Isolated systolic hypertension (ISH) is a highly prevalent condition which is powerful risk factor for cardiovascular disease. The value of treating patients with ISH has yet to be proven, however, the results of the SHEP study will be available when this project is reviewed. The joint National Committee on Detection, Evaluation, and Treatment of high blood pressure recommends non-pharmacologic therapy for patients with ISH. Unfortunately the scientific basis for such advice is virtually non-existent. Thus there is a compelling rationale for initiating a clinical trial to evaluate the efficacy of non-pharmacologic therapy in ISH. This intervention development proposal is to conduct a feasibility study for a larger multi-center grant submission of a project to determine if non-pharmacologic interventions are effective in treating borderline or moderate isolate systolic hypertension. The ultimate multi-center grant for which this proposal is a feasibility study would possibly involve as many as 4 sites depending on sample size calculations. The feasibility study will assess in 120 persons age 30 - 80 years 1) the ability to develop lifestyle modification interventions which are appropriate for older persons, 2) the feasibility of recruitment, 3) to assess acceptability tolerance and adherence over 12 months, and 4) to pilot test the various measures proposed including quality of life. The overall goal of the proposed research is to identify and quantitate the role of the two most promising non-pharmacologic interventions in the treatment of persons 60 - 80 with a borderline isolated elevation of systolic blood pressure (140-160 mm Hg with diastolic pressure < 90 mm Hg). These interventions include prescription of low sodium diets to obese and non-obese individuals and a weight reducing diet in obese individuals. The significance of the proposed study is that the feasibility study would lead to a full trial to identify a safe well-tolerated and effective method of lowering systolic blood pressure in the elderly. The study findings will complement those to be provided by the SHEP study and may provide a means to reduce the current epidemic of blood pressure related cardiovascular disease in the elderly.
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