1 Universidade Federal do Rio Grande do Sul, Brazil.
Data on the potential beneficial effects of combining diet and exercise on blood pressure (BP) are still scarce. To evaluate the effects of lifestyle intervention on BP homeostasis, we conducted a fourweek parallel randomized clinical trial in 40 patients with type 2 diabetes and hypertension using antihypertensive drugs and with uncontrolled BP at office (≥140/90 mmHg; Omron HEM705CP) and at ambulatory BP monitoring (ABPM; daytime ≥135/85 mmHg; Spacelabs 90207). Patients were randomly assigned to the Intervention Group [DASH diet plus walking 15-20 min daily, using a pedometer (Digiwalker CW200), additionally to their baseline activity] or Control Group (ADA dietary guidelines without any physical activity recommendation). Baseline characteristics did not differ between Intervention and Control groups. Changes in office BP did not differ between groups. ABPM during the study are shown in the Table. The reduction of 24h and nighttime systolic ABPM was greater in Intervention than in Control group. Daytime ABPM was reduced only in Intervention group. The number of steps and 24h urine aldosterone and potassium increased and the 24h urinary sodium decreased (P <0.05) only in the Intervention group. In conclusion, a DASH diet associated with increased walking induced a significant reduction in ABPM values in patients with type 2 diabetes and uncontrolled hypertension.