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 ) .
A food-based dietary strategy lowers blood pressure in a low socio-economic setting: a randomised study in South Africa.
OBJECTIVE To assess the impact of a food-based intervention on blood pressure ( BP ) in free-living South African men and women aged 50 - 75 years , with drug-treated mild-to-moderate hypertension . METHODS A double-blind controlled trial was undertaken in eighty drug-treated mild-to-moderate hypertensive subjects r and omised to an intervention ( n 40 ) or control ( n 40 ) arm . The intervention was 8-week provision of six food items with a modified cation content ( salt replacement ( SOLO ) , bread , margarine , stock cubes , soup mix and a flavour enhancer ) and 500 ml of maas ( fermented milk)/d . The control diet provided the same quantities of the targeted foods but of st and ard commercial composition and 500 ml/d of artificially sweetened cooldrink . FINDINGS The intervention effect estimated as the contrast of the within-diet group changes in BP from baseline to post-intervention was a significant reduction of 6.2 mmHg ( 95 % CI 0.9 , 11.4 ) for systolic BP . The largest intervention effect in 24 h BP was for wake systolic BP with a reduction of 5.1 mmHg ( 95 % CI 0.4 , 9.9 ) . For wake diastolic BP the reduction was 2.7 mmHg ( 95 % CI -0.2 , 5.6 ) . CONCLUSIONS Modification of the cation content of a limited number of commonly consumed foods lowers BP by a clinical ly significant magnitude in treated South African hypertensive patients of low socio-economic status . The magnitude of BP reduction provides motivation for a public health strategy that could be adopted through lobbying of the food industry by consumer and health agencies
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 ) .