For patients with resistant hypertension, a 4-month structured program of diet and exercise results in significant reductions in clinic and ambulatory BP, according to a study published in Circulation. Researchers randomly assigned 140 patients with resistant hypertension to a 4-month program of lifestyle modification, including dietary counseling, behavioral weight management, and exercise (Center-Based Life style Intervention [C-LIFE]) or a single counseling session providing Standardized Education and Physician Advice (SEPA). Clinic systolic BP was measured as the primary endpoint. Compared with SEPA, the reduction in clinic systolic BP was greater in C-LIFE (−12.5 vs −7.1 mm Hg); there was also a reduction in 24- hour ambulatory systolic BP compared with no change in SEPA (−7.0 vs −0.3 mm Hg). C-LIFE resulted in greater improvements in resting baroreflex sensitivity (2.3 vs −1.1 ms/mm Hg), high-frequency heart rate variability (0.4 vs −0.2 Ln ms2), and flow-mediated dilation (0.3% vs −1.4%) compared with SEPA.

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