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Native opportunities to stop hypertension: study protocol for a randomized controlled trial among urban American

Ka'imi Sinclair1, Cassandra J Nguyen2, Marianna S Wetherill3

  • 1Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, United States.

Frontiers in Public Health
|June 19, 2023
PubMed

Insights

Native Opportunities to Stop Hypertension (NOSH) is a diet intervention for American Indian and Alaska Native (AI/AN) adults with hypertension. This study assessed its effectiveness in lowering systolic blood pressure (BP) and improving cardiovascular disease (CVD) risk factors.

Area of Science:

  • Cardiovascular Disease Research
  • Nutritional Science
  • Public Health Interventions

Background:

  • American Indian and Alaska Native (AI/AN) adults face higher cardiovascular disease (CVD) morbidity and mortality, often linked to hypertension (HTN).
  • Dietary Approaches to Stop Hypertension (DASH) is effective for CVD prevention, but its impact on AI/AN populations requires specific investigation due to unique social determinants of health.

Purpose of the Study:

  • To evaluate the effectiveness of the Native Opportunities to Stop Hypertension (NOSH) intervention on reducing systolic blood pressure (BP) in urban AI/AN adults.
  • To assess the impact of the NOSH intervention on modifiable CVD risk factors and dietary intake within this population.

Main Methods:

  • A randomized controlled trial comparing an adapted DASH intervention (NOSH) with a control group among AI/AN adults (≥18 years) diagnosed with HTN and elevated systolic BP (≥130 mmHg).
  • The NOSH intervention involved eight weekly telenutrition counseling sessions with registered dietitians, focusing on DASH eating principles, with weekly financial incentives for food purchases.
  • Participants received assessments at baseline, 8 weeks, and 12 weeks post-intervention; a subsample underwent extended follow-up to 9 months.

Main Results:

  • The study assessed the primary outcome of systolic blood pressure (BP).
  • Secondary outcomes included changes in modifiable CVD risk factors, heart disease and stroke risk scores, and dietary intake patterns.

Conclusions:

  • The NOSH study is one of the first randomized controlled trials to examine a diet-based intervention for hypertension in urban AI/AN adults.
  • Findings from NOSH have the potential to guide future clinical strategies aimed at reducing blood pressure and improving cardiovascular health in AI/AN communities.
Abstract

Keywords:
American Indian/Alaska Nativeblood pressurecardiovascular diseasedietary approach to stop hypertensionhealth disparitieshealthy diettelenutritionurban health

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