A non-blind cluster RCT as part of the Community-Based Intervention for Control of Hypertension in Nepal (COBIN) trial was conducted in Nepal to assess the impact of lifestyle modification on blood pressure.

The study involved 1638 adults aged 25–65, divided into three cohorts based on blood pressure: normotensive, pre-hypertensive, and hypertensive. 

Female community health volunteers were trained to provide counseling four times during a 12-month intervention period for lifestyle modification. 

At the end of the intervention, SBP was significantly lower in the intervention group compared to the usual care group. 

However, after 60 months, the mean SBP increased by 10.4 mm Hg (95% CI 9•1–11•6) in the intervention group and 6.0 mm Hg (4•6–7•5) in the usual care group. 

This highlights the need for regular and timely counseling to sustain the beneficial effects of behavior change interventions. A Nepal Study revealed that limited-duration lifestyle interventions are unsustainable for blood pressure control.