This cluster-randomized controlled trial will evaluate whether a 3-month culturally adapted blood pressure-lowering dietary, called the Eastern Blood Pressure-Lowering Diet, can improve blood pressure and related health outcomes in Chinese adults with primary hypertension.
Approximately 800 participants from 16 workplace-based clusters will be assigned to either a standard hypertension management group or a dietary intervention group. Both groups will receive usual hypertension care, including health education and medication treatment when clinically indicated. In addition, participants in the dietary intervention group will receive specially designed weekday lunches, low-sodium salt and reduced-sodium seasonings, and app-based support for dietary recording and adherence monitoring.
The main outcome is change in resting systolic and diastolic blood pressure. Other outcomes include body weight, waist circumference, body fat, blood glucose, blood lipids, homocysteine, kidney function, estimated 24-hour urinary sodium and potassium excretion, lifestyle behaviors, sleep, psychological well-being, and the occurrence of hypertension-related complications or cardiovascular and cerebrovascular events. Blood, urine, and stool samples will also be analyzed to explore possible metabolic and gut microbiome mechanisms underlying the effects of the dietary intervention.
The active dietary intervention will last 3 months, and participants will be followed for up to 24 months.
Inclusion Criteria:
Exclusion Criteria:
jiashu.li@bjmu.edu.cn+86 - 15811092075
Participants will receive standard hypertension management in accordance with current Chinese hypertension guidelines, including routine clinical care, health education, and antihypertensive medication when clinically indicated. Medication decisions will remain under the responsibility of the participants' treating physicians. Participants will also use the study app for questionnaires, health education, dietary recording, and follow-up, and may wear a wearable device to record physical activity, heart rate, and sleep. They will not receive the structured Eastern Blood Pressure-Lowering Diet, workplace intervention lunches, or home sodium-reduction products.
Participants will receive the same standard hypertension management, routine clinical care, health education, app-based follow-up, and wearable-device monitoring as the active comparator group. In addition, they will receive a 3-month structured dietary intervention consisting of standardized blood pressure-lowering lunches provided on working days, with meal energy levels individualized according to sex, age, body mass index, occupational physical activity, and regular exercise. The dietary program emphasizes reduced sodium intake, increased potassium intake, whole grains, vegetables, high-quality protein, healthier fats, and lower-fat cooking methods. Participants will also receive low-sodium salt, reduced-sodium condiments, and salt-measuring utensils for use at home, with dietary adherence monitored through the study app.
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