The clinical effectiveness of therapeutic lifestyle changes in the management of prehypertension was investigated in a large cohort of men (n=666) and women (n=1,812), which included African Americans (n=448) and Caucasians (n=1,881). Participants were examined at baseline and after 6 months of a community-based lifestyle management program that included exercise training, nutrition, weight management, stress management, and smoking cessation. Decreases in systolic and diastolic blood pressure were 6±12 and 3±3 mmHg (p≤0.001), respectively. After the lifestyle management program, 38.4% of participants normalized their blood pressure (p≤0.001). There was no ethnic difference in the magnitude of reduction of blood pressure nor in the proportion of subjects who developed hypertension or who normalized their blood pressure. However, the magnitude of reduction in blood pressure and the proportion of individuals who normalized their blood pressure were higher in women despite a greater body weight loss in men (p≤0.001). The reduction in blood pressure was superior in subjects with baseline body mass index<30 kg/m2 than in those with body mass index ≥30 kg/m2. Results of this study are very encouraging and should help promote healthy lifestyle changes as the first line therapy at least in the treatment of prehypertension.
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