Non-pharmacological aspects of blood pressure management: What are the data

S. Susan Hedayati, Essam F. Elsayed, Robert F. Reilly

Research output: Contribution to journalReview articlepeer-review

49 Scopus citations

Abstract

Hypertension affects 29% of US adults and is a significant risk factor for cardiovascular morbidity and mortality. Epidemiological data support contribution of several dietary and other lifestyle-related factors to the development of high blood pressure (BP). Several clinical trials investigated the efficacy of non-pharmacological interventions and lifestyle modifications to reduce BP. Best evidence from randomized controlled trials supports BP-lowering effects of weight loss, the Dietary Approaches to Stop Hypertension (DASH) diet, and dietary sodium (Na+ ) reduction in those with prehypertension, with more pronounced effects in those with hypertension. In hypertensive participants, the effects on BP of DASH combined with low Na + alone or with the addition of weight loss were greater than or equal to those of single-drug therapy. Trials where food was provided to participants were more successful in showing a BP-lowering effect. However, clinical studies with long-term follow-up revealed that lifestyle modifications were difficult to maintain. Findings from controlled trials of increased potassium, calcium, or magnesium intake, or reduction in alcohol intake revealed modest BP-lowering effects and are less conclusive. The reported effects of exercise independent of weight loss on BP are inconsistent.

Original languageEnglish (US)
Pages (from-to)1061-1070
Number of pages10
JournalKidney international
Volume79
Issue number10
DOIs
StatePublished - May 2011

Keywords

  • DASH diet
  • blood pressure
  • hypertension
  • lifestyle modification

ASJC Scopus subject areas

  • Nephrology

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