HTN: Medical Nutrition Therapy (2022-24)

HTN: Medical Nutrition Therapy (2022-24)

• Intervention
  In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on arterial stiffness?

  • Conclusion

    In adults with prehypertension or hypertension, medical nutrition therapy provided by a dietitian may reduce arterial stiffness compared to no intervention or usual care.

  • Grade: Low (C)
    • 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 adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on arterial stiffness?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Blumenthal J, Babyak M, Sherwood A, Craighead L, Lin P, Johnson J, Watkins L, Wang J, Kuhn C, Feinglos M, Hinderliter A. Effects of the dietary approaches to stop hypertension diet alone and in combination with exercise and caloric restriction on insulin sensitivity and lipids. Hypertension 2010; 55:1199-1205
      • Gerage A, Benedetti T, Cavalcante B, Farah B, Ritti-Dias R. Efficacy of a behavior change program on cardiovascular parameters in patients with hypertension: a randomized controlled trial. Einstein (Sao Paulo, Brazil) 2020; 18:eAO5227
      • Lee C, Kim J, Shim E, Hong S, Lee M, Jeon J, Park S. The Effects of Diet Alone or in Combination with Exercise in Patients with Prehypertension and Hypertension: a Randomized Controlled Trial. Korean Circulation Journal 2018; 48:637-651
      • Vamvakis A, Gkaliagkousi E, Lazaridis A, Grammatikopoulou M, Triantafyllou A, Nikolaidou B, Koletsos N, Anyfanti P, Tzimos C, Zebekakis P, Douma S. Impact of Intensive Lifestyle Treatment (Diet Plus Exercise) on Endothelial and Vascular Function, Arterial Stiffness and Blood Pressure in Stage 1 Hypertension: Results of the HINTreat Randomized Controlled Trial. Nutrients 2020; 12:
  • Search Plan and Results: HTN: MNT for Prehypertension and Hypertension (2024)
     
  In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on blood pressure?

  • Conclusion

    In adults with pre-hypertension or hypertension, medical nutrition therapy provided by a dietitian may decrease systolic and diastolic blood pressure compared to no intervention or usual care.

