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

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.
AuthorsS Susan Hedayati, Essam F Elsayed, Robert F Reilly
JournalKidney international (Kidney Int) Vol. 79 Issue 10 Pg. 1061-70 (May 2011) ISSN: 1523-1755 [Electronic] United States
PMID21389976 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Review)
Chemical References
  • Calcium, Dietary
  • Potassium, Dietary
  • Magnesium
Topics
  • Alcohol Drinking
  • Calcium, Dietary (administration & dosage)
  • Clinical Trials as Topic
  • Diet
  • Diet, Sodium-Restricted
  • Exercise
  • Humans
  • Hypertension (therapy)
  • Magnesium (administration & dosage)
  • Potassium, Dietary (administration & dosage)
  • Weight Loss

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