomly to one of three groups. The first group had one 30-minute counseling session with a registered dietitian offering general advice on lowering blood pressure.

The second group had 18 counseling sessions over the six-month period on losing weight, reducing salt and increasing exercise but no advice on the DASH diet.

A third group also had 18 counseling sessions, but the counseling included advice on the DASH diet as well as on exercise, weight loss and salt reduction.

While members of all three groups lowered blood pressure, the third group had the best results by doubling the reduction in blood pressure of those in the group that received one session.

The third group also was much less likely to need blood pressure medications. By six months, 19 people in the one-session group needed blood pressure drugs, compared with two people in the second group and five people in the third group.

Other sources: Johns Hopkins Medical Institutions