  • Grade: Low (C)
    • 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 adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on blood pressure?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Agewall S, Wikstrand J, Samuelsson O, Persson B, Andersson O, Fagerberg B. The efficacy of multiple risk factor intervention in treated hypertensive men during long-term follow up. Risk Factor Intervention Study Group. Journal of internal medicine 1994; 236:651-659
      • Applegate W, Miller S, Elam J, Cushman W, el Derwi D, Brewer A, Graney M. Nonpharmacologic intervention to reduce blood pressure in older patients with mild hypertension. Archives of Internal Medicine 1992; 152:1162-1166
      • Blumenthal J, Babyak M, Sherwood A, Craighead L, Lin P, Johnson J, Watkins L, Wang J, Kuhn C, Feinglos M, Hinderliter A. Effects of the dietary approaches to stop hypertension diet alone and in combination with exercise and caloric restriction on insulin sensitivity and lipids. Hypertension 2010; 55:1199-1205
      • Dodson P, Stephenson J, Dodson L, Kurnik D, Kritzinger E, Taylor K, Fletcher R. Randomised blind controlled trial of a high fibre, low fat and low sodium dietary regimen in mild essential hypertension. Journal of Human Hypertension 1989; 3:197-202
      • Edwards K, Wilson K, Sadja J, Ziegler M, Mills P. Effects on blood pressure and autonomic nervous system function of a 12-week exercise or exercise plus DASH-diet intervention in individuals with elevated blood pressure. Acta Physiologica (Oxford, England) 2011; 203:343-350
      • Gerage A, Benedetti T, Cavalcante B, Farah B, Ritti-Dias R. Efficacy of a behavior change program on cardiovascular parameters in patients with hypertension: a randomized controlled trial. Einstein (Sao Paulo, Brazil) 2020; 18:eAO5227
      • Green B, Anderson M, Cook A, Catz S, Fishman P, McClure J, Reid R. e-Care for Heart Wellness: A Feasibility Trial to Decrease Blood Pressure and Cardiovascular Risk. American Journal of Preventive Medicine 2014; 46:368-377
      • Hjelstuen A, Anderssen S, Holme I, Seljeflot I, Klemsdal T. Effect of lifestyle and/or statin treatment on soluble markers of atherosclerosis in hypertensives. Scandinavian Cardiovascular Journal 2007; 41:313-320
      • Jalkanen L. The effect of a weight reduction program on cardiovascular risk factors among overweight hypertensives in primary health care. Scandinavian journal of social medicine 1991; 19:66-71
      • Jones D, Miller M, Wofford M, Anderson D, Cameron M, Willoughby D, Adair C, King N. The effect of weight loss intervention on antihypertensive medication requirements in the Hypertension Optimal Treatment (HOT) study. American Journal of Hypertension 1999; 12:1175-1180
      • Koopman H, Spreeuwenberg C, Westerman R, Donker A. Dietary treatment of patients with mild to moderate hypertension in a general practice: a pilot intervention study (1). The first three months. Journal of Human Hypertension 1990; 4:368-371
      • Kucharska A, Gajewska D, Kiedrowski M, Si?ska B, Juszczyk G, Czerw A, Augustynowicz A, Bobinski K, Deptala A, Niegowska J. The impact of individualised nutritional therapy according to DASH diet on blood pressure, body mass, and selected biochemical parameters in overweight/obese patients with primary arterial hypertension: a prospective randomised study. Kardiologia Polska 2018; 76:158-165
      • Lee C, Kim J, Shim E, Hong S, Lee M, Jeon J, Park S. The Effects of Diet Alone or in Combination with Exercise in Patients with Prehypertension and Hypertension: a Randomized Controlled Trial. Korean Circulation Journal 2018; 48:637-651
      • Lima S, da Silva Nalin de Souza B, França A, Salgado Filho N, Sichieri R. Dietary approach to hypertension based on low glycaemic index and principles of DASH (Dietary Approaches to Stop Hypertension): a randomised trial in a primary care service. British Journal of Nutrition 2013; 110:1472-1479
      • Lopes H, Martin K, Nashar K, Morrow J, Goodfriend T, Egan B. DASH diet lowers blood pressure and lipid-induced oxidative stress in obesity. Hypertension 2003; 41:422-430
      • Lynch E, Liebman R, Ventrelle J, Avery E, Richardson D. A self-management intervention for African Americans with comorbid diabetes and hypertension: a pilot randomized controlled trial. Preventing Chronic Disease 2014; 11:E90
      • Malta D, Arcand J, Ravindran A, Floras V, Allard J, Newton G. Adequate intake of potassium does not cause hyperkalemia in hypertensive individuals taking medications that antagonize the renin angiotensin aldosterone system. American Journal of Clinical Nutrition 2016; 104:990-994
      • Nakano M, Eguchi K, Sato T, Onoguchi A, Hoshide S, Kario K. Effect of Intensive Salt-Restriction Education on Clinic, Home, and Ambulatory Blood Pressure Levels in Treated Hypertensive Patients During a 3-Month Education Period. Journal of Clinical Hypertension 2016; 18:385-392
      • Nguyen-Huynh M, Young J, Ovbiagele B, Alexander J, Alexeeff S, Lee C, Blick N, Caan B, Go A, Sidney S. Effect of Lifestyle Coaching or Enhanced Pharmacotherapy on Blood Pressure Control Among Black Adults With Persistent Uncontrolled Hypertension: A Cluster Randomized Clinical Trial. JAMA Network Open 2022; 5:e2212397
      • Nowson C, Morgan T. Change in blood pressure in relation to change in nutrients effected by manipulation of dietary sodium and potassium. Clinical and Experimental Pharmacology & Physiology 1988; 15:225-242
      • Paula T, Viana L, Neto A, Leitão C, Gross J, Azevedo M. Effects of the DASH Diet and Walking on Blood Pressure in Patients With Type 2 Diabetes and Uncontrolled Hypertension: A Randomized Controlled Trial. Journal of Clinical Hypertension 2015; 17:895-901
      • Siani A, Strazzullo P, Giacco A, Pacioni D, Celentano E, Mancini M. Increasing the dietary potassium intake reduces the need for antihypertensive medication. Annals of Internal Medicine 1991; 115:753-759
      • Stamler R, Stamler J, Grimm R, Gosch F, Elmer P, Dyer A, Berman R, Fishman J, Van Heel N, Civinelli J. Nutritional therapy for high blood pressure. Final report of a four-year randomized controlled trial--the Hypertension Control Program. Journal of the American Medical Association 1987; 257:1484-1491
      • Stamler R, Stamler J, Gosch F, Civinelli J, Fishman J, McKeever P, McDonald A, Dyer A. Primary prevention of hypertension by nutritional-hygienic means. Final report of a randomized, controlled trial. Journal of the American Medical Association 1989; 262:1801-8107
      • Turnbull DA, Beilby JJ, Ziaian T, Qureshi F, Nelson M, Tonkin AL, Marley JE.. Disease Management for Hypertension A Pilot Cluster Randomized Trial of 67 Australian General Practices. Dis Manage Health Outcomes 2006; 14:27-35
      • Vamvakis A, Gkaliagkousi E, Lazaridis A, Grammatikopoulou M, Triantafyllou A, Nikolaidou B, Koletsos N, Anyfanti P, Tzimos C, Zebekakis P, Douma S. Impact of Intensive Lifestyle Treatment (Diet Plus Exercise) on Endothelial and Vascular Function, Arterial Stiffness and Blood Pressure in Stage 1 Hypertension: Results of the HINTreat Randomized Controlled Trial. Nutrients 2020; 12:
      • Wassertheil-Smoller S, Blaufox M, Oberman A, Langford H, Davis B, Wylie-Rosett J. The Trial of Antihypertensive Interventions and Management (TAIM) study. Adequate weight loss, alone and combined with drug therapy in the treatment of mild hypertension. Archives of Internal Medicine 1992; 152:131-136
      • The Trials of Hypertension Prevention Collaborative Research Group. The Effects of Nonpharmacologic Interventions on Blood Pressure of Persons With High Normal Levels. Journal of the American Medical Association 1992; 267:1213-1220
      • Whelton P, Appel L, Espeland M, Applegate W, Ettinger W, Kostis J, Kumanyika S, Lacy C, Johnson K, Folmar S,C utler J. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. Journal of the American Medical Association 1998; 279:839-846
  • Search Plan and Results: HTN: MNT for Prehypertension and Hypertension (2024)
     
