Abstract :
Byline: Senaida Fernandez (*), Kasandra L. Scales ([dagger]), Johanna M. Pineiro ([double dagger]), Antoinette M. Schoenthaler (*), Gbenga Ogedegbe (*) Keywords: hypertension; older adults; intervention; lifestyle; health disparities Abstract: OBJECTIVES: To test the feasibility, acceptability, and effect of a senior center-based behavioral counseling lifestyle intervention on systolic blood pressure (BP). DESIGN: A pre-post design pilot trial of behavioral counseling for therapeutic lifestyle changes in minority elderly people with hypertension. Participants completed baseline visit, Visit 1 (approximately 6 weeks postbaseline), and a final study Visit 2 (approximately 14 weeks postbaseline) within 4 months. SETTING: The study took place in six community-based senior centers in New York City with 65 seniors (mean age 72.29[+ or -]6.92; 53.8% female; 84.6% African American). PARTICIPANTS: Sixty-five minority elderly people. INTERVENTION: Six weekly and two monthly "booster" group sessions on lifestyle changes to improve BP (e.g., diet, exercise, adherence to prescribed antihypertensive medications). MEASUREMENTS: Primary outcome was systolic BP (SBP) measured using an automated BP monitor. Secondary outcomes were diastolic BP (DBP), physical activity, diet, and adherence to prescribed antihypertensive medications. RESULTS: There was a significant reduction in average SBP of 13.0[+ or -]21.1 mmHg for the intervention group (t(25)=3.14, P=.004) and a nonsignificant reduction in mean SBP of 10.6[+ or -]30.0 mmHg for the waitlist control group (t(29)=1.95, P=.06). For the intervention group, adherence improved 26% (t(23)=2.31, P=.03), and vegetable intake improved 23% (t(25)=2.29, P=.03). CONCLUSION: This senior center-based lifestyle intervention was associated with a significant reduction in SBP and adherence to prescribed antihypertensive medications and diet in the intervention group. Participant retention and group attendance rates suggest that implementing a group-counseling intervention in senior centers is feasible. Author Affiliation: (*)Division of General Internal Medicine, Department of Medicine, New York University School of Medicine, New York, New York ([dagger])State University of New York Upstate Medical University, Syracuse, New York ([double dagger])Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York. Article note: Address correspondence to Senaida Fernandez, PhD, New York University, 423 E. 23rd St., 15N-167, New York, NY 10010. E-mail: senaida.fernandez@nyumc.org