Blood Pressure Reduction in the Long-Term Cardiovascular Risk Reduction Dietary Intervention Trial

Abstract

As a follow-up in a series of studies designed to test the effect of a risk-reducing prepared meal plan on CVD endpoints in patients with CVD risk factors, this year-long study was designed to determine the long-term effects on blood pressure (BP) of a prepared meal plan (PMP) compared to a usual care self-selected diet (SSD). In a multi-center trial, 220 participants aged 25-70 with marginally controlled hypertension and dyslipidemia were randomized to either: 1) usual care SSD (n= 110) or 2) nutrient-fortified PMP (n=110). Both plans were designed to provide (as % energy) 22% fat, 17% protein and 61% carbohydrate. Supine systolic (SBP) and diastolic (DBP) blood pressure was measured at baseline (BL), week 12, and at the end of 26 weeks. ANOVA with repeated measures was used to determine changes in BP (mean change ±SD) from BL within and between diets through 6 months of intervention (interim data are shown): PMP SSD week12 week26 week12 week26 SBP −12.4±10.6 −15.0±9.9 −8.1±9.1 −8.8±10.9 DBP −8.0±6.5 −9.3±6.6 −4.9±6.4 −6.5±6.7 Baseline BP was 146/91 and 147/88 for the PMP and SSD respectively (p=ns). Within diets, SBP and DBP were reduced from BL in both groups (p < 0.001). Changes in SBP and DBP from BL were greater in the PMP compared to the SSD after 12 (p < 0.02) and 26 weeks (p < 0.03). Similar changes were noted for sitting SBP (p < 0.03). Within diets, further changes from week 12 to 26 were also observed for SBP (p < 0.04) and DBP (p < 0.007). Long-term dietary interventions to reduce BP can be effective strategies for controlling hypertension. The PMP offers a convenient modality for achieving more favorable long-term changes in BP control compared to usual care self-selected diets.