Investigating novel lifestyle interventions for early-stage hypertension management

Hypertension is rising rapidly in Uzbekistan, yet no evidence‑based lifestyle intervention has been tailored to the local culture. We conducted a randomised controlled trial in Tashkent and two rural districts between February and November 2025 to test a novel, culturally adapted lifestyle programme for adults with early‑stage hypertension (systolic blood pressure 130‑139 mmHg or diastolic 85‑89 mmHg, no medication). One hundred eighty‑four participants were randomly assigned to a six‑month intervention (dietary salt reduction using a marked spoon and local spices, increased walking with step‑counters, stress and sleep management, and daily Telegram support) or standard advice. The primary outcome was change in systolic blood pressure. At six months, the intervention group achieved a mean reduction of 6.8 mmHg compared to 1.2 mmHg in the control group (adjusted difference –5.6 mmHg, 95% CI –6.2 to –5.0, p<0.001). Normalisation of blood pressure occurred in 64.1% of intervention participants versus 18.5% of controls (number needed to treat 2.2). Improvements were also seen in daily salt intake (–2.6 g), walking frequency (+2.5 days/week), sleep duration (+0.7 hours), and perceived stress (–2.4 points). Adherence was good (84% attended most group sessions), and no serious adverse events occurred. The programme worked similarly across urban and rural settings, sexes, and age groups. A culturally adapted, low‑cost lifestyle intervention can substantially lower blood pressure and help most people with early‑stage hypertension avoid or delay medication. These findings have immediate implications for cardiovascular prevention in Uzbekistan and similar low‑resource settings.