HTN: Medical Nutrition Therapy (2015)

HTN: Medical Nutrition Therapy (2015)

• Intervention
  In persons with hypertension, how effective is Medical Nutrition Therapy provided by a registered dietitian nutritionist compared to no or other interventions on blood pressure?

  • Conclusion
    Medical nutrition therapy (MNT) provided by a registered dietitian nutritionist (RDN) using individual or group sessions reduces blood pressure (BP) in persons with hypertension or pre-hypertension. Six studies reported reductions in systolic blood pressure (SBP) up to 10mmHg and in diastolic blood pressure (DBP) up to 6.0mmHg after one to three months of MNT provided at least every other week for at least three sessions. Four studies reported similar significant reductions in BP from six to twelve months when MNT was provided at least monthly or with follow-up provided after five or more sessions. Five studies report sustained reductions for up to four years with MNT provided at least two to three times per year.
  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In persons with hypertension, how effective is Medical Nutrition Therapy provided by a registered dietitian nutritionist compared to no or other interventions on blood pressure?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Ferrara AL, Pacioni D, Di  Fronzo V, Russo BF, Stalano L, Speranza E, Gente R, Gargiulo F, Ferrara F. Lifestyle educational program strongly increases compliance to nonpharmacologic intervention in hypertensive patients: A two-year follow-up study. J Clin Hypertens. 2012; 14(11): 767-772. 
      • Huggins CE, Margerison C, Worsley A, Nowson CA. Influence of dietary modifcations on the blood pressure response to antihypertensive medication. Br J Nutr. 2011;105:248-255.
      • Kumanyika SK, Cook NR, Cutler JA, Belden L, Brewer A, Cohen JD, Hebert PR, Lasser VI, Raines J, Raczynski J, Shepek L, Diller L, Whelton PK, Yamamoto M; Trials of Hypertension Prevention Collaborative Research Group. Sodium reduction for hypertension prevention in overweight adults: Further results from the Trials of Hypertension Prevention Phase II. J Hum Hypertens. 2005 Jan; 19(1): 33-45.
      • Rankins JR, Sampson W, Brown B, Jenkins-Salley T. Dietary Approaches to Stop Hypertension (DASH) intervention reduces blood pressure among hypertensive African American patients in a neighborhood health care center. J Nutr Educ Behav. 2005; 37: 259-264.
      • Torres MRSG, Ferreira TS, Nogueira LP, Nascimento DCS, Sanjuliani AF. Dietary counseling on long-term weight loss in overweight hypertensive patients. Clinics. 2011; 66(10): 1,779-1,785.
  • Search Plan and Results: HTN: MNT 2013