The long-term effects of lifestyle change on blood pressure: One-year follow-up of the ENCORE study
Open accessAbstract
BACKGROUND: There is a paucity of data describing the sustained benefits of lifestyle interventions on health behaviors and blood pressure (BP). METHODS: We examined the persistence of changes in health habits and BP in the ENCORE study, a trial in which 144 overweight individuals with above-normal BP were randomized to one of the following 16-week interventions: Dietary Approaches to Stop Hypertension (DASH) diet alone (DASH-A), DASH diet plus a behavioral weight management intervention (DASH-WM), or Usual Care. Follow-up assessments were conducted 8 months after the end of treatment. RESULTS: At 16 weeks, systolic BP was reduced by 16.1 (95% confidence interval (CI) = 13.0-19.2) mm Hg in the DASH-WM group, 11.2 (95% CI = 8.1-14.3) mm Hg in the DASH-A group, and 3.4 (95% CI = 0.4-6.4) mm Hg in the Usual Care group. A decrease in BP persisted for 8 months, with systolic BP lower than baseline by 11.7 (95% CI = 8.1-15.3) mm Hg in the DASH-WM group, 9.5 (95% CI = 6.7-12.1) mm Hg in the DASH-A group, and 3.9 (95% CI = 0.5-7.3) mm Hg in the Usual Care group (P < 0.001 for active treatments vs. Usual Care). DASH-WM subjects lost 8.7 kg during the intervention and remained 6.3 kg lighter on follow-up examination. Changes in diet content were sustained in both DASH intervention groups. Among those who participated in DASH-WM, however, caloric intake was no longer lower, and only 21% reported still exercising regularly 8 months after completing the intervention. CONCLUSIONS: Changes in dietary habits, weight, and BP persisted for 8 months after completion of the 16-week ENCORE program, with some attenuation of the benefits. Additional research is needed to identify effective methods to promote long-term maintenance of the benefits of lifestyle modification programs. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT00571844.
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Despite a diagnosis of hypertension, few patients tend to modify their lifestyle or sustain adherence to lifestyle recommendations.
“Despite a diagnosis of hypertension, few patients tend to modify their lifestyle or sustain adherence to lifestyle recommendations [9,10,11].”
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- Authors
- Hinderliter, A. L., Sherwood, A., Craighead, L. W., Lin, P.-H., Watkins, L., Babyak, M. A., & Blumenthal, J. A.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Duke University (US)
- Emory University (US)
- Duke Medical Center (US)
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-10-01
- Volume
- 27
- Issue
- 5
- Pages
- 734-741
- ISSN
- 0895-7061 (ISSN-L)
- 1941-7225
- PMC
- PMC3978946
- OpenAlex
- W2145204959
- Cited by
- 94
- References
- 26
- Citations by year
- 2025: 7 · 2024: 8 · 2023: 7 · 2022: 4 · 2021: 11 · 2020: 9 · 2019: 5 · 2018: 12 · 2017: 16 · 2016: 8 · 2015: 4 · 2014: 3
- FWCI
- 3.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Hypertension (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (M01 RR30)
- National Heart, Lung, and Blood Institute (HL074103, M01-RR-30, R01HL074103)
- National Center for Research Resources (M01 RR 30, UL1RR024128)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- hypertension, blood pressure reduction, lifestyle intervention, DASH diet, weight management, dietary adherence, overweight adults, energy intake, physical activity, sustained weight loss, exercise adherence, health behavior change, usual care comparison, behavioral weight management, dietary fiber, sodium reduction, potassium intake, dietary cholesterol reduction
- MeSH terms
- Adult, Blood Pressure, Exercise Therapy, Feeding Behavior, Female, Humans, Hypertension, Health Knowledge, Attitudes, Practice, Life Style, Male, Middle Aged, North Carolina, Risk Factors, Time Factors, Weight Loss, Health Behavior, Cognitive Behavioral Therapy, Treatment Outcome, Caloric Restriction, Risk Reduction Behavior, Overweight, Sedentary Behavior, Weight Reduction Programs
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