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Randomised controlled factorial trial of dietary advice for patients with a single high blood pressure reading in primary care

Randomised controlled factorial trial of dietary advice for patients with a single high blood pressure reading in primary care
Randomised controlled factorial trial of dietary advice for patients with a single high blood pressure reading in primary care
Objective: To assess the effect of brief interventions during the "watchful waiting" period for hypertension.
Design: Factorial trial.
Setting: General practice.
Methods: 296 patients with blood pressure > 160/90 mm Hg were randomised to eight groups defined by three factors: an information booklet; low sodium, high potassium salt; prompt sheets for high fruit, vegetable, fibre; and low fat.
Main outcome measures: Blood pressure (primary outcome); secondary outcomes of diet, weight, and dietary biomarkers (urinary sodium:potassium (Na:K) ratio; carotenoid concentrations).
Results: Blood pressure was not affected by the booklet (mean difference (diastolic blood pressure) at one month 0.2, 95% confidence interval 1.6 to 2.0), salt (0.13; 1.7 to 2.0), or prompts (0.52; 1.3 to 2.4). The salt decreased Na:K ratio (difference 0.32; 0.08 to 0.56, P = 0.01), and the prompts helped control weight (difference 0.39 (0.85 to 0.05) kg at one month, P = 0.085; 1.2 (0.1 to 2.25) kg at six months, P = 0.03). Among those with lower fruit and vegetable consumption (< 300 g per day), prompts increased fruit and vegetable consumption and also carotenoid concentrations (difference 143 (16 to 269) mmol/l, P < 0.03) but did not decrease blood pressure.
Conclusion: During watchful waiting, over and above the effect of brief advice and monitoring, an information booklet, lifestyle prompts, and low sodium salt do not reduce blood pressure. Secondary analysis suggests that brief interventions—particularly lifestyle prompts—can make useful changes in diet and help control weight, which previous research indicates are likely to reduce the long term risk of stroke.
0959-8138
1054-1057
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Kelly, Jo
b7094829-aeb1-4bc1-b64c-7b7c716f73b5
Barnett, Jane
f10c0f99-e2f8-42e6-b52a-4987568453db
Dorward, Martina
ede98eab-1027-4a21-a38c-3bccb7c71e06
Margetts, Barrie
d415f4a1-d572-4ebc-be25-f54886cb4788
Warm, Daniel
3e225cef-1825-47b5-a7e7-78b6b6213fa4
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Kelly, Jo
b7094829-aeb1-4bc1-b64c-7b7c716f73b5
Barnett, Jane
f10c0f99-e2f8-42e6-b52a-4987568453db
Dorward, Martina
ede98eab-1027-4a21-a38c-3bccb7c71e06
Margetts, Barrie
d415f4a1-d572-4ebc-be25-f54886cb4788
Warm, Daniel
3e225cef-1825-47b5-a7e7-78b6b6213fa4

Little, Paul, Kelly, Jo, Barnett, Jane, Dorward, Martina, Margetts, Barrie and Warm, Daniel (2004) Randomised controlled factorial trial of dietary advice for patients with a single high blood pressure reading in primary care. BMJ, 328 (7447), 1054-1057. (doi:10.1136/bmj.38037.435972.EE).

Record type: Article

Abstract

Objective: To assess the effect of brief interventions during the "watchful waiting" period for hypertension.
Design: Factorial trial.
Setting: General practice.
Methods: 296 patients with blood pressure > 160/90 mm Hg were randomised to eight groups defined by three factors: an information booklet; low sodium, high potassium salt; prompt sheets for high fruit, vegetable, fibre; and low fat.
Main outcome measures: Blood pressure (primary outcome); secondary outcomes of diet, weight, and dietary biomarkers (urinary sodium:potassium (Na:K) ratio; carotenoid concentrations).
Results: Blood pressure was not affected by the booklet (mean difference (diastolic blood pressure) at one month 0.2, 95% confidence interval 1.6 to 2.0), salt (0.13; 1.7 to 2.0), or prompts (0.52; 1.3 to 2.4). The salt decreased Na:K ratio (difference 0.32; 0.08 to 0.56, P = 0.01), and the prompts helped control weight (difference 0.39 (0.85 to 0.05) kg at one month, P = 0.085; 1.2 (0.1 to 2.25) kg at six months, P = 0.03). Among those with lower fruit and vegetable consumption (< 300 g per day), prompts increased fruit and vegetable consumption and also carotenoid concentrations (difference 143 (16 to 269) mmol/l, P < 0.03) but did not decrease blood pressure.
Conclusion: During watchful waiting, over and above the effect of brief advice and monitoring, an information booklet, lifestyle prompts, and low sodium salt do not reduce blood pressure. Secondary analysis suggests that brief interventions—particularly lifestyle prompts—can make useful changes in diet and help control weight, which previous research indicates are likely to reduce the long term risk of stroke.

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Published date: 2004

Identifiers

Local EPrints ID: 25766
URI: http://eprints.soton.ac.uk/id/eprint/25766
ISSN: 0959-8138
PURE UUID: ac75f441-1994-4742-8576-297e742abfc9

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Date deposited: 19 Apr 2006
Last modified: 08 Jan 2022 12:53

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Contributors

Author: Paul Little
Author: Jo Kelly
Author: Jane Barnett
Author: Martina Dorward
Author: Barrie Margetts
Author: Daniel Warm

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