A Senior Center-Based Pilot Trial of the Effect of Lifestyle Intervention on Blood Pressure in Minority Elderly People with Hypertension

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 56; no. 10; pp. 1860 - 1866
• Main Authors: Fernandez, Senaida, Scales, Kasandra L., Pineiro, Johanna M., Schoenthaler, Antoinette M., Ogedegbe, Gbenga
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-10-2008; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: African Americans; Aged; Aged, 80 and over; Arterial hypertension. Arterial hypotension; Behavior modification; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Female; General aspects; Health Behavior; health disparities; Hispanic Americans; Humans; Hypertension; Hypertension - ethnology; Hypertension - prevention & control; Hypertension - therapy; intervention; lifestyle; Male; Medical sciences; Medication Adherence; Middle Aged; Minority & ethnic groups; Minority Groups; Miscellaneous; New York City; older adults; Older people; Patient Education as Topic; Pilot Projects; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Reduction Behavior; Senior citizen centers; New York City; Human; Hypertension; Center; Social Inequality; Cardiovascular disease; lifestyle; Gerontology; health disparities; Minority; older adults; Clinical trial; Arterial pressure; Blood pressure; Hemodynamics; intervention; Elderly; Public health; Geriatrics; Life style
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2008.01863.x

OBJECTIVES: To test the feasibility, acceptability, and effect of a senior center–based behavioral counseling lifestyle intervention on systolic blood pressure (BP).
DESIGN: A pre‐post design pilot trial of behavioral counseling for therapeutic lifestyle changes in minority elderly people with hypertension. Participants completed baseline visit, Visit 1 (approximately 6 weeks postbaseline), and a final study Visit 2 (approximately 14 weeks postbaseline) within 4 months.
SETTING: The study took place in six community‐based senior centers in New York City with 65 seniors (mean age 72.29±6.92; 53.8% female; 84.6% African American).
PARTICIPANTS: Sixty‐five minority elderly people.
INTERVENTION: Six weekly and two monthly “booster” group sessions on lifestyle changes to improve BP (e.g., diet, exercise, adherence to prescribed antihypertensive medications).
MEASUREMENTS: Primary outcome was systolic BP (SBP) measured using an automated BP monitor. Secondary outcomes were diastolic BP (DBP), physical activity, diet, and adherence to prescribed antihypertensive medications.
RESULTS: There was a significant reduction in average SBP of 13.0±21.1 mmHg for the intervention group (t(25)=3.14, P=.004) and a nonsignificant reduction in mean SBP of 10.6±30.0 mmHg for the waitlist control group (t(29)=1.95, P=.06). For the intervention group, adherence improved 26% (t(23)=2.31, P=.03), and vegetable intake improved 23% (t(25)=2.29, P=.03).
CONCLUSION: This senior center–based lifestyle intervention was associated with a significant reduction in SBP and adherence to prescribed antihypertensive medications and diet in the intervention group. Participant retention and group attendance rates suggest that implementing a group‐counseling intervention in senior centers is feasible.