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WebBased Counseling Helps Lower Blood Pressure

CardioSmart News

Web-based counseling is linked to significantly lower blood pressure in patients with hypertension, according to a recent study.

Presented at the American College of Cardiology’s 66th Annual Scientific Session, this was the first randomized trial to assess the impact of an online intervention on high blood pressure.

High blood pressure affects an estimated 75 million U.S. adults and is a major risk factor for heart disease and stroke. However, only half of adults with high blood pressure have their condition under control, highlighting the need for better education and treatment.

In the recent trial, researchers randomly assigned 264 middle-aged adults with high blood pressure to web-based counseling or standard education. The intervention lasted one year, during which time participants received periodic emails about a healthy lifestyle. The web-based counseling featured online multimedia and interactive tools, such as videos of patients discussing their own blood pressure diagnosis and treatment. Emails to the control group included only generic information about high blood pressure and heart-healthy living.

“In the e-Counseling intervention we tried to replicate the experience of going through face-to-face lifestyle counseling for a year,” said Robert P. Nolan, PhD, a senior scientist at the Peter Munk Cardiac Centre, University Health Network, associate professor at the University of Toronto and lead author of the study. “We made use of what we know from 60 years of research on the effective features of motivational interviewing and cognitive behavioral therapy, and we applied those features using the technology that was available to our team.”

By the end of the study, researchers found that patients receiving web-based counseling had a 10 mmHg reduction in systolic blood pressure (top number in a blood pressure reading), compared to a 6 mmHg reduction in the control group. This difference was considered statistically significant. Researchers also noted that participants receiving web-based counseling also increased their physical activity during the study period, while physical activity decreased among controls.

Based on findings, web-based counseling has the potential to help millions of Americans struggling with blood pressure control. “The electronic counseling intervention had an effect similar to that of adding an additional blood pressure-lowering medication,” explains Nolan. “We think this lifestyle counseling intervention can complement and optimize the effectiveness of medical therapy to reduce high blood pressure.”

However, authors also note that their recent study has limitations. Participants were mostly well-educated individuals, nearly three-quarters of which were white. Participants were also highly motivated, as they were initially identified during a visit to the Heart and Stroke Association of Canada website for health information. As a result, authors explain that additional research is needed to confirm findings in a larger, more diverse population.

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