---
title: "MeDiPA trial: Lifestyle interventions for uncontrolled blood pressure on antihypertensives"
id: "pubmed-42471008"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42471008"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42471008/"
doi: "10.1080/08037051.2026.2705014"
published_at: "2026-08-06T12:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# MeDiPA trial: Lifestyle interventions for uncontrolled blood pressure on antihypertensives
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42471008
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42471008/)
- **DOI:** [10.1080/08037051.2026.2705014](https://doi.org/10.1080%2F08037051.2026.2705014)
- **Published At:** 2026-08-06T12:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The MeDiPA trial is a randomized controlled trial testing whether lifestyle changes lower blood pressure in patients who remain above recommended targets despite taking antihypertensive medication. - Participants had office blood pressure ≥ 130/80 mmHg on two occasions while taking at least two antihypertensive drugs, and were overweight or obese with central adiposity. - Key exclusions included very high BP (≥ 160/100 mmHg), type 1 diabetes, recent cardiovascular events and chronic kidney disease. - Participants were randomized to a hypocaloric **Mediterranean diet**, increased **physical activity**, or control (usual care) for 6 months. - The primary outcome is change in **24-h ambulatory BP** at 6 months. Exploratory outcomes include metabolic measures and quality of life. - The trial included 66 participants (56% women) allocated 21 to diet, 22 to physical activity and 23 to control. Mean age was 59 years. - Baseline mean office BP was 137/90 mmHg; 61% had BP ≥ 140/90 mmHg. Mean BMI was 32.0 kg/m2 and waist circumference averaged ~106 cm in women and ~113 cm in men. - The cohort was predominantly Norwegian (85%) and highly educated (83% with higher education). - Trial registration: NCT04155112; first submitted 2019-10-23. - The trial aims to clarify the additive effect of lifestyle modification on BP control in pharmacologically treated patients who do not reach current recommended targets.
## Clinical Analysis & Structured Key Points
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Epub 2026 Aug 6. # Lifestyle modifications in individuals with blood pressure beyond treatment target despite pharmacological treatment: design and baseline characteristics of the MeDiPA randomised controlled trial [Ana R S de Sousa](https://pubmed.ncbi.nlm.nih.gov/?term=de+Sousa+ARS&cauthor_id=42471008)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#full-view-affiliation-1 "Division of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#full-view-affiliation-2 "Institute of Basic Medical Sciences, University of Oslo, Norway."), [Tor Ole Klemsdal](https://pubmed.ncbi.nlm.nih.gov/?term=Klemsdal+TO&cauthor_id=42471008)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#full-view-affiliation-1 "Division of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway."), [Reza Ghiasvand](https://pubmed.ncbi.nlm.nih.gov/?term=Ghiasvand+R&cauthor_id=42471008)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#full-view-affiliation-3 "Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#full-view-affiliation-4 "Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway."), [Mette Svendsen](https://pubmed.ncbi.nlm.nih.gov/?term=Svendsen+M&cauthor_id=42471008)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#full-view-affiliation-1 "Division of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#full-view-affiliation-2 "Institute of Basic Medical Sciences, University of Oslo, Norway."), [Kåre I Birkeland](https://pubmed.ncbi.nlm.nih.gov/?term=Birkeland+KI&cauthor_id=42471008)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#full-view-affiliation-1 "Division of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#full-view-affiliation-5 "Institute of Clinical Medicine, University of Oslo, Norway."), [Kari Anne Sveen](https://pubmed.ncbi.nlm.nih.gov/?term=Sveen+KA&cauthor_id=42471008)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#full-view-affiliation-1 "Division of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.") Affiliations Expand ### Affiliations * 1 Division of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway. * 2 Institute of Basic Medical Sciences, University of Oslo, Norway. * 3 Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway. * 4 Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway. * 5 Institute of Clinical Medicine, University of Oslo, Norway. * PMID: **42471008** * DOI: [ 10.1080/08037051.2026.2705014 ](https://doi.org/10.1080/08037051.2026.2705014) Free article Item in Clipboard Randomized Controlled Trial # Lifestyle modifications in individuals with blood pressure beyond treatment target despite pharmacological treatment: design and baseline characteristics of the MeDiPA randomised controlled trial Ana R S de Sousa et al. Blood Press. 2026 Dec. Free article Show details Display options Display options Format Abstract PubMed PMID Blood Press Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Blood+Press%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Blood+Press%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42471008/) . 2026 Dec;35(1):2705014. doi: 10.1080/08037051.2026.2705014. Epub 2026 Aug 6. ### Authors [Ana R S de Sousa](https://pubmed.ncbi.nlm.nih.gov/?term=de+Sousa+ARS&cauthor_id=42471008)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#short-view-affiliation-1 "Division of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#short-view-affiliation-2 "Institute of Basic Medical Sciences, University of Oslo, Norway."), [Tor Ole Klemsdal](https://pubmed.ncbi.nlm.nih.gov/?term=Klemsdal+TO&cauthor_id=42471008)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#short-view-affiliation-1 "Division of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway."), [Reza Ghiasvand](https://pubmed.ncbi.nlm.nih.gov/?term=Ghiasvand+R&cauthor_id=42471008)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#short-view-affiliation-3 "Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#short-view-affiliation-4 "Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway."), [Mette Svendsen](https://pubmed.ncbi.nlm.nih.gov/?term=Svendsen+M&cauthor_id=42471008)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#short-view-affiliation-1 "Division of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#short-view-affiliation-2 "Institute of Basic Medical Sciences, University of Oslo, Norway."), [Kåre I