Chronic hypertension lifestyle modification: Difference between revisions
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| In the United States, 1 “standard” drink contains roughly 14 g of pure alcohol, which is typically found in 12 oz of regular beer (usually about 5% alcohol), 5 oz of wine (usually about 12% alcohol), and 1.5 oz of distilled spirits (usually about 40% alcohol) | | In the United States, 1 “standard” drink contains roughly 14 g of pure alcohol, which is typically found in 12 oz of regular beer (usually about 5% alcohol), 5 oz of wine (usually about 12% alcohol), and 1.5 oz of distilled spirits (usually about 40% alcohol) | ||
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==2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk<ref name="pmid24898715">{{cite journal |vauthors= |title=Reprint: 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk |journal=J Am Pharm Assoc (2003) |volume=54 |issue=1 |pages=e2 |year=2014 |pmid=24898715 |doi=10.1331/JAPhA.2014.14501 |url=}}</ref>== | ==2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk<ref name="pmid24898715">{{cite journal |vauthors= |title=Reprint: 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk |journal=J Am Pharm Assoc (2003) |volume=54 |issue=1 |pages=e2 |year=2014 |pmid=24898715 |doi=10.1331/JAPhA.2014.14501 |url=}}</ref>== | ||
Revision as of 21:34, 24 November 2017
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Chronic Hypertension Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Lakshmi Gopalakrishnan , M.D.
Overview
Lifestyle modification may prevent or delay the occurrence of hypertension, reduce the blood pressure, increase the efficacy of medications, decrease risk factors for hypertension and reduce the incidence of target organ damage. Lifestyle modification should be implemented in all hypertensive patients irrespective of the hypertensive stage. lifestyle changes alone can be considered as initial antihypertensive measure in patients with stage 1 hypertension, even in the presence of up to 1 or 2 risk factors (excluding diabetes or metabolic syndrome or established target organ damage). In these patients, pharmacologic therapy can wait for three to six months until lifestyle changes alone are provided a chance to control blood pressure.
2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults
Nonpharmacological Interventions
| Class I |
| "1. Weight loss is recommended to reduce BP in adults with elevated BP or hypertension who are overweight or obese.(Level of Evidence: A) " |
| "2. A heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, that facilitates achieving a desirable weight is recommended for adults with elevated BP or hypertension.(Level of Evidence: A) " |
| "3. Sodium reduction is recommended for adults with elevated BP or hypertension.(Level of Evidence: A) " |
| "4. Potassium supplementation, preferably in dietary modification, is recommended for adults with elevated BP or hypertension, unless contraindicated by the presence of chronic kidney disease (CKD) or use of drugs that reduce potassium excretion.(Level of Evidence: A) " |
| "5. Increased physical activity with a structured exercise program is recommended for adults with elevated BP or hypertension.(Level of Evidence: A) " |
| "6. Adult men and women with elevated BP or hypertension who currently consume alcohol should be advised to drink no more than 2 and 1 standard drinks* per day, respectively.(Level of Evidence: A) " |
| In the United States, 1 “standard” drink contains roughly 14 g of pure alcohol, which is typically found in 12 oz of regular beer (usually about 5% alcohol), 5 oz of wine (usually about 12% alcohol), and 1.5 oz of distilled spirits (usually about 40% alcohol) |
2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk[1]
Recommendations for Lifestyle Management to Reduce Blood Pressure
Diet
| Class I |
| "1. 1. Consume a dietary pattern that emphasizes intake of vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, nontropical vegetable oils, and nuts; and limits intake of sweets, sugar-sweetened beverages, and red meats. a. Adapt this dietary pattern to appropriate calorie requirements, personal and cultural food preferences, and nutrition therapy for other medical conditions (including diabetes). |
| "2. Lower sodium intake.(Level of Evidence: A)" |
| "3. Combine the DASH dietary pattern with lower sodium intake.(Level of Evidence: A)" |
| Class IIa |
| "1. a. Consume no more than 2,400 mg of sodium/d; b. Further reduction of sodium intake to 1,500 mg/d can result in even greater reduction in BP; and |
Physical Activity
| Class IIa |
| "1. In general, advise adults to engage in aerobic physical activity to lower BP: 3–4 sessions per wk, lasting on average 40 min per session, and involving moderate- to vigorous-intensity physical activity. (Level of Evidence: A)" |
2013 ESH/ESC Guidelines For The Management of Arterial Hypertension[2]
Summary of Recommendations on Lifestyle Modification[2]
| Class I |
| "1. Salt restriction to 5-6 g per day is recommended.(Level of Evidence: A)" |
| "2. Moderation of alcohol consumption to no more than 20-30 g of ethanol per day in men and to no more than 10-20 g of ethanol per day in women is recommended. (Level of Evidence: A)" |
| "3. Increased consumption of vegetables, fruits, and low-fat dairy products is recommended.(Level of Evidence: A)" |
| "4. Reduction of weight to BMI of 25 kg/m2 and of waist circumference to <102 cm in men and <88 cm in women is recommended, unless contraindicated.(Level of Evidence: A)" |
| "5. Regular exercise, i.e. at least 30 min of moderate dynamic exercise on 5 to 7 days per week is recommended.(Level of Evidence: A)" |
| "6. It is recommended to give all smokers advice to quit smoking and to offer assistance.(Level of Evidence: A)" |
References
- ↑ "Reprint: 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk". J Am Pharm Assoc (2003). 54 (1): e2. 2014. doi:10.1331/JAPhA.2014.14501. PMID 24898715.
- ↑ 2.0 2.1 Authors/Task Force Members. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A; et al. (2013). "2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)". Eur Heart J. 34 (28): 2159–219. doi:10.1093/eurheartj/eht151. PMID 23771844.