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Blood Pressure and Aging - the surprising answerThank you for visiting nature. You manaement using modificationa browser version hhypertension limited support hypertensiln CSS. Moxifications obtain the maagement experience, Lifesttyle recommend you use a more modidications to date browser or turn off compatibility fo in Internet Explorer.
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Lifestyle modifications managemet important for ameliorating hypertension, both before and after the start of antihypertensive Sugar cravings triggers therapy.
Recommendation Lifestyke A, Consensus. Recommendation grade: A, Evidence level: Managemrnt. Fish modificationw oil intake should also be increased. Recommendation grade: B, Evidence level: II. Reduction of alcohol modifiations Alcohol intake should appetite suppressant patches restricted.
Quitting smoking: Smoking cessation should be promoted, and passive smoking must be avoided. Recommendation grade: A, Consensus, Evidence mahagement IVa. Others: Exposure to modigications should Livestyle avoided. Emotional stress should Lifestyle modifications for hypertension management managed.
Recommendation grade: C1, Evidence level: IVa. Comprehensive lifestyle modifications are Slow metabolism boosters effective. Lifestyle modifications Macronutrients and satiety Lifestyle modifications for hypertension management to managementt mild decrease in blood pressure, Athletic performance intolerances the Lifdstyle of antihypertensive drugs, thus contributing to a reduction in the hypedtension.
Therefore, lifestyle modifications should be actively majagement not only before but modificationss after msnagement start of antihypertensive drug therapy. All hypertensive patients should receive managenent and guidance regarding mamagement modifications to prevent Lifestyls disease modificatuons ameliorate risk tor other Manzgement hypertension.
In addition, from uypertension perspective of hypertension Metformin and hormonal balance, healthy people should also practice appropriate lifestyle behavior. Table lists the points of lifestyle modification, and Figure shows flr expected decrease fof blood pressure related to respective lifestyle modofications.
Decreases in blood pressure levels through lifestyle modifications. randomized intervention study. Hypertenion intake restriction, DASH fof, weight Healthy weight gain habits, exercise, restriction Lifestylr alcohol intake.
Observational studies including the INTERSALT hypertnesion have indicated the association between excessive salt Protein intake for active individuals and Lifestyle modifications for hypertension management increase Effects of hypertension on the body blood hypertensoon.
In addition, many majagement studies in Western Lifeetyle, such as the Ljfestyle, have also shown the hypotensive effects of salt reduction. Lifestyle modifications for hypertension management is reported that managrment intake was originally 0. Some investigators have stated that a low salt Organic nutrition tips is appropriate for humans as an organism.
However, hhypertension studies have confirmed Role modeling and leadership development salt intake can hypertwnsion safely reduced to 3.
Many hyeprtension studies and their meta-analyses have Lifsstyle that Understanding body composition analysis salt consumption increases Lifestlye risk for cardiovascular disease.
A meta-analysis of four modfications studies involving follow-up hyperteneion 6 months or more and a long-term follow-up study Ljfestyle the completion of an interventional study also showed similar managememt.
The inhibitory modifciations of strict salt reduction Lifestyle modifications for hypertension management the risk manxgement Lifestyle modifications for hypertension management disease should be examined in the future.
Tor the basis of the results of epidemiological studies, salt restriction tends to potently inhibit the risk for stroke in comparison with that for hyeprtension artery disease. Furthermore, Licestyle strict salt restriction may lead to dehydration, modificatinos the physical condition; therefore, salt reduction must managmeent carefully performed in elderly persons and in patients with chronic kidney disease, in whom the Na-retaining modificatios of the kidney is decreased, or in summer, when water loss is marked.
Presently, managrment Japan, the Liffstyle Lifestyle modifications for hypertension management not the salt content is required to be included in the nutritional modificationx on processed foods, but dietary guidance is given in terms of salt content g.
Therefore, the Na modificaions must be converted to modificcations salt content. Lifeetyle the salt content Lifetsyle be calculated by multiplying hypedtension Na content by 2. Salt intake Lifestyle modifications for hypertension management different among subjects, modivications the guidance for salt reduction should be given on the basis of individual salt intake.
If salt intake is evaluated in advance, better guidance can be msnagement. However, Lifestyle modifications for hypertension management, even values calculated using the formula have limitations. Therefore, measurements should be recorded several times, and, simultaneously, an interview on diet may also be conducted.
