A community-based lifestyle and weight loss intervention promoting a Mediterranean-style diet pattern evaluated in the stroke belt of North Carolina: the Heart Healthy Lenoir Project

Keyserling, Thomas C.; Samuel-Hodge, Carmen D.; Pitts, Stephanie Jilcott; Garcia, Beverly A.; Johnston, Larry F.; Gizlice, Ziya; Miller, Cassandra L.; Braxton, Danielle F.; Evenson, Kelly R.; Smith, Janice C.; Davis, Gwen B.; Quenum, Emmanuelle L.; Elliott, Nadya T. Majette; Gross, Myron D.; Donahue, Katrina E.; Halladay, Jacqueline R.; Ammerman, Alice S.

doi:10.1186/s12889-016-3370-9

Table 7 Change in blood pressure medication and physiologic outcomes at 24 months^a

From: A community-based lifestyle and weight loss intervention promoting a Mediterranean-style diet pattern evaluated in the stroke belt of North Carolina: the Heart Healthy Lenoir Project

Outcome	Phase 3
	12 months to 24 months		Baseline to 24 months
	(24 months minus 12 months)		(24 months minus baseline)
	n	Mean, 95 % CI	n	Mean, 95 % CI
Blood Pressure Medication
Taking BP lowering medication, %
All	237	0.4 % (−2.3 to 3.2)	250	0.8 % (−3.0 to 4.6)
--African American	169	1.2 %(−1.6 to 4.0)	177	1.1 % (−3.3 to 5.6)
--White	66	0.0 % (−5.9 to 5.9)	71	1.4 % (−5.9 to 8.7)
--Lifestyle	117	2.6 % (−1.1 to 6.3)	127	1.6 % (−4.2 to 7.3)
--Wt loss, group	48	2.1 % (−5.0 to 9.1)	51	2.0 % (−6.6 to 10.5)
--Wt loss, combination	72	−4.2 % (−8.8 to 0.4)	72	−1.4 % (−7.5 to 4.7)
Physiologic
Systolic BP, mm Hg
LS study only	95	−2.8 (−6.4 to 0.7)	104	−4.2 (−7.3 to 1.2) ^**
LS and HBP study	140	−0.2 (−3.8 to 3.5)	146	−9.4 (−13.4 to −5.4) ^***
All	235	−1.3 (−3.9 to 1.3)	250	−7.2 (−9.9 to −4.6) ^***
Subgroup by race^b
--African American	167	−2.0 (−5.3 to 1.2)	177	−8.4 (−11.8 to −5.1) ^***
--White	66	0.9 (−3.3 to 5.2)	71	−4.1 (−8.5 to 0.4)
Subgroup by intervention^c
--Lifestyle	116	−1.2 (−4.9 to 2.5)	127	−8.8 (−12.9 to −4.8) ^***
--Wt loss, group	47	0.4 (−3.9 to 4.8)	51	−3.9 (−8.4 to 0.6)
--Wt loss, combination	72	−2.4 (−7.8 to 2.9)	72	−6.8 (−11.8 to −1.9) ^**
Diastolic BP, mm Hg
LS study only	95	−3.4 (−5.4 to −1.5) ^***	104	−5.2 (−7.1 to −3.3) ^***
LS and HBP study	140	−0.9 (−2.9 to 1.0)	146	−7.8 (−10.1 to −5.5) ^***
All	235	−1.9 (−3.4 to −0.5)	250	−6.7 (−8.3 to −5.1) ^***
--African American	167	−2.4 (−4.2 to 0.5) ^**	177	−7.2 (−9.2 to −5.1) ^***
--White	66	−1.0 (−3.0 to 1.0)	71	−5.4 (−7.6 to −3.3) ^***
--Lifestyle	116	−1.9 (−4.0 to 0.2)	127	−6.8 (−9.1 to −4.4) ^***
--Wt loss, group	47	−3.1 (−5.8 to −0.4) ^*	51	−7.7 (−10.7 to −4.6) ^***
--Wt loss, combination	72	−1.3 (−3.9 to 1.3)	72	−6.0 (−8.8 to −3.2) ^***
Weight, kg
All	232	0.1 (−0.6 to 0.8)	247	−1.6 (−2.5 to −0.7) ^***
--African American	164	−0.1 (−1.0 to .08)	174	−1.8 (−2.8 to −0.8) ^***
--White	66	0.6 (−0.6 to 1.7)	71	−1.0 (−2.9 to 0.8)
--Lifestyle	113	−0.9 (−2.0 to 0.1)	124	−1.7 (−2.9 to −0.5) ^**
--Wt loss, group	47	1.2 (−0.4 to 2.8)	51	−2.1 (−4.3 to 0.0) ^*
--Wt loss, combination	72	1.0 (−0.2 to 2.2)	72	−1.1 (−2.7 to 0.4)
Weight, ≥ 5 % weight loss, %
All	232	12 % (8 to 16)	247	23 % (18 to 28)
--African American	164	12 % (7 to 17)	174	24 % (18 to 31)
--White	66	12 % (4 to 20)	71	18 % (9 to 27)
--Lifestyle	113	16 % (9 to 23)	124	23 % (16 to 31)
--Wt loss, group	47	11 % (2 to 20)	51	25 % (13 to 38)
--Wt loss, combination	72	7 % (1 to 13)	72	21 % (11 to 30)
Total cholesterol, mg/dL^d
All	196	1 (−3.3 to 5.0)	211	−3 (−7.8 to 1.7)
--African American	139	−1 (−6.3 to 4.7)	148	−4 (−10.3 to 1.4)
--White	55	4 (−0.9 to 9.8)	61	1 (−7.3 to 9.2)
--Lifestyle	91	2 (−4.0 to 8.8)	99	−2 (−8.1 to 4.3)
--Wt loss, group	41	−3 (−13.7 to 7.2)	46	−9 (−20.9 to 3.7)
--Wt loss, combination	64	1 (−4.7 to 7.1)	66	−1 (−9.3 to 7.2)
HDL cholesterol, mg/dL
All	196	0 (−0.8 to 1.3)	211	−1 (−2.3 to 0.3)
--African American	139	0 (−1.2 to 1.6)	148	−1 (−2.6 to 0.6)
--White	55	0 (−1.4 to 2.2)	61	−1 (−3.1 to 1.2)
--Lifestyle	91	0 (−1.4 to 1.7)	99	−2 (−4.0 to −0.1) ^*
--Wt loss, group	41	0 (−2.0 to 2.3)	46	1 (−1.6 to 3.6)
--Wt loss, combination	64	0 (−1.6 to 2.4)	66	−1 (−2.9 to 1.4)

Abbreviations: BP blood pressure, CI confidence interval, HBP high blood pressure, LS lifestyle
Note: Boldface indicates statistical significance ^*p ≤ 0.05; ^**p ≤ 0.01; ^***p ≤ 0.001
SI unit conversion factors: To convert all types of cholesterol to millimoles per liter, multiply by 0.0259
^a Data are means except where noted
^b 3 categorized as other race
^c Participants selected intervention group at 6 month follow-up visit; if they did not attend this visit they were assigned to lifestyle group
^d To convert from mg/dL to mmol/L divide by 68.37

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