Plain language summary
Blood pressure (BP) is influenced by nutritional, physical and psychosocial factors. The aim of this study was to compare the effect of a Comprehensive Approach to Lower Blood Pressure (CALM-BP) with the standard recommended Dietary Approach to Stop Hypertension (DASH) diet plus exercise on BP, medication use and cardiovascular risk factors. Study participants were adults with high BP being treated with at least one BP-lowering drug. Measures given to the CALM-BP group included a low-fat diet based on wholegrain rice, walking, yoga, relaxation and stress management. Those in the DASH group received a diet in line with that promoted by the US Department of Health and Human Services, plus walking. The interventions lasted for 16 weeks, and this was followed by a 6-month maintenance period. Normal BP readings were achieved by 71% of participants in the CALM-BP group compared with 33% in the DASH group. Medication was reduced in 70% of the CALM-BP group and 31% of the DASH group. Participants in the CALM-BP group reduced their BP by an average of 4.33/3.07 mm Hg compared with 4.0/1.9 mm Hg in the DASH group. After 6 months, only patients in the CALM-BP group had reduced their BMI and cholesterol and improved their quality of life scores. The authors concluded that lifestyle and diet modifications are highly effective with respect to BP control, medication use and cardiovascular risk factors.
Abstract
Complementary medicine advocates the use of a multifactorial approach to address the varied aspects of hypertension. The aim of this study was to compare the blood pressure (BP) effect and medication use of a novel Comprehensive Approach to Lowering Measured Blood Pressure (CALM-BP), based on complementary medicine principles, with the standard recommended Dietary Approach to Stop Hypertension (DASH). A total of 113 patients treated with antihypertensive drugs were randomly assigned to either CALM-BP treatment (consisting of rice diet, walks, yoga, relaxation and stress management) or to a DASH+exercise control group (consisting of DASH and walks). Ambulatory 24-h and home BP were monitored over a 16-week programme, followed by 6 months of maintenance period. Medications were reduced if systolic BP dropped below 110 mm Hg accompanied by symptoms. In addition to BP reduction, medications were reduced because of symptomatic hypotension in 70.7% of the CALM-BP group compared with 32.7% in the DASH group, P<0.0001. After 6 months, medication status was not altered in the majority of individuals. Significant reductions in body mass index, cholesterol and improved quality-of-life scores were observed only in the CALM-BP group. Lifestyle and diet modifications based on complementary medicine principles are highly effective with respect to BP control, medication use and cardiovascular risk factors.
Methodological quality
Jadad score
:
2
Allocation concealment
:
Yes