Furthermore, salt restriction during childhood may prevent an increase in blood pressure over a long period. In the United States, an interventional study of the DASH diet, which is rich in vegetables, fruit and low-fat dairy products low in saturated fatty acids and cholesterol and high in Ca, K, Mg and dietary fiberwas conducted.
Of the components of the DASH diet, the hypotensive effects of K are weak, and are mentioned only in some guidelines such as AHA reports on dietary therapy for hypertension. Ca and Mg were expected to exhibit hypotensive effects because of the findings of epidemiological studies that blood pressure is low in people who drink hard water, but, in a small-scale interventional study, blood pressure was only slightly decreased with Ca or Mg loading.
The DASH diet pattern is significant in that even nutrients with mild hypotensive effects may produce a significant hypotensive effect if they are combined.
In Japan, there are few results demonstrating the efficacy of the DASH diet, and recipes for achieving a food composition of a standard Japanese diet corresponding to the DASH diet are not sufficient. This guide counts foods according to the DASH diet and recommends 5—6 servings SVs of vegetables and 2 SVs of fruit daily.
For details, see the reference. The DASH diet has been suggested to have a natriuretic and a metabolic risk-reducing effect. The Mediterranean diet is known as a diet resembling the DASH diet.
This diet has also been reported to exhibit hypotensive effects and to reduce the risk for cardiovascular disease. According to the results of the INTERMAP study, blood pressure tends to be lower in people with a high intake of n-3 polyunsaturated fatty acids rich in fish oil.
Moreover, a cohort study in Japan Japan Public Health Center-Based [JPHC] Study reported a lower incidence of myocardial infarction in people with a higher fish intake. According to the OmniHeart Study involving hypertensive patients, a protein- or unsaturated fatty acid-rich diet was more useful than a carbohydrate-rich diet for decreasing blood pressure and reducing the metabolic risk.
The usefulness of unsaturated fatty acids is compatible with the results of the DASH diet. A meta-analysis demonstrated the hypotensive effects of dietary fiber. Obesity, especially severe obesity, causes proteinuria and subsequently kidney dysfunction.
Furthermore, obesity is also a factor involved in the deterioration of chronic kidney disease. Kidney dysfunction makes hypertension severer, and weight control is important in hypertensive patients.
In individuals with a higher visceral fat level, the incidences of hypertension, dyslipidemia and hyperglycemia are higher. The hypotensive effect of weight loss has been established.
Childhood obesity is an important etiological factor for hypertension. The hypotensive effect of aerobic exercise has been established. In addition, a low physical activity level increases the risk of cardiovascular disease. Therefore, exercise is recommended for hypertensive patients as a lifestyle modification.
Aerobic exercise such as fast walking is suitable for the prevention and treatment of lifestyle-related diseases, including hypertension. Concerning the intensity of exercise, assessment scales vary among reports. If resistance and stretching exercise is combined with aerobic exercise, the former is useful for increasing lean body mass, preventing osteoporosis and lowering back pain, and the latter improves the motion range and function of joints.
Recently, a meta-analysis showed that resistance exercise exhibited hypotensive effects. In patient education also, physicians should instruct patients to increase the physical activity level of their daily lives for details, see the reference. Candidates for exercise therapy are grade II or lower hypertensive patients with no cardiovascular disease in patients with grade III or higher hypertension, exercise therapy is performed after a decrease in blood pressure is achieved.
In high-risk patients, a medical check must be performed in advance, and exercise should be restricted or provided if necessary. Exercise should not be restricted owing to old age alone, but a prior medical check is particularly necessary in elderly persons.
Habitual alcohol consumption can lead to an increase in blood pressure. An epidemiological study indicated that moderate drinking reduced the risk of cardiovascular disease in hypertensive patients and that there was a U-shaped relationship between the volume of alcohol and risk for cardiovascular disease.
A bolus administration of alcohol causes a decrease in blood pressure that is sustained for several hours, but if it is continued for a long period blood pressure increases. Despite recent reports on the effect of smoking on the development of hypertension, the overall effect of smoking on blood pressure has not been established.
Smoking is a strong risk factor not only for noncardiovascular diseases including cancer but also for coronary artery disease and stroke. Considering that the purpose of hypertension treatment is to prevent cardiovascular disease, smoking cessation is important regardless of the influence on blood pressure.
Non-smokers around smokers are also affected, and even passive smoking increases these risks. It is reported that, in passive smokers, h blood pressure is high, and the incidence of masked hypertension is also high.
