Hypertension Improvement Project (HIP) Latino: results of a pilot study of lifestyle intervention for lowering blood pressure in Latino adults

Abstract

Objectives. To assess the feasibility of a culturally tailored behavioral intervention for improving hypertension-related health behaviors in Hispanic/Latino adults.

Design. Feasibility pilot study in a community health center and a Latino organization in Durham, North Carolina.

Intervention. The culturally adapted behavioral intervention consisted of six weekly group sessions incorporating motivational interviewing techniques. Goals included weight loss if overweight, adoption of the Dietary Approaches to Stop Hypertension dietary pattern, and increased physical activity. Participants were also encouraged to monitor their daily intake of fruits, vegetables, dairy and fat, and to record physical activity. Cultural adaptations included conducting the study in familiar places, using Spanish-speaking interventionist, culturally appropriate food choices, and physical activity.

Main outcomes. Systolic blood pressure (BP), weight, body mass index (BMI), exercise, and dietary pattern were measured at baseline and at 6 weeks follow-up. Qualitative evaluations of the recruitment process and the intervention were also conducted.

Results. There were 64 potential participants identified via healthcare provider referrals (33%), printed media (23%), and direct contact (44%). Seventeen participants completed the intervention and had main outcome data available. Participants ‘strongly agreed/agreed’ that the group sessions provided them with the tools they needed to achieve weight loss, BP control, and the possibility of sustaining the lifestyle changes after completing the intervention. At the end of the intervention, all physiological, diet, and exercise outcomes were more favorable, with the exception of fat. After 6 weeks, systolic BP decreased an average of −10.4±10.6 mmHg, weight decreased 1.5±3.2 lbs, BMI decreased 0.3±0.5, and physical activity increased 40 minutes per week.

Conclusion. Our findings suggest that lifestyle interventions for preventing and treating hypertension are feasible and potentially effective in the Hispanic/Latino population.

Keywords:

• hypertension
• Hispanic
• Latino
• non-pharmacologic interventions
• blood pressure control
• weight loss
• DASH dietary pattern
• lifestyle intervention

Acknowledgements

Dr Corsino was supported by NIH training grant #T32 DK007012-30S1. Dr Thorpe was supported by a post-doctoral fellowship from the Office of Academic Affairs, VAMC. Funds for the study were provided in part by an American Heart Association Established Investigator Award to Dr Bosworth. Dr Svetkey was supported by NIH Grant #5 R01 HL075373. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. The authors thank Evelyn Schmidt, MD (Director, Lincoln Community Health Center, Durham, NC, USA), and the staff of El Centro Hispano (Durham, NC, USA) for their support and collaboration.