Reducing blood pressure through lifestyle changes

Hypertension Exercise Program

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Therapeutic lifestyle changes focusing on weight reduction, exercise, and healthy eating (restricted sodium intake, the dietary approaches to stop hypertension [DASH] eating plan, and moderate alcohol consumption) is the foundation of hypertension management in persons with metabolic syndrome (Table 3) (16). Individuals should also be counseled to stop smoking to reduce their overall CVD risk. A realistic weight loss target is 10% of initial weight over 6 mo. Losing 22 lbs (10 kg) reduces SSP by 5-20 mmHg in a large proportion of overweight individuals (16).

Lifestyle interventions also prevent the development of diabetes, an important consideration in patients with metabolic syndrome. A program comprising weight loss and physical activity reduced the onset of diabetes by almost 60% vs placebo—and was significantly more effective than metformin—in prediabetic individuals with elevated fasting and postload plasma glucose levels (18). Lifestyle modifications also reduce the overall CVD risk by improving other disturbances characteristic of metabolic syndrome, including dyslipidemia, insulin resistance, plasma glucose, and serum levels of C-reactive protein and plasminogen activator inhibitor-1 (19).

Motivating patients to maintain lifestyle changes as a means of long-term blood pressure control presents another challenge to the physician. For example, many patients find it difficult to adhere to weight-reduction programs, or regain the lost weight after discharge from clinical care. Continued observation and encouragement with combined lifestyle interventions and antihypertensive therapy can help patients attain their blood

Table 3

Lifestyle Modifications to Prevent and Manage Hypertension

Table 3

Lifestyle Modifications to Prevent and Manage Hypertension

Modification

Recommendation

Approximate SSP reduction (range)

Weight reduction

Achieve and maintain normal body weight (BMI: 18.5-24.9 kg/m2) e.g.,

5-20 mmHg/10 kg

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