Moderators and mediators of behaviour change in a lifestyle program for treated hypertensives: a randomized controlled trial (ADAPT).

We aimed to examine moderators and mediators of behaviour change in a cognitive lifestyle program for drug-treated overweight hypertensives in Perth, Australia. We collected data at baseline, 4 months (post-intervention) and 1-year follow-up in a randomized controlled trial of a program that focused on weight loss, diet, and exercise. Mediation analysis used regression models that estimate indirect effects with bootstrapped confidence limits.

Changes in cognitive measures associated with a lifestyle program for treated hypertensives: a randomized controlled trial (ADAPT).

Cognitive changes are reported infrequently in programs targeting cardiovascular risk. We examined self-efficacy, behavioral barriers and health beliefs in a lifestyle program for drug-treated hypertensives that aimed to reduce blood pressure, antihypertensive drug needs and cardiovascular risk. In a randomized controlled trial, we compared usual care (controls) and a 4-month program focusing on weight loss, diet and exercise.

Long-term follow-up of participants in a health promotion program for treated hypertensives (ADAPT).

Background And Aims: Improvements in a lifestyle modification program for hypertensives were maintained 1 year later. Longer follow-up in such studies is limited; we therefore re-assessed participants after an additional 2 years in which there was no contact with program facilitators.

Methods And Results: Participants randomised to usual care (N=118) or a 4-month lifestyle program (N=123) were previously assessed after 4 months and 1 year.

A lifestyle program for treated hypertensives improved health-related behaviors and cardiovascular risk factors, a randomized controlled trial.

Objective: To assess effects of a cognitively based program on health-related behaviors and cardiovascular risk factors in overweight drug-treated hypertensives.

Study Design And Setting: In a clinical trials center, volunteers, recruited by advertisement, were randomized to usual care (N=118) or to a 4-month program (N=123) incorporating weight loss; a low-sodium diet, high in fruit, vegetables, and fish; and increased physical activity. Diet, physical activity, weight, blood lipids, glucose, and insulin were measured at 4 and 16 months.

Effects of a lifestyle programme on ambulatory blood pressure and drug dosage in treated hypertensive patients: a randomized controlled trial.

Objective: To assess effects of multifactorial lifestyle modification on antihypertensive drug needs in treated hypertensive individuals.

Design: Randomized controlled trial.

Setting: Research studies unit.

The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial.

Background: There is growing evidence that oxidative stress contributes to the pathogenesis of hypertension and endothelial dysfunction. Thus, dietary antioxidants may beneficially influence blood pressure (BP) and endothelial function by reducing oxidative stress.

Objective: To determine if vitamin C and polyphenols, alone or in combination, can lower BP, improve endothelial function and reduce oxidative stress in hypertensive individuals.

Hypertension research in the 21st century: where is the gold?

This paper presents a signpost for hypertension research, emphasizing areas most likely to yield major clinical and public health benefits. Specific questions are posed in the context of fetal and maternal precursors of cardiovascular disease, vascular biology, resistant hypertension, antihypertensive drugs, primary aldosteronism, lifestyle and genetic interactions and translational research. Worldwide increasing rates of obesity and diabetes demonstrate the need for a global approach to cardiovascular risk and the need for more effective use of existing knowledge.

Associations between blood pressure and overweight defined by new standards for body mass index in childhood.

Background: Using data from a longitudinal study of young Australians, we applied recent international standards for overweight and obesity to examine associations with blood pressure (BP) and to determine the prevalence and degree of tracking of overweight and obesity. We also aimed to examine socioeconomic status in relation to these variables.

Methods: BP, height, and weight were measured at 3-year intervals from age 9 to 18, and then at 25 years of age in a Western Australian cohort.

Measurement and application of arterial stiffness in clinical research: focus on new methodologies and diabetes mellitus.

The excess risk of cardiovascular disease in patients with Type 2 diabetes mellitus remains largely unexplained. Arterial stiffness, an early feature of diabetic vasculopathy involving several mechanisms, results in impaired arterial compliance, and has recently been proposed as a powerful independent predictor of cardiovascular disease. Increased arterial stiffness can contribute to the development and progression of hypertension, left ventricular hypertrophy and dysfunction, and to decreased myocardial perfusion, all of which are highly prevalent in Type 2 diabetes mellitus.