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Online counseling for high blood pressure: Washington Post wisely includes caveats


4 Star


Web-based counseling reduces blood pressure, according to a new study

Our Review Summary

This story describes a study comparing two groups of people with high blood pressure who either received standard online information on lowering blood pressure, or “e-Counseling,” a progressive, more interactive online program that closely mimicked face-to-face counseling.

The story had many strong points–it provided specifics on how much blood pressure was lowered in both the control group and the treatment group–and it explained the details of the study’s design, including limitations. We also appreciated the discussion of how common high blood pressure is and why it’s so important to treat.

That said, the story would have been stronger had it provided more information on when this intervention might become available to the public, and how much it might cost.


Why This Matters

High blood pressure is serious problem for a multitude of people and the story rightfully points out that one in three Americans suffer from it. Therefore, any new treatments–particularly those that involve non-drug interventions–are likely to be of wide interest to many people. News stories have a duty to make it clear when these treatments will be ready for primetime.


Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story didn’t mention the estimated cost; we think that would have been a useful detail to both patients and healthcare providers interested in offering this program.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?


The story makes it clear what the quantified benefits are: Participants in the e-Counseling program saw a 10 mm Hg reduction in systolic blood pressure (the upper number) while the control group saw a reduction of 6 mm Hg.

What would have been useful to add: That the difference–a decrease of 4 mm HG –is clinically meaningful and would provide some health benefits, even though it doesn’t sound like much of a change from the control group.

Does the story adequately explain/quantify the harms of the intervention?

Not Applicable

The story makes no mention of harms that might arise from the use of web-based tools and videos, but it’s hard to envision how they could harm study participants.

Does the story seem to grasp the quality of the evidence?


The story provides adequate details for readers to discern the quality of evidence. This paragraph in particular is helpful:

The randomized, double-blind study included 264 participants with an average age of 58, of whom 58 percent were women. The participants were divided into two groups, one of which received weekly emails with generic information about healthy living that is good for the heart and for reducing high blood pressure, and the other group received weekly emails with links to interactive tools and online multimedia, such as videos of people diagnosed with high blood pressure who made lifestyle changes. These tools were carefully chosen to increase in knowledge about and motivation to maintain a heart-healthy lifestyle.

We were also impressed to see a discussion on the limitations of the research:

“One of the caveats of the study was that participants were highly motivated people looking for ways to cope with and decrease their blood pressure. Participants were also largely white and well-educated, with most having a postsecondary education, so the results of the study might not be generalize well to other groups.”

Does the story commit disease-mongering?


The story does a good job of establishing how prevalent this condition is, and why new interventions are a good thing:

High blood pressure affects 1 in every 3 adults in the United States, according to a fact sheet by the Centers for Disease Control and Prevention. In 2013, high blood pressure was the major cause behind 360,000 deaths in the United States. Reduction in high blood pressure has added health benefits because it can potentially reduce the likelihood of heart attacks, strokes, chronic heart failure and kidney disease.

Does the story use independent sources and identify conflicts of interest?


The story includes quotes from two experts who spoke at the conference session where this research was presented. They do not appear to have any conflicts of interest. However, it’s unclear if the reporter interviewed the sources directly, or used statements they made to the entire audience at the session. The former is more suitable for obtaining comments that pertain to a lay audience like the Post’s.

Does the story compare the new approach with existing alternatives?

Not Applicable

Because the participants were already taking high blood pressure medication, which would be the typical alternative to compare this non-drug intervention against, we’ll rate this N/A.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The story doesn’t address the availability of the web-based program. Because high blood pressure is so common, we think it would have been useful for the story to address when or if this technology will become widely available.

Does the story establish the true novelty of the approach?

Not Satisfactory

The story didn’t explain how unique this treatment was. Is this the first of its kind? Or are similar models already available? The news release states it’s “the first randomized, double-blinded trial of an online behavioral intervention for high blood pressure.” This story would have been stronger if it had included a line or two establishing if this is indeed the case.

Does the story appear to rely solely or largely on a news release?


The story includes information not found in the news release.

Total Score: 5 of 8 Satisfactory


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