  In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on body mass index?

  • Conclusion

    In adults with pre-hypertension or hypertension, medical nutrition therapy provided by a dietitian likely reduces body mass index compared to no intervention or usual care.

  • Grade: Moderate (B)
    • 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 adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on body mass index?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Agewall S, Wikstrand J, Samuelsson O, Persson B, Andersson O, Fagerberg B. The efficacy of multiple risk factor intervention in treated hypertensive men during long-term follow up. Risk Factor Intervention Study Group. Journal of internal medicine 1994; 236:651-659
      • Beckmann S, Os I, Kjeldsen S, Eide I, Westheim A, Hjermann I. Effect of dietary counselling on blood pressure and arterial plasma catecholamines in primary hypertension. American Journal of Hypertension 1995; 8:704-711
      • Edwards K, Wilson K, Sadja J, Ziegler M, Mills P. Effects on blood pressure and autonomic nervous system function of a 12-week exercise or exercise plus DASH-diet intervention in individuals with elevated blood pressure. Acta Physiologica (Oxford, England) 2011; 203:343-350
      • Hjelstuen A, Anderssen S, Holme I, Seljeflot I, Klemsdal T. Effect of lifestyle and/or statin treatment on soluble markers of atherosclerosis in hypertensives. Scandinavian Cardiovascular Journal 2007; 41:313-320
      • Kucharska A, Gajewska D, Kiedrowski M, Si?ska B, Juszczyk G, Czerw A, Augustynowicz A, Bobinski K, Deptala A, Niegowska J. The impact of individualised nutritional therapy according to DASH diet on blood pressure, body mass, and selected biochemical parameters in overweight/obese patients with primary arterial hypertension: a prospective randomised study. Kardiologia Polska 2018; 76:158-165
      • Paula T, Viana L, Neto A, Leitão C, Gross J, Azevedo M. Effects of the DASH Diet and Walking on Blood Pressure in Patients With Type 2 Diabetes and Uncontrolled Hypertension: A Randomized Controlled Trial. Journal of Clinical Hypertension 2015; 17:895-901
      • Vamvakis A, Gkaliagkousi E, Lazaridis A, Grammatikopoulou M, Triantafyllou A, Nikolaidou B, Koletsos N, Anyfanti P, Tzimos C, Zebekakis P, Douma S. Impact of Intensive Lifestyle Treatment (Diet Plus Exercise) on Endothelial and Vascular Function, Arterial Stiffness and Blood Pressure in Stage 1 Hypertension: Results of the HINTreat Randomized Controlled Trial. Nutrients 2020; 12:
  • Search Plan and Results: HTN: MNT for Prehypertension and Hypertension (2024)
     
