Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 30, 2019
Date Accepted: Feb 9, 2020
Impact of a web-based exercise and nutritional educational intervention in obese patients with hypertension: a randomised waitlist-controlled trial
ABSTRACT
Background:
Internet-based interventions are a promising strategy for promoting healthy lifestyle behaviours; these have a tremendous potential for delivering eHealth interventions in scalable and cost-effective ways. There is strong evidence that the use of these programs can lead to weight loss and can lower average patient blood pressure (BP) levels. So far, very few studies have investigated the effects of internet-based programs on obese patients with hypertension (HTN).
Objective:
To investigate the short- and long-term efficacy in terms of body composition and BP parameters of a completely self-administered internet-based intervention involving different modules and learning techniques, aimed at promoting lifestyle changes (both physical activity and healthy eating) in obese patients with HTN.
Methods:
A randomised waitlist-controlled trial design was used. We recruited 105 adults with HTN who were overweight/obese and randomly assigned them either to a 3-month internet-based intervention group (IBI; n = 55) or the wait-list control group (WLC; n = 50). We assessed body mass index (BMI: primary outcome), body fat mass (BFM), systolic and diastolic BP (SBP and DBP), blood glucose and insulin levels, physical activity levels, and aerobic exercise capacity at Time 0 (pre-intervention) and Time 1 (post-intervention). All the patients in the WLC group subsequently received the intervention, and a secondary within-group analysis which also included these participants was conducted at Time 2 (12-months follow-up).
Results:
A two-way mixed ANOVA analysis showed a significant decrease in BMI, BFM, and blood glucose at 3 months in the IBI group; the effect size for the BMI and BFM parameters was moderate to large and there was also a borderline significant trend for DPB and insulin. These results were maintained or improved upon at Time 2 and showed significant changes for BMI (mean difference, MD, −0.4; 95% CI −0.1 to −0.6; P=.005), BFM (MD, −2.4; 95% CI −1.1 to −3.6; P<.001), DBP (MD, −1.8; 95% CI −0.2 to −3.3; P=.029), and blood glucose (MD, −2; 95% CI 0 to −4; P=.042).
Conclusions:
Implementation of our completely self-administered internet-based intervention which involved different learning techniques aimed to promote lifestyle changes, resulted in positive short- and long-term health benefits in obese patients with HTN. Clinical Trial: ClinicalTrials.gov NCT03396302; https://clinicaltrials.gov/ct2/show/NCT03396302
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