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Randomized Controlled Trial
. 2013 Oct;27(10):594-600.
doi: 10.1038/jhh.2013.29. Epub 2013 Apr 18.

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

A Ziv  1 , O Vogel, D Keret, S Pintov, E Bodenstein, K Wolkomir, K Doenyas, Y Mirovski, S Efrati
Affiliations
Randomized Controlled Trial

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

A Ziv et al. J Hum Hypertens. 2013 Oct.

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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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Screening, randomization and follow-up. 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.
Figure 2
Figure 2
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.
See this image and copyright information in PMC

References

    1. Miller ER, Erlinger TP, Young DR, Jehn M, Charleston J, Rhodes D. Results of the Diet, Exercise, and Weight Loss Intervention Trial (DEW-IT) Hypertension. 2002;40:612–618. doi: 10.1161/01.HYP.0000037217.96002.8E. - DOI - PubMed
    1. Appel LJ, Champagne CM, Harsha DW, Cooper LS, Obarzanek E, Elmer PJ, Writing Group of the PREMIER Collaborative Research Group Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA. 2003;289:2083–2093. - PubMed
    1. Burke V, Beilin LJ, Cutt HE, Mansour J, Wilson A, Mori TA. Effects of a lifestyle programme on ambulatory blood pressure and drug dosage in treated hypertensive patients: a randomized controlled trial. J Hypertens. 2005;23:1241–1249. doi: 10.1097/01.hjh.0000170388.61579.4f. - DOI - PubMed
    1. Whelton PK, Appel LJ, Espeland MA, Applegate WB, Ettinger WH, Jr, Kostis JB. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. JAMA. 1998;279:839–846. doi: 10.1001/jama.279.11.839. - DOI - PubMed
    1. Appel LJ, American Society of Hypertension Writing Group ASH position paper: dietary approaches to lower blood pressure. J Am Soc Hypertens. 2010;4:79–89. doi: 10.1016/j.jash.2010.03.004. - DOI - PubMed

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