Effects of the PREMIER interventions on health-related quality of life

Health-related quality of life (HRQOL) is an important aspect of well-being that may improve with health behavior interventions. However, health behavior change is difficult with pressure to maintain status quo.

This report examines the effects of two lifestyle interventions and an advice-only condition on HRQOL. Effects of meeting behavioral goals and weight loss also were examined.

Participants were 295 men and 467 women (34% African American) with pre-hypertension or stage 1 hypertension from the PREMIER trial. HRQOL was assessed by the Short Form-36. Participants were assigned randomly to (1) advice only (ADVICE), (2) established guidelines for blood pressure control (EST), or (3) established guidelines plus the Dietary Approaches to Stop Hypertension (DASH) dietary pattern (EST + DASH).

Assignment to EST resulted in improvement in three HRQOL subscales at 6 months and one at 18 months relative to ADVICE. EST + DASH improved in two subscales at 6 and 18 months compared with ADVICE. Across conditions, total fat, saturated fat, fruit, and vegetable intake change, along with ≥ 4-kg weight loss, resulted in HRQOL improvements at 6 and 18 months. No improvement was found for change in physical activity, and only a few HRQOL subscales were associated with change in sodium and low-fat dairy intake.

Intensive lifestyle interventions can result in improvements in HRQOL. Change in dietary intake and weight loss is also important.