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Publications [#270605] of James A. Blumenthal

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Journal Articles

  1. Hinderliter, AL; Sherwood, A; Craighead, LW; Lin, P-H; Watkins, L; Babyak, MA; Blumenthal, JA (2014). The long-term effects of lifestyle change on blood pressure: One-year follow-up of the ENCORE study.. Am J Hypertens, 27(5), 734-741. [doi]
    (last updated on 2019/07/23)

    BACKGROUND: There is a paucity of data describing the sustained benefits of lifestyle interventions on health behaviors and blood pressure (BP). METHODS: We examined the persistence of changes in health habits and BP in the ENCORE study, a trial in which 144 overweight individuals with above-normal BP were randomized to one of the following 16-week interventions: Dietary Approaches to Stop Hypertension (DASH) diet alone (DASH-A), DASH diet plus a behavioral weight management intervention (DASH-WM), or Usual Care. Follow-up assessments were conducted 8 months after the end of treatment. RESULTS: At 16 weeks, systolic BP was reduced by 16.1 (95% confidence interval (CI) = 13.0-19.2) mm Hg in the DASH-WM group, 11.2 (95% CI = 8.1-14.3) mm Hg in the DASH-A group, and 3.4 (95% CI = 0.4-6.4) mm Hg in the Usual Care group. A decrease in BP persisted for 8 months, with systolic BP lower than baseline by 11.7 (95% CI = 8.1-15.3) mm Hg in the DASH-WM group, 9.5 (95% CI = 6.7-12.1) mm Hg in the DASH-A group, and 3.9 (95% CI = 0.5-7.3) mm Hg in the Usual Care group (P < 0.001 for active treatments vs. Usual Care). DASH-WM subjects lost 8.7 kg during the intervention and remained 6.3 kg lighter on follow-up examination. Changes in diet content were sustained in both DASH intervention groups. Among those who participated in DASH-WM, however, caloric intake was no longer lower, and only 21% reported still exercising regularly 8 months after completing the intervention. CONCLUSIONS: Changes in dietary habits, weight, and BP persisted for 8 months after completion of the 16-week ENCORE program, with some attenuation of the benefits. Additional research is needed to identify effective methods to promote long-term maintenance of the benefits of lifestyle modification programs. CLINICAL TRIAL REGISTRATION: identifier: NCT00571844.

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