E-mail instead of a tablet

Emails Helped Lower blood pressure

Anna Stavina, XX2 century, based on the materials of the American College of Cardiology: Lifestyle Intervention Leads to 10-point Drop in Systolic Blood Pressure

In the first randomized double-blind study, it was possible to confirm the effectiveness of online behavior correction aimed at lowering blood pressure (BP). Web consultations led to a decrease in the systolic ("upper") blood pressure of the experimental group participants by 10 mmHg. In the control group, the same indicator was only 6 mmHg. The results of the study were presented at the 66th annual scientific conference of the American College of Cardiology (American College of Cardiology).

"E-counseling proved to be comparable in effectiveness to the addition of another antihypertensive drug," says study leader Robert Nolan, associate professor at the University of Toronto. "We believe that lifestyle correction consultations can complement drug therapy aimed at lowering blood pressure and increase its effectiveness."

264 volunteers, 58% women and 42% men, were included in the work. The average age of participants is 57.5 years. The average blood pressure at the start of the study was 140/90 mmHg (arterial hypertension of the first degree). 39 participants (15%) had grade II arterial hypertension – their blood pressure was at least 160/100 mm Hg. 83% of participants took at least one hypotensive drug. During the study, members of both groups were regularly seen by a doctor.

Arterial hypertension (hypertension, hypertension, hypertension; etc.-Greek. ὑπέρ – "above, above" + others.-Greek. τόνος – "tension; tone") – persistent increase in blood pressure from 140/90 mm Hg and above.

Arterial hypertension is one of the most common diseases of the cardiovascular system. It has been established that 20-30% of the adult population suffer from arterial hypertension. With age, the prevalence of the disease increases and reaches 50-65% in people over 65 years of age.

More than 20 combinations in the human genetic code contribute to the occurrence of hypertension.

After recruitment, the volunteers were randomly assigned to two groups – experimental (e-counseling groups) and control. Participants in both groups received one e-mail per week for the first four months of the study, one e-mail every two weeks for the next four months, and one e-mail per month for the last four months of work. The letters that were sent to the participants of the e-counseling group contained links to multimedia materials and interactive tools to increase motivation and master the skills necessary for the transition to a healthy lifestyle and its maintenance. In particular, the participants of the experimental group had access to videos, the characters of which talked about their diagnosis of "arterial hypertension" and what they were doing to make their lifestyle healthier. Also, the volunteers from this group were sent links to programs that help control nutrition and physical activity. The participants of the second, control group received letters with general information about a healthy lifestyle and a decrease in blood pressure.

"In e-counseling, we tried to reproduce the experience that people get who attend personal lifestyle change consultations during the year," says Nolan. – We used the information accumulated over 60 years of studying effective approaches to motivational counseling and cognitive behavioral therapy. And then we applied this knowledge using available technologies."

The primary endpoints of the study were changes in systolic and diastolic blood pressure and pulse amplitude, which is the difference between systolic and diastolic blood pressure. Also, scientists attributed to the primary points a decrease in cholesterol minus "good" or high-density lipoproteins and a change in the number of points on the Framingham risk scale, which helps to assess the likelihood of a stroke or heart attack in the next 10 years. The secondary endpoints of the study were changes in physical activity and consumption of fruits and vegetables, as well as smoking cessation.

After completion of the twelve-month program, in the e–counseling group, systolic pressure decreased by an average of 10 mmHg, and in the control group - only by 6 mmHg. The change in pulse amplitude was 4 mmHg. and 1.5 mmHg., respectively. In both cases, the difference was statistically significant. These results were similar for all participants and did not depend on the initial severity of hypertension.

The number of steps taken per day – it was measured using a pedometer for 4 days – in the group that underwent e-counseling turned out to be significantly higher – by about 1200 steps per day compared to participants from the control group. There were no significant changes in the diet, as volunteers from both groups reported at the time of entering the study that they ate the recommended 8 servings of vegetables and fruits daily. However, as Nolan noted: "By describing their diet, participants can idealize it. And this factor could have an impact on the results of our work."

Since only 9% of the volunteers smoked at the start of the study, the authors of the work failed to obtain statistically significant data on smoking cessation.

Upon leaving work, the participants took part in an interview. Volunteers from the e-counseling group noted that they became attached to the characters they saw in the videos. And it helped to develop motivation and achieve goals.

"We believe that a dynamic approach to patient engagement [in activity] can be a powerful tool to help change behavior," adds Nolan.

Portal "Eternal youth" http://vechnayamolodost.ru  21.03.2017