Hypertension lifestyle modifications

Recommend appropriate lifestyle modifications and pharmacotherapy for patients with hypertension. 

Therapeutic lifestyle modifications consisting of nonpharmacologic approaches to blood pressure reduction should be an active part of all treatment plans for patients with hypertension. The most widely studied interventions demonstrating effectiveness include ... 

The results of these trials demonstrate that ERT or HRT should not be prescribed for the prevention of CHD or in patients with preexisting CHD. For women suffering from vasomotor symptoms with a history of CHD, including CHD risk factors, alternative therapies should be considered. Additionally, lifestyle modifications should be implemented, and therapies to treat risk factors such as hypertension and hyperlipidemia should be prescribed. It is important to note that the average age of women included in the HERS and the WHI trials was 67 and 63 years, respectively. Therefore, these trials were unable to assess the true risk in younger, potentially healthier women with fewer cardiovascular risk factors. 

All patients with prehypertension and hypertension should be prescribed lifestyle modifications, including (1) weight reduction if overweight, (2) adoption ofthe Dietary Approaches to Stop Hypertension eating plan, (3) dietary sodium restriction ideally to 1.5 g/day (3.8 g/day sodium chloride), (4) regular aerobic physical activity, (5) moderate alcohol consumption (two or fewer drinks per day), and (6) smoking cessation. 

Lifestyle modification alone is appropriate therapy for patients with prehypertension. Patients diagnosed with stage 1 or 2 hypertension should be placed on lifestyle modifications and drug therapy concurrently. 

Svetkey LP, Erlinger TP, Vollmer WM, et al. Effect of lifestyle modifications on blood pressure by race, sex, hypertension status, and age. / Hum Hypertens. 2005 19 21-31. 

The Clinical Knowledge Summary on Hypertension (2007) suggests that people with hypertension should be advised on appropriate lifestyle modifications to reduce cardiovascular disease risk. Advice should be given on ... 

Individual lifestyle modifications that are known to reduce blood pressure include (North of England Hypertension Guideline Development Group, 2006) ... 

I ll end this chapter with one more set of statistics, not to scare you but rather to encourage you to make your best possible effort to control both your diabetes and your hypertension. By all means, try the lifestyle modifications, including diet and exercise, and give the supplements a chance. But if they don t take you all the way to... 

This study confirmed the findings of another project, the Atherosclerosis Risk in Communities Study, which found that retinal blood vessel narrowing predicted hypertension within three years. Doctors point out that by knowing the risk of future blood pressure problems, one can immediately take lifestyle modification steps to avoid them. 

Lifestyle modifications should be prescribed in all patients with hypertension and prehypertension. However, they should never be used as a replacement for antihypertensive drug therapy in patients with hypertension. 

After a dehnitive diagnosis of hypertension is made, patients should be placed on both lifestyle modihcations and drug therapy concurrently. Lifestyle modihcation alone is considered appropriate therapy for patients with prehypertension. However, lifestyle modifications alone are not considered adequate for patients with hypertension or patients with BP goals of less than 130/80 mm Hg (those with diabetes and chronic kidney disease) who have BP values above their goal. 

TABLE 13—4. Lifestyle Modifications to Prevent and Manage Hypertension... 

Many women with pregnancy-inflnenced gastrointestinal issues can be treated safely with lifestyle modification or medications, many of them nonprescription. Gestational diabetes, hypertension, and thyrotoxicosis may or may not require drug therapy venous thromboembolism usually will require therapy with a low-molecular-weight heparin and compression stockings. 

The indications and efficacy of various lifestyle modifications in hypertension are reviewed in a summary statement from the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (www.nhlbi.nih.gov/guidelines/hypertension). 

LEAD patients often suffer from comorbidities, including hypertension, diabetes mellitus, dyslipidemia, and coronary artery disease. In addition, the sedentary lifestyle fostered by claudication accelerates the deterioration of cardiorespiratory and muscular functions, and leads to a decline in the overall health and quality of life for the LEAD patient (4). Thus, treatment for intermittent claudication should include lifestyle changes for positive modification of the traditional cardiovascular disease risk factors. 

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