  In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on body weight?

  • Conclusion

    In adults with pre-hypertension or hypertension, medical nutrition therapy provided by a dietitian may reduce body weight compared to no intervention or usual care.

  • Grade: Low (C)
    • 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 adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on body weight?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Agewall S, Wikstrand J, Samuelsson O, Persson B, Andersson O, Fagerberg B. The efficacy of multiple risk factor intervention in treated hypertensive men during long-term follow up. Risk Factor Intervention Study Group. Journal of internal medicine 1994; 236:651-659
      • Applegate W, Miller S, Elam J, Cushman W, el Derwi D, Brewer A, Graney M. Nonpharmacologic intervention to reduce blood pressure in older patients with mild hypertension. Archives of Internal Medicine 1992; 152:1162-1166
      • Blumenthal J, Babyak M, Sherwood A, Craighead L, Lin P, Johnson J, Watkins L, Wang J, Kuhn C, Feinglos M, Hinderliter A. Effects of the dietary approaches to stop hypertension diet alone and in combination with exercise and caloric restriction on insulin sensitivity and lipids. Hypertension 2010; 55:1199-1205
      • Dodson P, Stephenson J, Dodson L, Kurnik D, Kritzinger E, Taylor K, Fletcher R. Randomised blind controlled trial of a high fibre, low fat and low sodium dietary regimen in mild essential hypertension. Journal of Human Hypertension 1989; 3:197-202
      • Gerage A, Benedetti T, Cavalcante B, Farah B, Ritti-Dias R. Efficacy of a behavior change program on cardiovascular parameters in patients with hypertension: a randomized controlled trial. Einstein (Sao Paulo, Brazil) 2020; 18:eAO5227
      • Green B, Anderson M, Cook A, Catz S, Fishman P, McClure J, Reid R. e-Care for Heart Wellness: A Feasibility Trial to Decrease Blood Pressure and Cardiovascular Risk. American Journal of Preventive Medicine 2014; 46:368-377
      • Hjelstuen A, Anderssen S, Holme I, Seljeflot I, Klemsdal T. Effect of lifestyle and/or statin treatment on soluble markers of atherosclerosis in hypertensives. Scandinavian Cardiovascular Journal 2007; 41:313-320
      • Jalkanen L. The effect of a weight reduction program on cardiovascular risk factors among overweight hypertensives in primary health care. Scandinavian journal of social medicine 1991; 19:66-71
      • Kucharska A, Gajewska D, Kiedrowski M, Si?ska B, Juszczyk G, Czerw A, Augustynowicz A, Bobinski K, Deptala A, Niegowska J. The impact of individualised nutritional therapy according to DASH diet on blood pressure, body mass, and selected biochemical parameters in overweight/obese patients with primary arterial hypertension: a prospective randomised study. Kardiologia Polska 2018; 76:158-165
      • Lee C, Kim J, Shim E, Hong S, Lee M, Jeon J, Park S. The Effects of Diet Alone or in Combination with Exercise in Patients with Prehypertension and Hypertension: a Randomized Controlled Trial. Korean Circulation Journal 2018; 48:637-651
      • Lima S, da Silva Nalin de Souza B, França A, Salgado Filho N, Sichieri R. Dietary approach to hypertension based on low glycaemic index and principles of DASH (Dietary Approaches to Stop Hypertension): a randomised trial in a primary care service. British Journal of Nutrition 2013; 110:1472-1479
      • Lynch E, Liebman R, Ventrelle J, Avery E, Richardson D. A self-management intervention for African Americans with comorbid diabetes and hypertension: a pilot randomized controlled trial. Preventing Chronic Disease 2014; 11:E90
      • Nakano M, Eguchi K, Sato T, Onoguchi A, Hoshide S, Kario K. Effect of Intensive Salt-Restriction Education on Clinic, Home, and Ambulatory Blood Pressure Levels in Treated Hypertensive Patients During a 3-Month Education Period. Journal of Clinical Hypertension 2016; 18:385-392
      • Nowson C, Morgan T. Change in blood pressure in relation to change in nutrients effected by manipulation of dietary sodium and potassium. Clinical and Experimental Pharmacology & Physiology 1988; 15:225-242
      • Siani A, Strazzullo P, Giacco A, Pacioni D, Celentano E, Mancini M. Increasing the dietary potassium intake reduces the need for antihypertensive medication. Annals of Internal Medicine 1991; 115:753-759
      • Stamler R, Stamler J, Grimm R, Gosch F, Elmer P, Dyer A, Berman R, Fishman J, Van Heel N, Civinelli J. Nutritional therapy for high blood pressure. Final report of a four-year randomized controlled trial--the Hypertension Control Program. Journal of the American Medical Association 1987; 257:1484-1491
      • Stamler R, Stamler J, Gosch F, Civinelli J, Fishman J, McKeever P, McDonald A, Dyer A. Primary prevention of hypertension by nutritional-hygienic means. Final report of a randomized, controlled trial. Journal of the American Medical Association 1989; 262:1801-8107
      • Wassertheil-Smoller S, Langford H, Blaufox M, Oberman A, Hawkins M, Levine B, Cameron M, Babcock C, Pressel S, Caggiula A. Effective dietary intervention in hypertensives: sodium restriction and weight reduction. Journal of the American Dietetic Association 1985; 85:423-30
      • The Trials of Hypertension Prevention Collaborative Research Group. The Effects of Nonpharmacologic Interventions on Blood Pressure of Persons With High Normal Levels. Journal of the American Medical Association 1992; 267:1213-1220
      • Wylie-Rosett J, Wassertheil-Smoller S, Blaufox M, Davis B, Langford H, Oberman A, Jennings S, Hataway H, Stern J, Zimbaldi N. Trial of antihypertensive intervention and management: greater efficacy with weight reduction than with a sodium-potassium intervention. Journal of the American Dietetic Association 1993; 93:408-415
  • Search Plan and Results: HTN: MNT for Prehypertension and Hypertension (2024)
     
