Abstract
BackgroundInternet-based interventions are a promising strategy for promoting healthy lifestyle behaviors. These have a tremendous potential for delivering electronic health interventions in scalable and cost-effective ways. There is strong evidence that the use of these programs can lead to weight loss and can lower patients’ average blood pressure (BP) levels. So far, few studies have investigated the effects of internet-based programs on patients who are obese with hypertension (HTN).ObjectiveThe aim of this study is to investigate the short- and long-term efficacy, in terms of body composition and BP parameters, of a self-administered internet-based intervention involving different modules and learning techniques aimed at promoting lifestyle changes (both physical activity and healthy eating) in patients who are obese with HTN.MethodsA randomized wait-list controlled trial design was used. We recruited 105 adults with HTN who were overweight or obese and randomly assigned them to either a 3-month internet-based intervention group (n=55) or the wait-list control group (n=50). We assessed BMI (primary outcome), body fat mass (BFM), systolic (S)BP and diastolic (D)BP, blood glucose and insulin levels, physical activity levels, and functional capacity for aerobic exercise at Time 0 (preintervention) and Time 1 (postintervention). All the patients in the wait-list control group subsequently received the intervention, and a secondary within-group analysis, which also included these participants, was conducted at Time 2 (12-month follow-up).ResultsA 2-way mixed analysis of covariance showed a significant decrease in BMI, BFM, and blood glucose at 3 months in the internet-based intervention group; the effect size for the BMI and BFM parameters was moderate to large, and there was also a borderline significant trend for DBP and insulin. These results were either maintained or improved upon at Time 2 and showed significant changes for BMI (mean difference −0.4, 95% CI −0.1 to −0.6; P=.005), BFM (mean difference −2.4, 95% CI −1.1 to −3.6; P<.001), DBP (mean difference −1.8, 95% CI −0.2 to −3.3; P=.03), and blood glucose (mean difference −2, 95% CI 0 to −4; P=.04).ConclusionsImplementation of our self-administered internet-based intervention, which involved different learning techniques aimed to promote lifestyle changes, resulted in positive short- and long-term health benefits in patients who are obese with HTN.Trial RegistrationClinicalTrials.gov NCT03396302; https://clinicaltrials.gov/ct2/show/NCT03396302
Highlights
BackgroundCardiovascular disease is the leading cause of morbidity and mortality in developed countries and continues to be a major public health issue that accounts for over 4 million deaths per year in Europe [1]
Implementation of our self-administered internet-based intervention, which involved different learning techniques aimed to promote lifestyle changes, resulted in positive short- and long-term health benefits in patients who are obese with HTN
To the best of our knowledge, no study has assessed the efficacy of a self-administered internet-based intervention MD (IBI), which entails the completion of different modules and incorporates several learning techniques aimed at promoting lifestyle changes in patients who are obese with HTN
Summary
BackgroundCardiovascular disease is the leading cause of morbidity and mortality in developed countries and continues to be a major public health issue that accounts for over 4 million deaths per year in Europe [1]. Obesity, which has been described as a global pandemic [2], is one of the most significant medical threats It is associated with early death [3,4] and is universally recognized as a risk factor for many health complications such as hypertension (HTN). Health consequences, and costs of obesity and HTN rise, clinicians and researchers are continuing to investigate a variety of treatment options for these patients. Promoting healthy behaviors such as physical activity and healthy eating through lifestyle counselling is recommended as the first-line therapy for the treatment of these patients and may be an effective tool for treating obesity and preventing obesity-related health burdens [6,8,9]. Few studies have investigated the effects of internet-based programs on patients who are obese with hypertension (HTN)
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