Non-pharmacological management of hypertension: in the light of current research

• Published in: Irish journal of medical science Vol. 188; no. 2; pp. 437 - 452
• Main Authors: Mahmood, Sajid, Shah, Kifayat Ullah, Khan, Tahir Mehmood, Nawaz, Sarfraz, Rashid, Haroon, Baqar, Syed Waqar Ali, Kamran, Sohail
• Format: Journal Article
• Language: English
• Published: London Springer London 01-05-2019
• Subjects: Antihypertensive Agents - pharmacology; Antihypertensive Agents - therapeutic use; Blood Pressure Determination - methods; Diet - methods; Family Medicine; General Practice; Humans; Hypertension - pathology; Hypertension - therapy; Internal Medicine; Life Style; Medicine; Medicine & Public Health; Review Article; Hypertension; Exercise; Non-pharmacological management; Lifestyle modifications; Low salt diet; DASH diet
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-018-1889-8

Hypertension is a major risk factor for a number of cardiovascular diseases. Proper management of hypertension may require both pharmacological and non-pharmacological interventions. Non-pharmacological interventions help reduce the daily dose of antihypertensive medication and delay the progression from prehypertension to hypertension stage. Non-pharmacological interventions include lifestyle modifications like dietary modifications, exercise, avoiding stress, and minimizing alcohol consumption. Nutritional requirements of hypertensive individuals can be addressed through adopting either the DASH diet or through traditional Mediterranean diet. These dietary guidelines promote the consumption of fruits, vegetables, grains, dairy products, and food rich in K
+
, Mg
+2
, Ca
+2
, and phosphorus. Restriction of Na
+
intake has the greatest role in lowering the blood pressure. The DASH diet alone has the effect equal to that of a single drug therapy. After dietary modifications, exercise and weight loss are the second major intervention for hypertension management. Avoiding stressful lifestyle, depression, and anxiety also help to reduce elevated blood pressure. Minimizing alcohol intake also favors the blood pressure reduction. However, lifestyle modification is a dynamic process and requires continuous adherence. It is a multi-factorial approach targeting more than one intervention. However, 6–12-month lifestyle modifications can be attempted in stage-1 hypertensive patients without any cardiovascular complication, in the hope that they may be sufficiently effective to make it unnecessary to use medicines.