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Lifestyle interventions improve BP in black patients

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Stephen Sidney

Black patients who were treated with successful lifestyle interventions had improved BP control compared with those who were treated with usual care, according to an abstract presented at the International Stroke Conference.

Elevated BP is one of the strongest risk factors for stroke.

Stephen Sidney, MD, MPH, director of research clinics and senior research scientist in the division of research at Kaiser Permanente Northern California in Oakland, and colleagues analyzed data from black patients (median age, 61 years) with a high BP reading of at least 140 mm Hg systolic/90 mm Hg diastolic. These patients were from 98 primary care physicians from the Shake, Rattle and Roll trial.

Patients were assigned to usual care (n = 1,129), enhanced monitoring of Kaiser Permanente Northern California BP management protocol (n = 346) or culturally tailored lifestyle coaching that focused on the Dietary Approaches to Stop Hypertension (DASH) diet (n = 286). The intervention continued for 12 months, which was followed by 15 months for data collection.

Electronic medical records were used to collect data on medications and demographics. BP measurements from enrollment and 27 months after enrollment were utilized to assess BP control rates.

At 12 months after intervention, patients assigned lifestyle coaching had higher BP control rates compared with those assigned usual care (73.2% vs. 60.6%; P < .001). There was a trend toward the enhanced monitoring group having a greater rate of BP control vs. the usual-care group at 12 months (67% vs. 60.5%; P = .07).

There were no differences in weight change, BP medication adherence or outpatient primary care utilization in all three groups.

“The sustainability of a culturally appropriate [successful lifestyle] intervention with a focus on DASH should be studied further for implementation in adults with uncontrolled [hypertension],” Sidney and colleagues wrote. – by Darlene Dobkowski

Reference:

Nguyen Huynh MN, et al. Abstract 186. Presented at: International Stroke Conference; Jan. 23-26, 2018; Los Angeles.

Disclosures: Sidney reports no relevant financial disclosures.