E-counseling can significantly lower blood pressure, improve lifestyle and enhance quality of life, says Heart and Stroke Foundation researcher Dr. Robert Nolan.

"E-counseling has the potential to strengthen the effects of medical treatment for high blood pressure," Dr. Nolan told the Canadian Cardiovascular Congress, which is co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society. "We found that it led to an almost double decrease in the blood pressure levels of participants compared to those who did not receive the e-counseling."

The study investigated whether e-counseling contributes to improvement in blood pressure control over a period of at least one year and whether it helps to maintain improved quality of life as well as survival among persons with high blood pressure.

Dr. Nolan and his team from the University Health Network, University of Western Ontario and the Ontario Public Health Unit in Grey Bruce evaluated Heart&Stroke Health eSupport, a Heart and Stroke Foundation personalized action plan and e-mail support program developed to help people control their blood pressure and maintain a healthy lifestyle.

The researchers found that e-counseling motivates people to stay on track with diet and exercise plans, which leads to lower blood pressure.

The moods of people coping with high blood pressure also improved while they were participating in the e-counseling program. Depression is known to have an adverse effect on patients with high blood pressure, says Dr. Nolan. It causes them to lose interest in eating healthy foods and exercising ? two lifestyle choices that can significantly improve their health. "Knowing this, we wanted to look at the effect of e-counseling in terms of improving lifestyle behaviors, as well as decreasing blood pressure."

The study evaluated 387 people ranging in age from 45 to 74, over a four-month period. All had been diagnosed with high blood pressure and 72 per cent were taking one or more blood pressure medications.

One group was sent a standard e-newsletter from the Heart and Stroke Foundation, containing heart health information and general tips to manage their health. The second group received eight emails over four months that provided both educational information as well as motivational messages.

Prior to receiving the emails, the second group filled out surveys identifying what they wanted to change about their lifestyle, such as quitting smoking, improving their diet, or being more physically active. The emails then addressed their individual concerns and included tailored suggestions and personal encouragement to help them achieve their goals.

Participants in the study who received these emails recorded approximately double the amount of decrease in blood pressure, compared to subjects who received just the newsletter, Dr. Nolan reported.

"We found the e-counseling was associated with an improvement in both exercise and diet behavior. The motivational component was therapeutic," said Dr. Nolan. "E-tools to promote healthy lifestyles are becoming an established success ? it's the way of the future."

He notes that study participants ranged in age from 45 to 70. "This was a powerful tool to provide a connection to some of the older participants who were once isolated," says Dr. Nolan. "Seventy years ago someone would be standing in a doctor's office - flash forward to now and people's risks are being reduced in their own homes through the power of e-support."

He says e-counseling may prove to be a cost-efficient way to extend the reach of healthcare programs to people in need, without overtaxing the resources of our healthcare system. He noted that this issue will likely become a research priority if long-term health benefits of e-counseling are established.

"If you know and control your blood pressure, you can cut your risk of stroke by up to 40 per cent and myocardial infarction by up to 25 per cent," says Heart and Stroke Foundation spokesperson Dr. Beth Abramson. "Lifestyle changes such as following a healthy, low sodium diet, being physically active, being smoke-free, achieving and maintaining a healthy weight, and managing stress all reduce your risk."

She says this study suggests that e-counseling, paired with monitoring by a physician and the proper medication, is a promising trio for people dealing with high blood pressure.

With such encouraging results, Dr. Nolan and his team are currently exploring the benefits of e-counseling further with a larger and longer-term clinical trial.

"Our next goal is to study whether e-counseling may also help with adherence to medications for blood pressure control," says Dr. Nolan. "Ongoing support from an e-counseling program may be an effective way to provide education and encouragement to help patients maintain the benefit of their medical treatment."