Birkeland](https://pubmed.ncbi.nlm.nih.gov/?term=Birkeland+KI&cauthor_id=42471008)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#short-view-affiliation-1 "Division of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#short-view-affiliation-5 "Institute of Clinical Medicine, University of Oslo, Norway."), [Kari Anne Sveen](https://pubmed.ncbi.nlm.nih.gov/?term=Sveen+KA&cauthor_id=42471008)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42471008/#short-view-affiliation-1 "Division of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.") ### Affiliations * 1 Division of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway. * 2 Institute of Basic Medical Sciences, University of Oslo, Norway. * 3 Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway. * 4 Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway. * 5 Institute of Clinical Medicine, University of Oslo, Norway. * PMID: **42471008** * DOI: [ 10.1080/08037051.2026.2705014 ](https://doi.org/10.1080/08037051.2026.2705014) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Many patients pharmacologically treated for hypertension do not reach blood pressure (BP) treatment targets. In Europe, a target of BP < 130/80 mmHg has recently been recommended. Presently, the effect of combining pharmacological approaches and lifestyle changes is unclear. The Hypocaloric Mediterranean Diet or Physical Activity (MeDiPA) randomised controlled trial aims at investigating the effects of lifestyle modifications in patients with uncontrolled hypertension taking antihypertensives. Here, we present the MeDiPA design and baseline population characteristics. **Methods:** We included participants with office BP ≥ 130/80 mmHg on two occasions, taking at least two antihypertensives, with body mass index (BMI) 25-40 kg/m2 and waist circumference ≥88 cm (women)/≥102 cm (men). We excluded participants with BP ≥ 160/100 mmHg, type 1 diabetes, recent cardiovascular disease or chronic kidney disease. Participants were randomised to a hypocaloric Mediterranean-style diet, increased physical activity or control, for 6 months. The main outcome is changes in 24-h ambulatory BP after 6 months. Exploratory outcomes include changes in metabolic parameters and quality of life. **Results:** Sixty-six participants were included (56% women): 21, 22 and 23 in the diet, physical activity and control groups, respectively. Mean (standard deviation) age was 59 (8) years, 85% of participants were Norwegian and 83% had higher education. Mean BMI was 32.0 (4.5) kg/m2 and waist circumference was 106.3 (11.8) cm (women)/113.3 (8.6) cm (men). Mean BP was 137 (15)/90 (8) mmHg and 61% of participants had BP ≥ 140/90 mmHg. **Conclusion:** This trial will improve our understanding of how lifestyle modifications modulate BP in pharmacologically treated patients with uncontrolled hypertension.**Trial registration** [NCT04155112](http://clinicaltrials.gov/show/NCT04155112 "See in ClinicalTrials.gov"); first submitted 2019-10-23. **Keywords:** Mediterranean diet; Weight-loss; blood pressure; cardiometabolic disease; metabolic syndrome; physical activity. ## Plain language summary Many patients medicated for high blood pressure (BP) do not achieve BP as low as recommended.Recently, BP guidelines have become stricter and medicated patients are now recommended BP < 130/80 mmHg.Whether BP medication in combination with lifestyle changes help achieve recommended BP levels is unknown.Our study will investigate the effects of lifestyle changes in patients who take BP medication but do not reach the recommended BP levels.We included participants with BP ≥ 130/80 mmHg twice, taking at least two BP medications, who were overweight or obese and had central obesity. Individuals with very high BP, type 1 diabetes, recent history of heart disease or chronic kidney disease were excluded.Participants were randomly distributed to one of the three possible groups: a healthy low-calorie diet, increased physical activity or usual care, for 6 months. We measured participants at the start of the study, after 3, 6 and 12 months.Our main interest is changes in 24-h BP after 6 months. Additionally, we will investigate other health effects.We included 66 participants (56% women): 21 in the diet group, 22 in the physical activity group and 23 in the usual care group. On average, participants were 59 years old and had BP 137/90 mmHg; 85% were Norwegian and 83% had higher education. Overall, we included participants at high risk of cardiovascular disease.Our study will help understand how lifestyle changes can affect BP patients who already take BP medication. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Publication types * Randomized Controlled Trial Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Randomized+Controlled+Trial%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Randomized+Controlled+Trial) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42471008/) ## MeSH terms * Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42471008/) * Antihypertensive Agents* / therapeutic use Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Antihypertensive+Agents%2Ftherapeutic+use%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Antihypertensive+Agents) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42471008/) * Blood Pressure* / drug effects Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Blood+Pressure%2Fdrug+effects%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Blood+Pressure) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42471008/) * Diet, Mediterranean* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Diet%2C+Mediterranean%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Diet%2C+Mediterranean) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42471008/) * Exercise* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Exercise%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Exercise) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42471008/) * Female Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Female) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42471008/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42471008/) * Hypertension* / drug therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Hypertension%2Fdrug+therapy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Hypertension) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42471008/) * Hypertension* / physiopathology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Hypertension%2Fphysiopathology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH
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