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Comprehensive Approach to Lower Blood Pressure (CALM-BP): a randomized controlled trial of a multifactorial lifestyle intervention.

Ziv A, Vogel O, Keret D, Pintov S, Bodenstein E, Wolkomir K, Doenyas K, Mirovski Y, Efrati S - J Hum Hypertens (2013)

Bottom Line: Medications were reduced if systolic BP dropped below 110 mm Hg accompanied by symptoms.In addition to BP reduction, medications were reduced because of symptomatic hypotension in 70.7% of the CALM-BP group compared with 32.7% in the DASH group, P<0.0001.Significant reductions in body mass index, cholesterol and improved quality-of-life scores were observed only in the CALM-BP group.

View Article: PubMed Central - PubMed

Affiliation: Shiram Integrated Medicine Unit, Assaf Harofeh Medical Center, Zerifin, Israel.

ABSTRACT
Complementary medicine advocates the use of a multifactorial approach to address the varied aspects of hypertension. The aim of this study was to compare the blood pressure (BP) effect and medication use of a novel Comprehensive Approach to Lowering Measured Blood Pressure (CALM-BP), based on complementary medicine principles, with the standard recommended Dietary Approach to Stop Hypertension (DASH). A total of 113 patients treated with antihypertensive drugs were randomly assigned to either CALM-BP treatment (consisting of rice diet, walks, yoga, relaxation and stress management) or to a DASH+exercise control group (consisting of DASH and walks). Ambulatory 24-h and home BP were monitored over a 16-week programme, followed by 6 months of maintenance period. Medications were reduced if systolic BP dropped below 110 mm Hg accompanied by symptoms. In addition to BP reduction, medications were reduced because of symptomatic hypotension in 70.7% of the CALM-BP group compared with 32.7% in the DASH group, P<0.0001. After 6 months, medication status was not altered in the majority of individuals. Significant reductions in body mass index, cholesterol and improved quality-of-life scores were observed only in the CALM-BP group. Lifestyle and diet modifications based on complementary medicine principles are highly effective with respect to BP control, medication use and cardiovascular risk factors.

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Related in: MedlinePlus

Time until blood pressure medication reduction during the intervention period. Antihypertensive medications were reduced or discontinued if the mean systolic blood pressure was <110 mm Hg on two consecutive days in conjunction with symptoms related to hypotension (weakness, dizziness, blurred vision or presyncope). CALM-BP: Comprehensive Approach to Lowering Measured Blood Pressure, based on complementary medicine principles. DASH: the standard recommended Dietary Approach to Stop Hypertension according to the US Department of Health and Human Services, National Institute of Health, National Heart, Lung, and Blood Institute.
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fig2: Time until blood pressure medication reduction during the intervention period. Antihypertensive medications were reduced or discontinued if the mean systolic blood pressure was <110 mm Hg on two consecutive days in conjunction with symptoms related to hypotension (weakness, dizziness, blurred vision or presyncope). CALM-BP: Comprehensive Approach to Lowering Measured Blood Pressure, based on complementary medicine principles. DASH: the standard recommended Dietary Approach to Stop Hypertension according to the US Department of Health and Human Services, National Institute of Health, National Heart, Lung, and Blood Institute.

Mentions: During the 16-week period, BP measurements <110 mm Hg accompanied by symptoms of hypotension were recorded on two consecutive days in 41 of 58 (70.7%) participants in the CALM-BP group compared with 18 of 55 (32.7%) participants in the DASH group (P<0.0001). BP reductions were observed mainly during the first 5 weeks in the CALM-BP group in comparison with a steady-reduction rate in the DASH group (P<0.0001; Figure 2). For these participants, the dosage of the antihypertensive medication was reduced or medications were stopped. The first drugs to be withdrawn according to the protocol were diuretic. Accordingly, diuretics were stopped in 19 of 27 (70.4%) participants in the CALM-BP group compared with 8 of 26 (30.8%) in the DASH group (P=0.006).


