Supporting cardiovascular risk reduction in overweight and obese hypertensive patients through DASH diet and lifestyle education by primary care nurse practitioners

J Am Assoc Nurse Pract. 2014 Sep;26(9):498-503. doi: 10.1002/2327-6924.12124. Epub 2014 May 13.

Abstract

Purpose: To describe an intervention among overweight and obese hypertensive patients, encouraging Dietary Approaches to Stop Hypertension (DASH) diet and lifestyle changes, designed and led by a primary care nurse practitioner (NP).

Data sources: A pre- and postintervention quasi-experimental time-series design was implemented over 2 months. Intervention included three group classes and two individual counseling telephone calls. Forty-five hypertensive patients enrolled, with a mean age of 55 years and mean initial BMI of 32. Twenty-six (58%) completed the program. Standard instruments (Rapid Eating Assessment for Patients [REAP] and Partners in Health [PIH] questionnaires) were used to evaluate diet and lifestyle factors before and after the program.

Conclusions: Participants had statistically significant improvements in diet and lifestyle scores on both REAP and PIH questionnaires, as well as statistically significant weight loss (average 3.6 pounds lost) over the 2-month intervention period.

Implications for practice: This NP-led primary care intervention on diet and lifestyle showed early success in improving the health of overweight and obese hypertensive patients. Investment in NP-led diet and lifestyle counseling should be considered among high-risk patients in the primary care setting.

Keywords: Dietary practices; hypertension; lifestyle; nurse practitioners; obesity.

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / prevention & control*
  • Counseling / methods*
  • Female
  • Humans
  • Hypertension / complications
  • Hypertension / diet therapy*
  • Hypertension / therapy
  • Life Style*
  • Male
  • Middle Aged
  • Nurse Practitioners*
  • Obesity / complications
  • Obesity / therapy*
  • Primary Health Care / methods*
  • Risk Factors
  • Risk Reduction Behavior*