Key result
The PACE+ Japan follow-up program, which included an action-plan sheet and regular counseling, significantly reduced systolic blood pressure by 12 mmHg compared to a 3 mmHg reduction in the control group over 24 weeks.
Why the study?
Does a multicomponent lifestyle modification program (PACE+ Japan) with regular counseling reduce systolic blood pressure in outpatients with essential hypertension?
RCT (n=57)
Open-label
Randomly divided into two intervention groups, with an additionally selected matched control group
No
Does a multicomponent lifestyle modification program (PACE+ Japan) with regular counseling reduce systolic blood pressure in outpatients with essential hypertension?
A multicomponent lifestyle modification program combining an action plan with regular physician and counselor follow-up significantly reduced systolic blood pressure and urinary sodium excretion in patients with essential hypertension.
Answers are grounded in this paper and cite their sources.
May support BP reduction via theory-based counseling in outpatients; leaves open need for RCTs to confirm efficacy.
With conventional lifestyle modification programs, it can be difficult for hypertensive individuals to modify their lifestyles and maintain the changes. We assessed whether a multicomponent program (patient-centered assessment and counseling for exercise plus nutrition [PACE+ Japan]) based on behavior theory and social cognitive theory would be effective for treating patients with essential hypertension. We examined 57 outpatients aged 62+/-10 years with essential hypertension irrespective of antihypertensive drug treatment. Participants were randomly divided into two groups: 1) a PACE+ Japan follow-up group (n =18), who were given an action-plan sheet and systemic health counseling by a physician and counselor every 4 weeks for 24 weeks, and 2) a PACE+ Japan-only group (n =20), who were given an action-plan sheet but did not receive counseling. An age- and sex-matched control group (n =19) was also selected. The decrease in systolic blood pressure (SBP) (Delta SBP=SBP at 24 weeks minus that at 0 weeks) in the PACE+ Japan follow-up group was significantly greater than that in the control group. In addition, the Delta percentage of Fat (%Fat) and Delta urinary sodium extraction (U-Na) in the PACE+ Japan follow-up group were significantly greater than those in the control group. With regard to changes in total energy expenditure, exercise energy expenditure and total energy intake between 0 weeks and 24 weeks, significant improvements were observed for the PACE+ Japan follow-up group. Delta U-Na was determined to significantly predict Delta SBP as assessed by stepwise selection. In addition, the partial correlation coefficient of Delta SBP with Delta U-Na was 0.361 (p =0.011) as assessed by a multiple regression analysis. Therefore, PACE+ Japan follow-up counseling was associated with a reduction in SBP, which in turn was associated with reduction in U-Na. This new program may be effective for reducing blood pressure in hypertensives.
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Miura et al. (2004) conducted an RCT in Essential hypertension (n=57). PACE+ Japan follow-up program vs. PACE+ Japan-only (action-plan sheet only) and Control group (no intervention) was evaluated on Change in systolic blood pressure (ΔSBP) at 24 weeks (p=<0.05). The PACE+ Japan follow-up program, which included an action-plan sheet and regular counseling, significantly reduced systolic blood pressure by 12 mmHg compared to a 3 mmHg reduction in the control group over 24 weeks.
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