Medically-tailored Meals for Hypertension

(SMART Trial)

This trial aims to find the best way to assist people with high blood pressure who struggle to access enough healthy food. It will test various methods, including home-delivered medically-tailored meals (MTM), community health worker support, and resource information, to determine which helps individuals adhere to their treatment and improve blood pressure. Suitable candidates for this trial include those with high blood pressure who are on medication, face challenges in obtaining nutritious food, and have recently visited their primary care doctor. As an unphased trial, this study provides a unique opportunity to explore innovative solutions for managing high blood pressure and improving access to nutritious food.

The trial does not specify if you need to stop taking your current medications. However, since it involves people already prescribed blood pressure medications, it seems likely you can continue them.

Research has shown that meals designed for medical needs are generally safe and can improve health. For example, one study found that recipients of these meals had better nutrition and fewer instances of low blood sugar. Another study demonstrated that these meal programs benefit people with serious illnesses. Dietitians plan these meals to help manage conditions like high blood pressure.

Community health worker support is also safe and effective. Studies have shown that when community health workers assist, people better control their blood pressure. This support helps individuals manage high blood pressure and leads to improved health.

Researchers are excited about medically-tailored meals (MTM) for hypertension because they offer a personalized dietary approach that could directly impact blood pressure management. Unlike standard treatments like medications and lifestyle changes, MTM delivers weekly meals specifically designed by dietitians based on the DASH diet, which has been shown to lower blood pressure. Additionally, the involvement of community health workers (CHWs) provides personalized support, helping participants overcome barriers in managing their condition. This holistic approach, combining tailored nutrition with community support, sets it apart from typical hypertension treatments.

This trial will compare the effects of different interventions on hypertension management. Participants in one arm will receive Medically-tailored Meals (MTM), which research has shown can improve health for people with certain illnesses. One study found that people following a diet similar to MTM, called the DASH diet, experienced a greater drop in their top blood pressure number by 5.7 points compared to those managing their diet independently. However, another study found no significant change in blood pressure after 12 weeks of using MTM.

Another arm will involve assistance from Community Health Workers (CHWs). Research indicates that CHWs can greatly improve blood pressure control. Specifically, one study showed that 68.2% of people working with CHWs had better blood pressure control compared to 41.6% in a group without this help.