Lifestyle intervention is known to improve the cardiometabolic risk profile of patients by, among other things, lowering blood pressure. The PREMIER study investigated the effects of lifestyle intervention—based on established recommendations alone or in addition to the Dietary Approaches to Stop Hypertension (DASH)—on blood pressure and metabolic variables in subjects with/without metabolic syndrome (NCEP-ATP III criteria). Half of patients had the metabolic syndrome (399/796) at baseline. After the six-month intervention program, both groups reduced systolic blood pressure. Among patients who received the established recommendations plus the DASH intervention, the reduction in systolic blood pressure was similar. However, the presence of the metabolic syndrome attenuated the response of patients receiving only the established recommendations. Finally, changes in diastolic blood pressure, lipids, and insulin resistance (HOMA model) were similar in both intervention groups regardless of whether the metabolic syndrome was present.
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