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This shows that monitoring of lifestyle changes can effectively be implemented in conjunction with other drug therapies to provide the most effective results for patients in need. Additionally, another 2010 (Navidian et al.) study showed that although lifestyle monitoring may not have been much different in terms of systolic blood pressure, there were statistical differences in terms of diastolic blood pressure. In this study, 61 patients with systolic hypertension were split into two groups, where the control group was exposed to a rigid intervention strategy that promoted education and facilitated motivational interviewing. Navidian et al. (2010) shows that such monitored strategy situations can still impact blood pressure in a positive manner.
Conclusion
There are still mixed signals being sent by the literature here. On one hand, lifestyle modification strategies involving supervision seem to be more productive in helping patients adhere to their commitment. Yet, some research shows that this still does not have a significant impact on systolic blood pressure, but other studies show that diastolic levels were impacted. With these conflicting results, it is clear more trials are needed, especially within the more specific category of adults with pre-hypertension. Still, there are several recommendations for changing practice that can still be made based on the literature as it stands. There needs to be increased use of monitored intervention strategies in conjunction with drug treatments. The possibility of success is worth the effort, especially with so little to loose. Additionally, there needs to be more trials with different combinations of treatment combinations to provide more effective multi-faceted approaches to treatment strategies for lowering blood pressure levels.
References
Aizawa, K.; Shoemaker, J.K.; Overend, T.J.; & Petrella, R.J. (2009). Effects of lifestyle modification on central artery stiffness in metabolic syndrome subjects with pre-hypertension and/or pre-diabetes. Diabetes Research and Clinical Practice, 83(2), 249-256.
Balady, G.J.; Williams, M.A.; Ades, P.A.; Bittner, V.; Comoss, P.; Foody, J.M.; Franklin, B.; Sanderson, B.; & Southard, D. (2007). Core components of cardiac rehabilitation / secondary prevention programs: 2007 update. Circulation AHA, 115(2007), 2675-2682.
Bonds, D.E.; Hogan, P.; Bertoni, A.G.; Chen, H.; Clinch, R.; Hiott, A.E.; Rosenberger, E.L.; & Goff, D, C. (2010). A multifaceted intervention to improve blood pressure control:...
American Heart Journal, 157(2), 278-284.
Blumenthal, J.A.; Babyak, M.A.; Hinderliter, A.; Watkins, L.L.; Craighead, L.; Lin, P.; Caccia, C.; Johnson, J.; Waugh, R., & Sherwood, A. (2010). Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure. Archives of Internal Medicine, 170(2), 126-135.
Cohen, D.L.; Bloedon, L.T.; Rothman, R.L.; Farrar, J.T.; Galantino, M.L.; Volger, S.; Mayor, Christine; Szapary, P.O.; & Townsend, R.R. (2011). Iyengar yoga vs. enhanced usual care on blood pressure in patients with prehypertension to stage I hypertension: A randomized controlled trial. Evidence-Based Complementary Alternative Medicine. Article ID 546428. Web. http://downloads.hindawi.com/journals/ecam/2011/546428.pdf
Dusek, J.A.; Hibberd, P.L.; Buczynski, B.; Chang, B.; Dusek, K.; Johnston, J.M.; Wohlhueter, A.L.; Benson, H.; & Zuxman, R.A. (2008). Stress management vs. lifestyle modification on systolic hypertension and medication elimination: A randomized trial. The Journal of Alternative and Complementary Medicine, 14(2), 129-138.
Vavidian, A.; Abedi, M.R.; Baghban, I.; Fateizadeh, M.; & Poursharifi, H. (2010). Effect of motivational interview of blood pressure of hypertensive patients. Kowsar Medical Journal, 15(2), 115-121.
Smith, S.R.; Aronne, L.J.; Burns, C.M., Kesty, N.C.; Halseth, A.E.; Weyer, C. (2008). Diabetes Care, 31(9), 1816-1823.
Tuomilehto, H.P.L.; Seppa, J.M.; Partinen, M.M.; Peltonen, M.; Gylling, H.; Tuomilehto, J.O.I.; Vanninen, E.J.; Kokkarinen, J.; Sahlma, J.K.; Martikainen, T.; Soini, E.J.; Randell, J.; Tukianen, H.; & Uusitupa, M. (2009). Lifestyle intervention with weight reduction. American Journal of Respiratory and Critical Care Medicine, 179(2009), 320-327.
Weber, M.A.; Black, H.; Bakris, G.; Krum, H.; Linas, S.; Weiss, R.; Linseman, J.V.; Warren, M.; & Lindholm, L.H. (2009). A selective endothelin-receptor antagonist to reduce nlood pressure in patients with treatment-resistant hypertension: A randomized, double-blind, placebo controlled trial. The Lancet, 374(9699), 1423-1431.
Wexler, R.; Elton, T.; Taylor, C.A.; Pleister, A.; & Feldman, D. (2009). Physician reported perception in the treatment of high blood pressure does not correspond to practice. BMC Family Practice, 10(23). Web. http://www.biomedcentral.com/content/pdf/1471-2296-10-23.pdf
References
Aizawa, K.; Shoemaker, J.K.; Overend, T.J.; & Petrella, R.J. (2009). Effects of lifestyle modification on central artery stiffness in metabolic syndrome subjects with pre-hypertension and/or pre-diabetes. Diabetes Research and Clinical Practice, 83(2), 249-256.
Balady, G.J.; Williams, M.A.; Ades, P.A.; Bittner, V.; Comoss, P.; Foody, J.M.; Franklin, B.; Sanderson, B.; & Southard, D. (2007). Core components of cardiac rehabilitation / secondary prevention programs: 2007 update. Circulation AHA, 115(2007), 2675-2682.
Bonds, D.E.; Hogan, P.; Bertoni, A.G.; Chen, H.; Clinch, R.; Hiott, A.E.; Rosenberger, E.L.; & Goff, D, C. (2010). A multifaceted intervention to improve blood pressure control: The Guideline Adherence for Heart Health (GLAD). American Heart Journal, 157(2), 278-284.
Blumenthal, J.A.; Babyak, M.A.; Hinderliter, A.; Watkins, L.L.; Craighead, L.; Lin, P.; Caccia, C.; Johnson, J.; Waugh, R., & Sherwood, A. (2010). Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure. Archives of Internal Medicine, 170(2), 126-135.
Cohen, D.L.; Bloedon, L.T.; Rothman, R.L.; Farrar, J.T.; Galantino, M.L.; Volger, S.; Mayor, Christine; Szapary, P.O.; & Townsend, R.R. (2011). Iyengar yoga vs. enhanced usual care on blood pressure in patients with prehypertension to stage I hypertension: A randomized controlled trial. Evidence-Based Complementary Alternative Medicine. Article ID 546428. Web. http://downloads.hindawi.com/journals/ecam/2011/546428.pdf
Wexler, R.; Elton, T.; Taylor, C.A.; Pleister, A.; & Feldman, D. (2009). Physician reported perception in the treatment of high blood pressure does not correspond to practice. BMC Family Practice, 10(23). Web. http://www.biomedcentral.com/content/pdf/1471-2296-10-23.pdf
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