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Hypertension

Lifestyle modifications

Introduction

  • Stage 1 hypertension with low cardiovascular disease risk can be managed by lifestyle changes alone for the first 3-6 months and then re-evaluated. Many will require medications (1)


NUTRITION

  • Limit daily sodium intake to < 1.5g (1)

  • Potassium rich diet unless contraindicated (1)

  • Dietary approaches to stop hypertension (DASH) diet: 8-10 servings of fruit and vegetables daily, whole grains, low sodium, low-fat proteins (1)

  • Limit alcohol intake to max 20-30g/d for men, or 10-20g/d for women (1). Excessive alcohol intake increases blood pressure (3)

  • Beetroot: A daily intak of 70-250 ml beetroot juice reduces systolic blood pressure in people with arterial hypertension (2)

  • A high intake of dietary fiber reduces blood pressure (4)

  • Replacing carbohydrates with soy protein or dairy protein has been shown to reduce blood pressure (4)


PHYSICAL ACTIVITY

  • Regular physical activity, preferrably 30 minutes of moderate intensity aerobic exercise 5 days a week or 150 min / week (1)

  • Regular aerobic or resistance training may reduce blood pressure on average 4-6 mmHg (3)


SLEEP

  • Insufficient sleep (< 7 hours) is a risk factor for hypertension, and increasing the amount of sleep may lower blood pressure  (3)


SMOKING

  • Smoking cessation for maintaining good vascular health. However smoking cessation is not associated with reduced blood pressure (1)


WEIGHT

  • Weight loss if obese (1)

  • Weight circumference for men: < 102cm. 

  • Weight circumference for women: < 88cm

  • For every kg weight loss blood pressure is reduced by 0.5 - 2 mmHG (3)

References

Resources

Evidence Pyramid

EXPLANATION TO EVIDENCE PRESENTATION

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Evidence based on guidelines and evidence based Clinical Decision Systems is written in BOLD

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Evidence based on meta analysis or systematic reviews is written in BOLD and CURSIVE

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Evidence based on randomized controlled trials is written in plain font

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Evidence based on observational / cohort studies is written in CURSIVE

Figure: Evidence pyramid

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