Compliance to Multidisciplinary Lifestyle Intervention Decreases Blood Pressure in Patients with Resistant Hypertension : A Cross-Sectional Pilot Study
Espinel Garuz, Eugenia (Hospital Universitari Vall d'Hebron)
Azancot, María A (Hospital Universitari Vall d'Hebron)
Gomez-Garrido, Alba (Hospital Universitari Vall d'Hebron)
Beneria, Anna (Hospital Universitari Vall d'Hebron)
Caraben, Anna (Hospital Universitari Vall d'Hebron)
Andurell, Laura (Hospital Universitari Vall d'Hebron)
Delgado Martínez, María Pilar (Hospital Universitari Vall d'Hebron)
Castañé, Helena (Universitat Rovira i Virgili)
Joven, Jorge (Universitat Rovira i Virgili)
Seron, Daniel (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Hypertension is a common chronic medical condition. Treatment is not satisfactory in a significant proportion of patients with primary hypertension, despite the concurrent use of three or more medications with different mechanisms of action. Such treatment-resistant hypertension is a clinical challenge associated with poor prognosis and needs further investigation. The efficacy of lifestyle changes has not been established yet in patients with resistant hypertension, and educational efforts appear clinically irrelevant in patients who must achieve behavioral changes without supervision. A 6-month multidisciplinary pilot intervention enrolled 50 patients with established resistant hypertension. The aims were: (1) to examine whether intensive and supervised lifestyle changes contribute to decreasing blood pressure in this condition, and (2) to identify which components affect compliance and feasibility. The program provided intensive changes in nutrition, physical exercise, and control of sleep disturbances supervised by nutritionists, physiotherapists, and psychologists. Nurses and pharmacists followed up on adherence to the antihypertensive medication. The primary outcome was 24 h blood pressure control. Data in patients with full compliance (n = 30) indicate that lifestyle modifications in resistant hypertension significantly reduced 24 h both systolic and diastolic blood pressure (p < 0. 01), body mass index (p < 0. 01), medication burden (p = 0. 04), improving physical fitness, and cardiovascular risk markers such as heart rate (p = 0. 01) and augmentation index (p = 0. 02). The adherence to the intervention was moderate, with an attrition rate of 12%. A modified version reducing visits and explorations will likely improve compliance and can be used to assess the long-term maintenance of these benefits in managing resistant hypertension by diverse healthcare providers.
Ajuts:	Instituto de Salud Carlos III PI21/00510
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Hypertension ; Therapeutics ; Weight management
Publicat a:	Journal of clinical medicine, Vol. 12 (january 2023) , ISSN 2077-0383

DOI: 10.3390/jcm12020679
PMID: 36675608

13 p, 1.4 MB

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