  In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on cardiovascular disease risk score?

  • Conclusion

    In adults with pre-hypertension or hypertension, medical nutrition therapy provided by a dietitian likely reduces cardiovascular disease risk score compared to no intervention or usual care.

  • Grade: Moderate (B)
    • 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 adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on cardiovascular disease risk score?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Green B, Anderson M, Cook A, Catz S, Fishman P, McClure J, Reid R. e-Care for Heart Wellness: A Feasibility Trial to Decrease Blood Pressure and Cardiovascular Risk. American Journal of Preventive Medicine 2014; 46:368-377
      • Hinderliter A, Smith P, Sherwood A, Blumenthal J. Lifestyle Interventions Reduce the Need for Guideline-Directed Antihypertensive Medication. American Journal of Hypertension 2021; 34:1100-1107
      • Oberman A, Wassertheil-Smoller S, Langford H, Blaufox M, Davis B, Blaszkowski T, Zimbaldi N, Hawkins C. Pharmacologic and nutritional treatment of mild hypertension: changes in cardiovascular risk status. Annals of Internal Medicine 1990; 112:89-95
      • Turnbull DA, Beilby JJ, Ziaian T, Qureshi F, Nelson M, Tonkin AL, Marley JE.. Disease Management for Hypertension A Pilot Cluster Randomized Trial of 67 Australian General Practices. Dis Manage Health Outcomes 2006; 14:27-35
  • Search Plan and Results: HTN: MNT for Prehypertension and Hypertension (2024)
     
  In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on change in anti-hypertensive medications?

