Multiple risk factor intervention a useful tool for primary prevention of hypertension in the community; the results of a randomized clinical trial with five years of follow up

Objective: Multiple risk factor intervention (MRFI) is one of the key strategies for primary prevention of cardiovascular disease. This randomized clinical trial aimed to test the efficacy of a tailored MRFI for primary prevention of systolic and diastolic hypertension in a community sample of women at risk of cardiovascular disease. Methods: Healthy Hearts for Women was a randomized clinical trial which allocated 400 women at risk of cardiovascular disease into intervention (n=200, 84% Caucasian) and control (n=200, 77% Caucasian) groups. Intervention was a multiple risk factor intervention including tailored coaching, motivational interviewing and health communication. Blood pressure was measured at baseline, 6th month, 12th month, and then annually for the next 4 years. We used latent growth curve modeling for data analysis. Results: The intervention group showed a significantly smaller quadratic coefficient (the change in the rate of change) for systolic blood pressure during 5 years of follow up. By other means, although intervention did not show an effect on linear change in systolic blood pressure, it did decrease the rate of increase of the change. The intervention group also showed a significantly smaller linear coefficient for diastolic blood pressure during 5 years. Conclusions: Based on our findings, there is still hope for primary prevention of hypertension among women. Multiple risk factor interventions which aim to alter various modifiable risk factors such as smoking, hypertension, hyperlipidemia, high fat diet, lack of exercise, and obesity may be an effective strategy for primary prevention of hypertension in the community.