Physical Activity Counseling for Adults with Hypertension: A Randomized Controlled Pilot Trial

Abstract

The effect of physical activity counseling (PAC) in hypertensive adults is unclear. This study investigated the effect of PAC on blood pressure (BP), physical activity level, sitting time, metabolic profile, and body composition in hypertensive adults. Twenty-two hypertensive adults (48.8 ± 7.3 years) participated in this pilot trial. The 12-week PAC was based on the 5 A's model considering the FITT principle (Frequency, Intensity, Time, and Type) of physical activity. The control group received instructions about FITT in one face-to-face meeting at baseline. Pedometer-measured physical activity, sitting time, resting and ambulatory BP, metabolic profile (cholesterol, triglycerides, fasting glucose), and body composition (fat mass, abdominal fat, fat free mass) were assessed. The PAC group showed higher steps per day (5839 ± 992 vs. 5028 ± 902; p = 0.044) and a trend for lower sitting time (5.6 ± 1.3 vs. 8.0 ± 4.0 h/day; p = 0.059) than the control group. No changes were observed in BP, metabolic profile, and body composition (p > 0.05). In conclusion, 12 weeks of a PAC program based on the 5 A's model resulted in a modest increase of ~800 steps per day and a trend to decrease ~2 h/day in sitting time, but there were no associated reduction in BP and improvements in metabolic and body composition.

Keywords: cardiovascular health; exercise; health behavior; pedometry; sitting/standing.

Figure 1

Flow diagram of the study.

Figure 2

Heart rate (black square; left Y axis) and rating of perceived exertion (white square; right Y axis) responses during the 12-week physical activity counseling program. Dotted lines represent moderate intensity according to American College of Sports Medicine [33]: 64–76% of maximum heart rate (HR) and rating of perceived exertion (RPE) [12,13]. HR data of the participants under beta-blocker (n = 7) were not included due to its effect on HR. Data are expressed as mean ± standard deviation.

Figure 3

Pedometer-measured physical activity level of the participants from the physical activity (PA) counseling program group and control group at baseline and after 12 weeks. Data are expressed as estimated marginal means and 95% confidence interval. * Difference from the control group (p = 0.044) through the generalized linear model with linear distribution model adjusted by baseline value.

Figure 4

Sitting time of the participants from the physical activity (PA) counseling program group and control group at baseline and after 12 weeks. Data are expressed as estimated marginal means and 95% confidence interval. # Difference from the control group (p = 0.059) through the generalized linear model with gamma distribution model adjusted by baseline value.