Subgroup analyses showed smaller sample s reporting larger effect sizes ; intervention lasting less than 6 months showed larger effect sizes and intention-to-treat analysis showed smaller effect sizes Lifestyle interventions may be of value in preventing and reducing blood pressure in LMICs .
Despite the overwhelming evidence supporting the effectiveness of antihypertensive medication , hypertension remains poorly controlled in low and middle-income countries ( LMICs ) .
Reduction of global cardiovascular risk with nutritional versus nutritional plus physical activity intervention in Colombian adults
Background Cardiovascular disease is a major cause of morbidity/mortality in non-developed countries . Reports of the effects of non-pharmacological interventions on global cardiovascular risk in Latin American adults , however , are scarce . Objective To compare the change in global cardiovascular risk induced by a tailored , Adult Treatment Panel-III compliant nutrition program versus the same program with addition of supervised , regular physical activity in Colombian adults . Design The study was a r and omized , controlled trial . Methods Seventy-five Colombian patients aged 40–70 years and with Framingham-estimated global cardiovascular risk of 1 % or higher were r and omly assigned to a nutritional intervention program or a combined nutritional intervention-physical exercise program for 16 weeks . Patients underwent medical and anthropometric evaluation , bioelectrical impedance , lipid profile and Framingham global cardiovascular risk determination at baseline and at the end of follow-up . Results The groups were comparable at baseline ; 21 persons in the nutritional intervention program group and 27 in the nutritional intervention-physical exercise program group completed the follow-up . Global cardiovascular risk modification ( mean ± SE ) was −2.04 ± 1.1 absolute percentage points ( relative reduction 19.6 % ) in the nutritional intervention-physical exercise program group , compared with 0.23 ± 0.9 ( relative increase 2.8 % ) in the nutritional intervention program group . Mean difference in global cardiovascular risk modification between groups reached borderline statistical significance in ANCOVA ( P = 0.054 ) . Reductions in systolic and diastolic blood pressure , waist circumference and low-density lipoprotein cholesterol were similar , but the nutritional intervention-physical exercise program group achieved significantly greater improvements in body weight , body mass index , percentage body fat and high-density lipoprotein cholesterol . Conclusions Our data suggest that a structured nutritional intervention-physical exercise program is more efficacious than a nutritional intervention program in the reduction of global cardiovascular risk and cardiovascular risk factors , in only 16 weeks
Subgroup analyses showed smaller sample s reporting larger effect sizes ; intervention lasting less than 6 months showed larger effect sizes and intention-to-treat analysis showed smaller effect sizes Lifestyle interventions may be of value in preventing and reducing blood pressure in LMICs .
Despite the overwhelming evidence supporting the effectiveness of antihypertensive medication , hypertension remains poorly controlled in low and middle-income countries ( LMICs ) .