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Health Education Research Advance Access originally published online on May 4, 2007
Health Education Research 2008 23(2):202-217; doi:10.1093/her/cym017
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© The Author 2007. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Changes in cognitive measures associated with a lifestyle program for treated hypertensives: a randomized controlled trial (ADAPT)

Valerie Burke*, J. Mansour, T. A. Mori, L. J. Beilin, H. E. Cutt and A. Wilson

School of Medicine and Pharmacology, Royal Perth Hospital Unit and West Australian Institute for Medical Research, University of Western Australia, Perth, WA 6000, Australia

* Correspondence to: V. Burke. School of Medicine and Pharmacology, Royal Perth Hospital Unit, GPO Box X2213, Perth, WA 6847, Australia. E-mail: vburke{at}cyllene.uwa.edu.au

Cognitive changes are reported infrequently in programs targeting cardiovascular risk. We examined self-efficacy, behavioral barriers and health beliefs in a lifestyle program for drug-treated hypertensives that aimed to reduce blood pressure, antihypertensive drug needs and cardiovascular risk. In a randomized controlled trial, we compared usual care (controls) and a 4-month program focusing on weight loss, diet and exercise. Outcomes were assessed at baseline, 4 months and 1-year follow-up. Of 241 individuals randomized, 102/123 in the program and 90/118 of controls completed follow-up. In the program group, dietary barriers fell by 14% at 4 months (controls 2%, P = 0.025) and by 8% at follow-up (controls 3%, P = 0.010). Exercise barriers fell by 11% at 4 months (controls 3%, P = 0.020) and 17% (controls 4%, P = 0.002) at follow-up. Dietary self-efficacy improved by 3% at 4 months (controls –1%, P = 0.003) and by 2% at follow-up (controls –1%, P = 0.051). Exercise self-efficacy increased by 8% at 4 months (controls 3%, P < 0.001) and by 5% at follow-up (controls 3%, P = 0.130). Changes in cognitive variables predicted changes in health-related behaviors at 4 months and follow-up. A cognitively based lifestyle program in treated hypertensives is associated with improvements in cognitive measures in the shorter and longer term.

Received on March 8, 2007; accepted on March 27, 2007


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