The impact of dietary modifications on blood pressure control in patients with newly diagnosed hypertension

Dietary modifications are recommended for hypertension, but evidence from low- and middle-income countries remains surprisingly thin. We conducted a randomized controlled trial in Uzbekistan to test whether a pragmatic, culturally adapted dietary counseling program improves blood pressure control in newly diagnosed hypertensive patients. Between April and October 2025, 160 adults (mean age 54 years, 61% female) with recently confirmed hypertension (baseline SBP ~148 mmHg) were assigned to either four structured nurse‑led counseling sessions plus a illustrated booklet (intervention) or usual care (brief physician advice plus a standard pamphlet). The primary outcome was change in systolic blood pressure at six months. Follow‑up was complete for 147 participants (92%). The intervention group showed a mean SBP reduction of 10.8 mmHg versus 4.2 mmHg in controls a between‑group difference of 6.3 mmHg (95% CI: 3.1–9.5, p=0.001). Fewer intervention participants started antihypertensive medication (34% vs 53%, p=0.02), yet blood pressure control rates (<140/90) were higher (54% vs 39%, p=0.04). Self‑reported dietary adherence improved substantially in the intervention group, though social desirability bias cannot be ruled out. Body mass index changes were minimal, suggesting the BP effect was mediated largely by sodium reduction rather than weight loss. A reviewer once pointed out that behavioral interventions often fade after contact ends, so longer follow‑up is needed. Still, these findings seem to suggest that low‑intensity dietary counseling deliverable through existing primary care infrastructure can meaningfully lower blood pressure and reduce medication dependence in newly diagnosed patients. This is, to our knowledge, the first trial of its kind in Central Asia.