Toronto (July 16, 2018) – Hypertension patients were able to sustain lifestyle changes throughout one year with the support of an e-counselling program developed by a team of researchers at the Cardiac eHealth and Behavioural Cardiology Research Unit Peter Munk Cardiac Centre (PMCC), University Health Network. Patients who participated in the clinical trial presented, on average, a decrease of 10 points in blood pressure, a change that studies show result in 27 per cent lower risk for stroke and 28 per cent for heart failure. The findings are being published today in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

During 12 months, the participants used the automated platform developed at PMCC in a double-blind trial called REACH (Reducing risk with E-based support for Adherence to lifestyle Change in Hypertension). This innovative comprehensive e-counseling program complements medical therapy by providing online interactive sessions that help patients in keeping healthy habits such as changes in diet, maintaining an exercise routine, supporting medication adherence and smoking cessation.

REACH contains informational and motivational videos, self-monitoring tools that patients use to rate their confidence and register their progress, as well as interactive tools. Participants learn, for example, how to read nutritional labels and get tips from fitness experts on how to design and follow an exercise regime.

In total, 133 participants received regular emails with links to REACH materials while the control group with 131 participants received emails with generic information available from public health websites, to help control blood pressure. The first group achieved an average reduction of 10 points in systolic blood pressure compared to 6 points in the control group.

"It is very exciting to see that patients using REACH showed a meaningful reduction in blood pressure, and that was significantly better in comparison to the control group," says Dr. Rob Nolan, Director of the Cardiac eHealth and Behavioural Cardiology Research Unit at PMCC and the principal investigator of the study.

Over the last seven years, Dr. Nolan has been studying the best strategies to support patients with hypertension. He observed that it is challenging for people to initiate and sustain therapeutic lifestyle changes.

"High blood pressure is unfortunately very common, affecting 40 per cent of the global population and 22 per cent of Canadians, and it is a major risk factor for stroke and heart diseases," says Dr. Nolan. "We need to develop a best-evidence program for lifestyle change that help extend the effectiveness of medical therapy if we want to see this picture change."

As of now, REACH is being adapted for the wider population in Canada and internationally. To achieve that, Dr. Nolan and the team still need to conduct a phase 3 randomized trial that will allow the team to assess REACH's effectiveness in larger scale.

For the REACH trial, participants were men and women, 35 to 74 years of age, living in Toronto, Vancouver, London, ON. and Grey Bruce region of Ontario, and Prince Edward Island.

This study was funded by the Canadian Institutes of Health Research (CIHR).

Patient experience

Virpi Kononen, 60, was one of the participants of the study who used REACH for 12 months. Having tried different diets and programs in the past, she says REACH was particularly effective because it is designed to adjust to each person's needs.

"I found it to be a very structured program, with great information and tools," she says. "It is quite unique in a sense that it is geared to you, to what you need and can do to adopt healthy habits."

Virpi says she started to take morning walks and to make better choices in her daily diet. That resulted in reduced blood pressure, and also reflected in her general well-being.

"It's impressive how little changes can have a huge impact. I feel more balanced, energetic and I sleep better too," she says.


Credit: "Courtesy UHN"

About the Peter Munk Cardiac Centre

The Peter Munk Cardiac Centre (PMCC), established through the generous support of the Munks, is the premier cardiac centre in Canada. Since its opening, the PMCC has saved and improved the lives of cardiac and vascular patients from around the world. Each year, over 163,000 patients receive innovative and compassionate care from multidisciplinary teams in the PMCC, which trains more cardiologists, cardiovascular surgeons, and vascular surgeons than any other hospital in Canada. The PMCC is based at the Toronto General Hospital and the Toronto Western Hospital – members of the University Health Network. For more information, visit

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