Importance of lifestyle in the relationship to hypertension and lifestyle changes

Importance of lifestyle

• Has implications for both the prevention and treatment of hypertension

• Interventions should address overall cardiovascular disease risk

• Been shown to prevent the development of hypertension

• If these interventions do not produce a sufficient reduction of blood pressure to avoid drug therapy, the number of medications or dosages required for blood pressure control may be reduced

• Obesity

- Prevention and treatment of obesity are important for reducing blood pressure and
cardiovascular disease risk.

- Even modest weight loss can lead to a reduction of blood pressure and an increase of insulin
sensitivity.

- A Cochrane review of 18 trials with 2611 participants concluded that for overweight
hypertensive patients, weight loss of 3% to 9% of body weight is associated with 3 mm Hg
decreases in both SBP and DBP

• •Physical activity

- Regular physical activity facilitates weight loss, decreases blood pressure, and reduces the overall risk of cardiovascular disease.

- A well-done systematic review and meta-analysis from 2002 (including 15 studies with 770 participants) concluded that for hypertensive patients, aerobic exercise with at least one 40-minute session of moderate intensity per week is associated with a drop in SBP of about 5 mm Hg and a drop in DBP of about 4 mm Hg.

• Salt intake

- A Cochrane review of 17 trials with 734 participants concluded that for individuals with
hypertension, a reduced-salt diet results in a mean SBP and DBP reductions of 5 mm Hg
and 3 mm Hg, respectively

• Alcohol intake

- A well-done meta-analysis of alcohol reduction and blood pressure included 7 studies with
415 hypertensive patients.

- Mean baseline alcohol consumption was 3 to 6 alcoholic drinks per day, and the mean
reduction in consumption was 67%.

- For this patient population, the average improvement was almost 4 mm Hg for SBP and
nearly 2.5 mm Hg for DBP.

• DASH diet

- The DASH (Dietary Approaches to Stop Hypertension) trial convincingly demonstrated
that over an 8-week period a diet high in fruits, vegetables, and low-fat dairy products
lowers blood pressure in individuals with high-normal blood pressures or mild
hypertension.

- Participants were provided with all food during the entire 8-week length of the trial.

- DASH diet lowered SBP for hypertensive patients by an average of 11 mm Hg and DBP by
an average of 5.5 mm Hg compared with the control group.


Lifestyle changes to manage hypertension

• Stop smoking

• Reduce alcohol intake (consume 2 drinks/day in men and 1 drink/day in women)

• Reduce salt intake

• Increase physical activity
  

• Reduce weight if obese