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 5 Change in blood pressure medication and physiologic outcomes at 12 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 2
	6 months to 12 months		Baseline to 12 months
	(12 months minus 6 months)		(12 months minus baseline)
	n	Mean, 95 % CI	n	Mean, 95 % CI
Blood Pressure Medication
Taking BP lowering medication, %
All	221	−0.5 % (−2.8 to 1.9)	253	0.0 % (−3.3 to 3.3)
--African American	153	0.0 % (−3.1 to 3.1)	178	−0.6 % (−4.5 to 3.4)
--White	66	−1.5 % (−4.5 to 1.4)	73	1.4 % (−4.6 to 7.4)
--Lifestyle	95	−1.0 % (−3.1 to 1.0)	127	−0.8 % (−5.4 to 3.8)
--Wt loss, group	51	−2.0 % (−8.6 to 4.7)	51	−2.0 % (−10.5 to 6.6)
--Wt loss, combination	75	1.3 % (−3.2 to 5.8)	75	2.7 % (−2.5 to 7.9)
Physiologic
Systolic BP, mm Hg
LS study only	99	3.2 (0.3 to 6.2) ^*	101	−1.4 (−4.5 to 1.6)
LS and HBP study	121	−2.5 (−6.5 to 1.4)	150	−9.3 (−13.6 to −5.1) ^***
All	220	0.0 (−2.5 to 2.6)	251	−6.1 (−9.0 to −3.3) ^***
Subgroup by race^b
--African American	152	−0.9 (−4.0 to 2.1)	176	−6.9 (−10.5 to −3.3) ^***
--White	66	2.5 (−2.5 to 7.4)	73	−4.2 (−8.8 to 0.3)
Subgroup by intervention^c
--Lifestyle	95	−2.2 (−6.2 to 1.8)	126	−8.3 (−12.6 to −3.9) ^***
--Wt loss, group	50	3.3 (−1.0 to 7.6)	50	−3.6 (−7.8 to 0.5)
--Wt loss, combination	75	0.7 (−3.8 to 5.3)	75	−4.3 (−9.7 to 1.1)
Diastolic BP, mm Hg
LS study only	99	0.4 (−1.4 to 2.2)	101	−2.0 (−3.7 to −0.4) ^*
LS and HBP study	121	−3.1 (−5.3 to −1.0) ^**	150	−7.0 (−9.0 to −4.9) ^***
All	220	−1.5 (−2.9 to −0.1) ^*	251	−5.0 (−6.4 to −3.6) ^***
--African American	152	−2.3 (−4.0 to −0.5) ^**	176	−5.2 (−7.0 to −3.4) ^***
--White	66	0.7 (−1.8 to 3.2)	73	−4.2 (−6.4 to −1.9) ^***
--Lifestyle	95	−2.2 (−4.4 to 0.1)	126	−5.4 (−7.5 to −3.2) ^***
--Wt loss, group	50	1.2 (−1.0 to 3.4)	50	−4.2 (−6.9 to −1.6) ^**
--Wt loss, combination	75	−2.5 (−5.1 to 0.1)	75	−4.5 (−7.2 to −2.3) ^***
Weight, kg
All	219	−1.1 (−1.7 to −0.5) ^***	250	−1.7 (−2.5 to 1.0) ^***
--African American	151	−0.9 (−1.6 to −0.3) ^**	175	−1.7 (−2.6 to −0.8) ^***
--White	66	−1.4 (−2.3 to −0.3) ^*	73	−1.6 (−3.1 to −0.2) ^*
--Lifestyle	94	−0.3 (−1.3 to 0.6)	125	−0.9 (−2.1 to 0.2)
--Wt loss, group	50	−1.3 (−2.4 to −0.2) ^*	50	−3.1 (−4.9 to −1.3) ^***
--Wt loss, combination	75	−1.9 (−2.8 to −1.0) ^***	75	−2.1 (−3.2 to −1.0) ^***
Weight, ≥ 5 % weight loss, %
All	219	18 % (13 to 23)	250	23 % (18 to 28)
--African American	151	18 % (12 to 24)	175	23 % (17 to 30)
--White	66	18 % (9 to 28)	73	22 % (12 to 31)
--Lifestyle	94	14 % (7 to 21)	125	19 % (12 to 26)
--Wt loss, group	50	22 % (10 to 34	50	34 % (21 to 47)
--Wt loss, combination	75	21 % (12 to 31)	75	23 % (13 to 32)
Total cholesterol, mg/dL^d
All			221	−3 (−7.0 to 0.7)
--African American			155	−4 (−8.5 to 0.4)
--White			64	0 (−7.8 to 7.7)
--Lifestyle			106	−3 (−9.1 to 2.7)
--Wt loss, group			44	−6 (−13.5 to 1.4)
--Wt loss, combination			71	−1 (−8.0 to 5.2)
HDL cholesterol, mg/dL
All			220	−2 (−2.8 to −0.4) ^**
--African American			154	−2 (−3.0 to 0) ^*
--White			64	−2 (−3.8 to 0.3)
--Lifestyle			106	−2 (−3.8 to −0.1)
--Wt loss, group			44	−1 (−3.1 to 1.5)
--Wt loss, combination			70	−1 (−3.5 to 0.5)

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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