  • Conclusion

    In adults with pre-hypertension or hypertension, medical nutrition therapy provided by a dietitian likely improves anti-hypertension medication usage compared to no intervention or usual care.

  • Grade: Moderate (B)
    • 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 adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on change in anti-hypertensive medications?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Jones D, Miller M, Wofford M, Anderson D, Cameron M, Willoughby D, Adair C, King N. The effect of weight loss intervention on antihypertensive medication requirements in the Hypertension Optimal Treatment (HOT) study. American Journal of Hypertension 1999; 12:1175-1180
      • Siani A, Strazzullo P, Giacco A, Pacioni D, Celentano E, Mancini M. Increasing the dietary potassium intake reduces the need for antihypertensive medication. Annals of Internal Medicine 1991; 115:753-759
      • Stamler R, Stamler J, Grimm R, Gosch F, Elmer P, Dyer A, Berman R, Fishman J, Van Heel N, Civinelli J. Nutritional therapy for high blood pressure. Final report of a four-year randomized controlled trial--the Hypertension Control Program. Journal of the American Medical Association 1987; 257:1484-1491
      • Whelton P, Appel L, Espeland M, Applegate W, Ettinger W, Kostis J, Kumanyika S, Lacy C, Johnson K, Folmar S,C utler J. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. Journal of the American Medical Association 1998; 279:839-846
  • Search Plan and Results: HTN: MNT for Prehypertension and Hypertension (2024)
     
  In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on endothelial function?

  • Conclusion

    In adults with pre-hypertension or hypertension, the relationship between medical nutrition therapy provided by a dietitian, compared to no intervention or usual care, is unclear. 

  • Grade: Very Low (D)
    • 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 adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on endothelial function?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Blumenthal J, Babyak M, Sherwood A, Craighead L, Lin P, Johnson J, Watkins L, Wang J, Kuhn C, Feinglos M, Hinderliter A. Effects of the dietary approaches to stop hypertension diet alone and in combination with exercise and caloric restriction on insulin sensitivity and lipids. Hypertension 2010; 55:1199-1205
      • Vamvakis A, Gkaliagkousi E, Lazaridis A, Grammatikopoulou M, Triantafyllou A, Nikolaidou B, Koletsos N, Anyfanti P, Tzimos C, Zebekakis P, Douma S. Impact of Intensive Lifestyle Treatment (Diet Plus Exercise) on Endothelial and Vascular Function, Arterial Stiffness and Blood Pressure in Stage 1 Hypertension: Results of the HINTreat Randomized Controlled Trial. Nutrients 2020; 12:
  • Search Plan and Results: HTN: MNT for Prehypertension and Hypertension (2024)
     
  In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on mortality?

  • Conclusion

    In adults with pre-hypertension or hypertension, medical nutrition therapy provided by a dietitian may not affect total or cardiovascular mortality compared to no intervention or usual care.

  • Grade: Low (C)
    • 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 adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on mortality?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Agewall S, Wikstrand J, Samuelsson O, Persson B, Andersson O, Fagerberg B. The efficacy of multiple risk factor intervention in treated hypertensive men during long-term follow up. Risk Factor Intervention Study Group. Journal of internal medicine 1994; 236:651-659
  • Search Plan and Results: HTN: MNT for Prehypertension and Hypertension (2024)
     
  In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on quality of life?

  • Conclusion

    In adults with pre-hypertension or hypertension, the relationship between medical nutrition therapy provided by a dietitian, compared to no intervention or usual care, and quality of life is unclear.

