AJLM CME/CE Article Quiz Volume 18, Issue 5

Impact of Lifestyle Medicine Interventions on the Management of Systemic Hypertension in Primary Care: A Canadian Randomized Controlled Trial

The study aimed to evaluate the feasibility of implementing lifestyle interventions in primary care settings with hypertensive patients and their effect on blood pressure, body composition, cardiometabolic markers, and antihypertensive drug use. Sixty participants diagnosed with stage 1 hypertension were randomly assigned to 4 groups: (1) Standard medical care (control), (2) Physical activity protocol, (3) Dietary Approach to Stop Hypertension (DASH) diet, and (4) Combination of physical activity protocol and DASH diet. Participants received counseling from family physicians, nurses, kinesiologists, and registered dietitians. Various assessments were conducted before (T0) and after (T6) the interventions, including 24-h ambulatory blood pressure monitoring, blood and urine tests, anthropometric measurements, computed tomography to measure adipose tissue, submaximal exercise test to estimate maximal oxygen consumption and health questionnaires. Fifty-one (51) participants (51/57, 89%) completed the program. All interventions reduced blood pressure indices between T0 and T6, except the combined interventions group. Body composition and cardiometabolic parameters were improved in all groups, except for the control group. In total, 28% of participants (7/23) reduced or stopped their antihypertensive medications at T6. The results suggest that structured lifestyle interventions are feasible in primary care and improve blood pressure and cardiometabolic parameters in patients with stage 1 hypertension.

Learning Objectives

After studying the article, participants will be able to: 

  1. Describe the dietary and physical activity interventions used to reduce blood pressure 
  2. State the minimum difference in systolic blood pressure (SBP) this study was designed to detect 
  3. Determine which interventions reduced SBP and diastolic blood pressure (DBP) 
  4. Compare the effect of lifestyle interventions on blood pressure in participants who were taking anti-hypertensive medications and those who were not on these medications