Comprehensive Approach to Lower Blood Pressure (CALM-BP): a randomized controlled trial of a multifactorial lifestyle intervention.

Ziv A, Vogel O, Keret D, Pintov S, Bodenstein E, Wolkomir K, Doenyas K, Mirovski Y, Efrati S - J Hum Hypertens (2013)

Time until blood pressure medication reduction during the intervention period. Antihypertensive medications were reduced or discontinued if the mean systolic blood pressure was <110 mm Hg on two consecutive days in conjunction with symptoms related to hypotension (weakness, dizziness, blurred vision or presyncope). CALM-BP: Comprehensive Approach to Lowering Measured Blood Pressure, based on complementary medicine principles. DASH: the standard recommended Dietary Approach to Stop Hypertension according to the US Department of Health and Human Services, National Institute of Health, National Heart, Lung, and Blood Institute.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3775127&req=5

fig2: Time until blood pressure medication reduction during the intervention period. Antihypertensive medications were reduced or discontinued if the mean systolic blood pressure was <110 mm Hg on two consecutive days in conjunction with symptoms related to hypotension (weakness, dizziness, blurred vision or presyncope). CALM-BP: Comprehensive Approach to Lowering Measured Blood Pressure, based on complementary medicine principles. DASH: the standard recommended Dietary Approach to Stop Hypertension according to the US Department of Health and Human Services, National Institute of Health, National Heart, Lung, and Blood Institute.
Mentions: During the 16-week period, BP measurements <110 mm Hg accompanied by symptoms of hypotension were recorded on two consecutive days in 41 of 58 (70.7%) participants in the CALM-BP group compared with 18 of 55 (32.7%) participants in the DASH group (P<0.0001). BP reductions were observed mainly during the first 5 weeks in the CALM-BP group in comparison with a steady-reduction rate in the DASH group (P<0.0001; Figure 2). For these participants, the dosage of the antihypertensive medication was reduced or medications were stopped. The first drugs to be withdrawn according to the protocol were diuretic. Accordingly, diuretics were stopped in 19 of 27 (70.4%) participants in the CALM-BP group compared with 8 of 26 (30.8%) in the DASH group (P=0.006).

Bottom Line: Medications were reduced if systolic BP dropped below 110 mm Hg accompanied by symptoms.In addition to BP reduction, medications were reduced because of symptomatic hypotension in 70.7% of the CALM-BP group compared with 32.7% in the DASH group, P<0.0001.Significant reductions in body mass index, cholesterol and improved quality-of-life scores were observed only in the CALM-BP group.

View Article: PubMed Central - PubMed

Affiliation: Shiram Integrated Medicine Unit, Assaf Harofeh Medical Center, Zerifin, Israel.

ABSTRACT
Complementary medicine advocates the use of a multifactorial approach to address the varied aspects of hypertension. The aim of this study was to compare the blood pressure (BP) effect and medication use of a novel Comprehensive Approach to Lowering Measured Blood Pressure (CALM-BP), based on complementary medicine principles, with the standard recommended Dietary Approach to Stop Hypertension (DASH). A total of 113 patients treated with antihypertensive drugs were randomly assigned to either CALM-BP treatment (consisting of rice diet, walks, yoga, relaxation and stress management) or to a DASH+exercise control group (consisting of DASH and walks). Ambulatory 24-h and home BP were monitored over a 16-week programme, followed by 6 months of maintenance period. Medications were reduced if systolic BP dropped below 110 mm Hg accompanied by symptoms. In addition to BP reduction, medications were reduced because of symptomatic hypotension in 70.7% of the CALM-BP group compared with 32.7% in the DASH group, P<0.0001. After 6 months, medication status was not altered in the majority of individuals. Significant reductions in body mass index, cholesterol and improved quality-of-life scores were observed only in the CALM-BP group. Lifestyle and diet modifications based on complementary medicine principles are highly effective with respect to BP control, medication use and cardiovascular risk factors.

Show MeSH
Related in: MedlinePlus