Obesity in adults. Effect of diet and physical exercise on weight, hypertension and biochemical profile

AJH–April 2002–VOL. 15, NO. 4, PART 2

P-422 CHANGES IN AMBULATORY MONITORED BLOOD PRESSURE AFTER SUPPRESSION OF ALCOHOL CONSUMPTION IN UNTREATED HYPERTENSIVE PATIENTS Jose E. Lopez, Carlos Calvo, Manuel Covelo, Diana E. Ayala, Ramon C. Hermida. Hypertension and Vascular Risk Unit, Hospital Clinico Universitario, Santiago, Spain; Bioengineering & Chronobiology Labs., University of Vigo, Vigo, Spain. Previous epidemiological studies have shown a positive correlation between blood pressure (BP) and alcohol consumption, independently of age, gender, ethnic origin, or obesity. Some prospective studies have also shown a pressor effect of alcohol both in normotensive as well as hypertensive subjects [Potter et al. Hypertension. 1986;8:625-631. Abe et al. Circulation. 1994;89:2626-2633]. The aim of this study was to evaluate the effects of suppression of alcohol consumption on the circadian pattern of BP determined by ambulatory monitoring (ABPM) in untreated hypertensive patients. We studied 40 patients (21 men; age 52.8⫾4.9 years) with mild essential hypertension. Alcohol intake was assessed by questionnaire and expressed in g/day. Moderate drinkers (⬍80 g/day) were excluded. After their initial clinical evaluation including 24-hour ABPM, patients followed hygienic-dietary recommendations, including suppression of alcohol intake. After 3 months, patients were evaluated again by ABPM and quantification of alcohol consumption. The circadian pattern of BP in each group (drinkers, n⫽13; exdrinkers, n⫽13; non-drinkers, n⫽14) was established by population multiple-component analysis [Fernandez & Hermida. Chronobiol Int. 1998;15:191-204]. Circadian parameters obtained for each group before and after intervention were compared by nonparametric paired testing. After 3 months of hygienic-dietary recommendations there was a statistically significant reduction for the non-drinkers in the 24-hour mean of systolic BP (5.0 mm Hg; P⫽0.002), as well as in the daily mean of systolic (3.2 mm Hg; P⬍0.001) and diastolic BP (2.3 mm Hg; P⫽0.042) for the ex-drinkers. This group was also characterized by a statistically significant reduction in standard deviation (P⫽0.027), as well as in circadian amplitude of BP (P⫽0.020), due to the reduction in the diurnal mean and the increase in the nocturnal mean of BP after alcohol suppression. There was no significant change in circadian parameters of BP in the group of drinkers who continued consuming alcohol above 80 g/day. Suppression of alcohol consumption in conjunction with other hygienic-dietary recommendations was effective in lowering BP and its variability in untreated hypertensive patients who regularly consumed alcohol (⬎80 g/day). SUPPORT: DGES, PM98-0106; PGICT00-PXI-32205PN; University of Vigo. Key Words: Ambulatory Blood Pressure Monitoring, Alcohol Consumption, Mild Hypertension

P-423 OBESITY IN ADULTS. EFFECT OF DIET AND PHYSICAL EXERCISE ON WEIGHT, HYPERTENSION AND BIOCHEMICAL PROFILE Rosa M. Santos, Joao P. Freitas, Mario E. Macedo, Elisabeth M. Castro, Rebelo Irene, Agostinho A. Monteiro, Maria J. Lima, Antonio F. Freitas. Centro Estudos Func¸ a˜ o Autono´ mica, Hospital Sao Joao, Porto, Portugal; Biochemistry, School of Pharmacy, Porto, Portugal. We evaluated the effect of a low caloric diet and regular aerobic exercise on blood pressure, lipid profile, waist-to-hip circumference (W/H) ratio and weight reduction. Thirty-five obese subjects aged 38⫾12 years BMI⬎27 Kg/m2, with a mean follow-up of 12⫾3 months were studied. Implementation of aerobic exercise (40 minutes, 3 times for week) was prescribed. Blood © 2002 by the American Journal of Hypertension, Ltd. Published by Elsevier Science Inc.

