Motivation Key To Blood Pressure Control

Individually, lifestyle factors such as weight loss, regular exercise, and limited sodium, alcohol, and diet ary fat have all been shown to help lower blood pressure in patients with hypertension. However, the researchers found another important intervention when examining how all lifestyle factors could be combined to lower blood pressure. This was called persuasion.

Researchers say encouraging words can help patients lose weight and blood pressure, regardless of whether it is a doctor's recommendation on how important it is to control blood pressure.

Laura P. Svetkey MD is the director of Duke University's Hypertension Center. She says, "Motivation was certainly one of many very important behavior elements for helping to control blood pressure." People can lose weight and increase physical activity by being nudged in the right direction. This will help lower blood pressure, reduce cardiovascular risk, and encourage people to eat healthier. It takes just a small push to motivate people to follow the correct path.

Her study was published this week in the Journal of the American Medical Association. It examined whether consuming a heart-healthy diet, DASH, would help to lower blood pressure for people who also have healthy lifestyle choices. The DASH diet -- Dietary Approaches to Stop Hypertension -- is a low-fat diet rich in fruits, vegetables, and low-fat dairy products and is designed to lower blood pressure.

Around 800 participants were split into three different groups. Healthy lifestyle changes were the first group. These lifestyle changes were also implemented by the second group, who added DASH to their diet. Only the counselors provided general advice to third group.

Results: DASH diet only had a slight effect on blood pressure.

Svetkey said that they were expecting to see more difference among those who ate the DASH Diet as part of their intervention than those who ate everything but that diet. This is something Svetkey explained to WebMD. There is only so much you can do with a variety of lifestyle interventions. The social support provided by both groups seemed to be a great help. The people helped one another and developed specific strategies such as ways to avoid eating holiday cookies and cakes.

The real surprise was in the 273 patients in the "control" group. They received no guidance, no support groups or individual counseling. However, they did receive occasional visits with an intervention counselor. She advised them about the importance and offered strategies for achieving those goals. The average blood pressure dropped by almost seven points in each group, and they lost about three pounds on average. This compares to the six-pound loss experienced by patients in the other two groups.

Plus, the study found that nearly one fifth of this advice-only group had achieved ideal blood pressure by the end of the study, in comparison to 35% of individuals who have made lifestyle changes and 30% of those who are following DASH diets.

Svetkey shares his surprise at how well the advice-only group performed with WebMD. They performed better than the control group in similar studies."

She says that encouragement can be used to encourage or maintain motivation. Even generic advice about why blood pressure control matters, but not specific strategies, is helpful.

In an editorial accompanying the article, one expert states that physicians should still counsel patients with high blood pressure on how to lose weight and what exercise is best for them. WebMD is told by Svetkey that he doesn't think the DASH diet should be discounted. In past studies, people who followed this diet were served all the meals. However, in Svetkey’s study they received the diet guidelines and had to make their own food. This allowed researchers to determine how close patients adhered to the DASH diet.

Thomas G. Pickering MD, PhD of Mount Sinai Medical Center said that the DASH diet has additional benefits than lowering blood pressure. He didn't take part in Svetkey’s study. It is generally considered a healthy diet which can lower the chance of developing diabetes or heart disease. DASH can be used to help patients lose weight. This study didn't reveal how willing people were to adhere to DASH.

According to Catherine Champagne, Ph.D., a Pennington Biomedical Research Center researcher, "What this study shows is that people will lose weight if they want to." They will be able to lose weight more if they receive more intense intervention. The fact that those in the control didn't receive this support, but were still able to meet with intervention specialists during the trial shows they were motivated. That motivation is certainly a plus.