  • Grade: Very Low (D)
    • 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 adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on quality of life?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Agewall S, Wikstrand J, Dahlöf C, Fagerberg B. A randomized study of quality of life during multiple risk factor intervention in treated hypertensive men at high cardiovascular risk. Journal of Hypertension 1995; 13:1471-1477
      • Gerage A, Benedetti T, Ritti-Dias R, Dos Santos A, de Souza B, Almeida F. Effectiveness of a Behavior Change Program on Physical Activity and Eating Habits in Patients With Hypertension: A Randomized Controlled Trial. Journal of Physical Activity & Health 2017; 14:943-952
      • Wassertheil-Smoller S, Blaufox M, Oberman A, Langford H, Davis B, Wylie-Rosett J. The Trial of Antihypertensive Interventions and Management (TAIM) study. Adequate weight loss, alone and combined with drug therapy in the treatment of mild hypertension. Archives of Internal Medicine 1992; 152:131-136
  • Search Plan and Results: HTN: MNT for Prehypertension and Hypertension (2024)
     
  In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on risk of myocardial infarction?

  • Conclusion

    In adults with pre-hypertension or hypertension, medical nutrition therapy provided by a dietitian may have no effect on risk of mycardial infarction compared to no intervention or usual care.

  • Grade: Low (C)
    • 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 adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on risk of myocardial infarction?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Agewall S, Wikstrand J, Samuelsson O, Persson B, Andersson O, Fagerberg B. The efficacy of multiple risk factor intervention in treated hypertensive men during long-term follow up. Risk Factor Intervention Study Group. Journal of internal medicine 1994; 236:651-659
      • Whelton P, Appel L, Espeland M, Applegate W, Ettinger W, Kostis J, Kumanyika S, Lacy C, Johnson K, Folmar S,C utler J. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. Journal of the American Medical Association 1998; 279:839-846
  In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on risk of stroke?

  • Conclusion

    In adults with pre-hypertension or hypertension, medical nutrition therapy provided by a dietitian likely reduces risk of stroke compared to no intervention or usual care.

  • Grade: Moderate (B)
    • 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 adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on risk of stroke?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Agewall S, Wikstrand J, Samuelsson O, Persson B, Andersson O, Fagerberg B. The efficacy of multiple risk factor intervention in treated hypertensive men during long-term follow up. Risk Factor Intervention Study Group. Journal of internal medicine 1994; 236:651-659
      • Whelton P, Appel L, Espeland M, Applegate W, Ettinger W, Kostis J, Kumanyika S, Lacy C, Johnson K, Folmar S,C utler J. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. Journal of the American Medical Association 1998; 279:839-846
  • Search Plan and Results: HTN: MNT for Prehypertension and Hypertension (2024)
     
  In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on waist circumference?

  • Conclusion

    In adults with pre-hypertension or hypertension, medical nutrition therapy provided by a dietitian my reduce waist circumference compared to no intervention or usual care.

  • Grade: Low (C)
    • 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 adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian, compared to no intervention or usual care, on waist circumference?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Hjelstuen A, Anderssen S, Holme I, Seljeflot I, Klemsdal T. Effect of lifestyle and/or statin treatment on soluble markers of atherosclerosis in hypertensives. Scandinavian Cardiovascular Journal 2007; 41:313-320
      • Kucharska A, Gajewska D, Kiedrowski M, Si?ska B, Juszczyk G, Czerw A, Augustynowicz A, Bobinski K, Deptala A, Niegowska J. The impact of individualised nutritional therapy according to DASH diet on blood pressure, body mass, and selected biochemical parameters in overweight/obese patients with primary arterial hypertension: a prospective randomised study. Kardiologia Polska 2018; 76:158-165
      • Lee C, Kim J, Shim E, Hong S, Lee M, Jeon J, Park S. The Effects of Diet Alone or in Combination with Exercise in Patients with Prehypertension and Hypertension: a Randomized Controlled Trial. Korean Circulation Journal 2018; 48:637-651
      • Paula T, Viana L, Neto A, Leitão C, Gross J, Azevedo M. Effects of the DASH Diet and Walking on Blood Pressure in Patients With Type 2 Diabetes and Uncontrolled Hypertension: A Randomized Controlled Trial. Journal of Clinical Hypertension 2015; 17:895-901
  • Search Plan and Results: HTN: MNT for Prehypertension and Hypertension (2024)