Robust statistically significant effects were found for improved diet , aerobic exercise , alcohol and sodium restriction , and fish oil supplements : mean reductions in systolic blood pressure of 5.0 mmHg [ 95 % confidence interval ( CI ) : 3.1 - 7.0 ] , 4.6 mmHg ( 95 % CI : 2.0 - 7.1 ) , 3.8 mmHg ( 95 % CI : 1.4 - 6.1 ) , 3.6 mmHg ( 95 % CI : 2.5 - 4.6 ) and 2.3 mmHg ( 95 % CI : 0.2 - 4.3 ) , respectively , with corresponding reductions in diastolic blood pressure .
Relaxation significantly reduced blood pressure only when compared with non-intervention controls .
We found no robust evidence of any important effect on blood pressure of potassium , magnesium or calcium supplements .
Available evidence does not support relaxation therapies , calcium , magnesium or potassium supplements to reduce blood pressure
PURPOSE To quantify effectiveness of lifestyle interventions for hypertension .
A randomized trial of improved weight loss with a prepared meal plan in overweight and obese patients: impact on cardiovascular risk reduction.
OBJECTIVE To assess the long-term effects of a prepackaged , nutritionally complete , prepared meal plan compared with a usual-care diet ( UCD ) on weight loss and cardiovascular risk factors  in overweight and obese persons . DESIGN In this r and omized multicenter study , 302 persons with hypertension and dyslipidemia ( n = 183 ) or with type 2 diabetes mellitus ( n = 119 ) were r and omized to the nutrient-fortified prepared meal plan ( approximately 22 % energy from fat , 58 % from carbohydrate , and 20 % from protein ) or to a macronutrient-equivalent UCD . MAIN OUTCOME MEASURES The primary outcome measure was weight change . Secondary measures were changes in blood pressure or plasma lipid , lipoprotein , glucose , or glycosylated hemoglobin levels ; quality of life ; nutrient intake ; and dietary compliance . RESULTS After 1 year , weight change in the hypertension/dyslipidemia group was -5.8+/-6.8 kg with the prepared meal plan vs -1.7+/-6.5 kg with the UCD plan ( P<.001 ) ; for the type 2 diabetes mellitus group , the change was -3.0+/-5.4 kg with the prepared meal plan vs -1.0+/-3.8 kg with the UCD plan ( P<.001 ) ( data given as mean + /- SD ) . In both groups , both interventions improved blood pressure , total and low-density lipoprotein cholesterol levels , glycosylated hemoglobin level , and quality of life ( P<.02 ) ; in the diabetic group , the glucose level was reduced ( P<.001 ) . Compared with those in the UCD group , participants with hypertension/dyslipidemia in the prepared meal plan group showed greater improvements in total ( P<.01 ) and high-density lipoprotein ( P<.03 ) cholesterol levels , systolic blood pressure ( P<.03 ) , and glucose level ( P<.03 ) ; in participants with type 2 diabetes mellitus , there were greater improvements in glucose ( P = .046 ) and glycosylated hemoglobin ( P<.02 ) levels . The prepared meal plan group also showed greater improvements in quality of life ( P<.05 ) and compliance ( P<.001 ) than the UCD group . CONCLUSIONS Long-term dietary interventions induced significant weight loss and improved cardiovascular risk in high-risk patients . The prepared meal plan simultaneously provided the simplicity and nutrient composition necessary to maintain long-term compliance and to reduce cardiovascular  risk
Robust statistically significant effects were found for improved diet , aerobic exercise , alcohol and sodium restriction , and fish oil supplements : mean reductions in systolic blood pressure of 5.0 mmHg [ 95 % confidence interval ( CI ) : 3.1 - 7.0 ] , 4.6 mmHg ( 95 % CI : 2.0 - 7.1 ) , 3.8 mmHg ( 95 % CI : 1.4 - 6.1 ) , 3.6 mmHg ( 95 % CI : 2.5 - 4.6 ) and 2.3 mmHg ( 95 % CI : 0.2 - 4.3 ) , respectively , with corresponding reductions in diastolic blood pressure .
Relaxation significantly reduced blood pressure only when compared with non-intervention controls .
We found no robust evidence of any important effect on blood pressure of potassium , magnesium or calcium supplements .
Available evidence does not support relaxation therapies , calcium , magnesium or potassium supplements to reduce blood pressure
PURPOSE To quantify effectiveness of lifestyle interventions for hypertension .