POSTERS: Non-Pharmacologic Therapy

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pressure (BP) and heart rate (HR) parameters were calculated noninvasively during 10 minutes by Finapres威 arterial wave. Biochemical analysis were done after 12 hours of fasting. Data were performed before and after prescription of a low caloric diet adjusted to age, gender, physical activity and professional lifestyle. No changes in drug prescription or salt intake were allowed. First evaluation vs last evaluation: weight (Kg) 81.3⫾13.7 vs 73.5⫾ 12.8 (p⬍0.05), W/H 0.833⫾ 0.1 vs 0.781⫾0.1 (p⬍0.05); % Body fat 39.6⫾8.5 vs 36.4⫾ 8.1; SBP (mmHg) 148.8⫾36.0 vs 123.8⫾27.7 (p⬍0.05); DBP(mmHg) 90.9⫾26.1 vs 76.4⫾16.7 (p⬍0.01); HR(bpm) 74.6⫾9.5 vs 68.7⫾9.5; Glucose(mg/L) 102.0⫾40.3 vs 87.1⫾8.9 (p⬍0.05); T.Cholesterol(mg/dl) 208.2⫾37.6 vs 193.0⫾ 47.3; C-HDL(mg/dl) 55.2⫾17.3 vs 58.3⫾18.6; C-LDL(mg/dl) 127.8⫾34.3 vs 123.0⫾32.2; Triglycerides(mg/L) 103.9⫾53.6 vs 93.0⫾32.2; Homocysteine(␮mol/L) 6.4⫾2.9 vs 5.2⫾1.1 (p⬍0.05); Lp(a)(mg/dl) 33.2⫾12.2 vs 28.6⫾10.8; Apo A-I(mg/dl) 70.2⫾20.1 vs 62.7⫾12.7; Apo B(mg/dl) 141.1⫾19.7 vs 113.6⫾19.7 (p⬍0.001). Weight reduction as a result of low caloric diet and regular physical exercise induced a significant improvement in blood pressure, plasma glucose, and lipid profile. Key Words: Biochemical Profile, Physical Exercise, Hypertension

P-424 FIRST STEPS: RECRUITMENT AND ENTRANCE OF PARTICIPANTS IN A NURSING INTERVENTION FOR HYPERTENSIVE AFRICAN AMERICAN WOMEN JoAnne Banks-Wallace. Nursing, University of Missouri-Columbia, Columbia, MO,United States. This study is concerned with the development and preliminary testing of a culturally consistent nursing intervention to promote walking among sedentary hypertensive African American women. The primary aim is to measure the effect of a culture-based intervention on problem solving, social support, general physical activity, and walking behavior. This 12-month group intervention uses culture-based storytelling, interactive learning, group physical activity, and paired walking. A pre/post single group design, with a 6 -month follow-up, will be used for this pilot study. Outcome data will be collected every 3 months for 18 months. African Americans comprise approximately 10% of the population where the study is being conducted. An African American woman who is a lifelong resident of the local community and highly respected African woman was hired as a recruitment and retention specialist for this study. Word of mouth and two community-based group orientation sessions were used to provide information about the study. To date, 38 women have expressed interest in participating in the study. Women were given the option of obtaining a screening physical exam from either their personal healthcare provider or an African American nurse practitioner associated with the study. Fifty percent of the women have chosen to see the nurse practitioner. The ease at getting an appointment and desire to be evaluated by an African American woman have been the reasons most often cited by women choosing to have their physicals completed by the nurse practitioner. Twenty-one women have met the criteria for inclusion, obtained health clearance to participate, and been entered into the study. African American study personnel and the use of culturally consistent recruitment techniques have been important factors in recruiting and entering participants for this study. Completion of the study will illuminate the significance of culture-based nursing interventions for the adoption of routine walking and lay the foundation for a clinical trial comparing the efficacy of a culture-based versus a usual care approach for increasing physical activity among African American women. Key Words: Physical Activity Interventions, Culture-Based Interventions, African American Women 0895-7061/02/$22.00