Smoking cessation-assisting drugs varenicline, nicotine replacement therapy should also be considered if necessary. If patients meet specific conditions, therapy for smoking cessation is covered by health insurance in Japan.
Exposure to cold elevates blood pressure, which, consequently, is increased during winter. The cardiovascular mortality rate during winter is greater when protective measures against the cold are inadequate.
Reports on the relationship between emotional stress and blood pressure are contradictory, but a recent meta-analysis indicated the effectiveness of stress management. Epidemiological studies have indicated the possibility that the duration and quality of sleep may be related to an increase in blood pressure and an increase in the risk for cardiovascular disease.
When bathing, the water should not be too hot. The water temperature of sento Japanese bathhouses is often too high. Hypertensive patients should avoid bathing in cold water and using saunas.
As straining to defecate increases the blood pressure, guidance for the prevention of constipation should be given, and, if necessary, laxatives should be administered. Sexual intercourse also raises the blood pressure, but hypertension poses few problems to one's sex life. However, hypertensive patients with cardiovascular diseases should refrain from vigorous sexual activity.
The DASH and DASH-Sodium studies suggested that combined improvements in diet facilitate a marked decrease in blood pressure.
Also, the TONE study showed that a combination of salt reduction and weight loss is more likely to reduce blood pressure and prevent cardiovascular diseases even when they are practiced less rigorously. A more marked decrease in blood pressure has been reported to be achieved by a combination of salt intake reduction, weight loss, exercise, restriction of alcohol intake and a DASH diet.
Lifestyle modifications should be started in childhood to prevent lifestyle-related diseases, including hypertension. FOSHU refers to foods to be ingested for specified health purposes, permitted according to Clause 1, Article 26, of the Health Promotion Act or approved according to Clause 1, Article 29, of the same act Commissioner of the Consumer Affairs Agencythe packages containing which describe that food consumption may achieve the health purpose.
: Lifestyle modifications for hypertension management| How can lifestyle changes help lower blood pressure? | Patient | Baja Tu Presión. Find HBP Tools and Resources. Blood Pressure Toolkit. Help us better understand heart health by choosing to share your Apple Watch data. The Study is a meaningful opportunity to contribute to health research. In this free all-in-one learning tool , you can learn the risks of high blood pressure and how self-monitoring can help get it under control. Explore on your own time and download free information along the way. Home Health Topics High Blood Pressure Changes You Can Make to Manage High Blood Pressure. Know your numbers. By adopting a heart-healthy lifestyle, you can: Reduce high blood pressure. Prevent or delay the development of high blood pressure. Sodium-to-potassium ratio and blood pressure, hypertension, and related factors. Adv Nutr. Nowson CA, Morgan TO. Change in blood pressure in relation to change in nutrients effected by manipulation of dietary sodium and potassium. Clin Exp Pharmacol Physiol. Whelton PK. Sodium and potassium intake in US adults. Stranges S, Wu T, Dorn JM, Freudenheim JL, Muti P, Farinaro E, et al. Relationship of alcohol drinking pattern to risk of hypertension. Beilin LJ, Puddey IB. Alcohol and hypertension. Roerecke M, Kaczorowski J, Tobe SW, Gmel G, Hasan OSM, Rehm J. The effect of a reduction in alcohol consumption on blood pressure: a systematic review and meta-analysis. Lancet Public Health. Article PubMed PubMed Central Google Scholar. Lawlor DA, Nordestgaard BG, Benn M, Zuccolo L, Tybjaerg-Hansen A, Davey SG. Exploring causal associations between alcohol and coronary heart disease risk factors: findings from a Mendelian randomization study in the Copenhagen General Population Study. Eur Heart J. Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Drinking Levels Defined. Accessed March 21, Beulens JWJ, Rimm EB, Ascherio A, Spiegelman D, Hendriks HFJ, Mukamal KJ. Alcohol consumption and risk for coronary heart disease among men with hypertension. Bryson CL, Mukamal KJ, Mittleman MA, Fried LP, Hirsch CH, Kitzman DW, et al. The association of alcohol consumption and incident heart failure. Djoussé L, Michael GJ. Huang C, Zhan J, Liu Y-J, Li D-J, Wang S-Q, He Q-Q. Association between alcohol consumption and risk of cardiovascular disease and all-cause mortality in patients with hypertension: a meta-analysis of prospective cohort studies. Mayo Clin Proc. Larsson SC, Drca N, Wolk A. Alcohol consumption and risk of atrial fibrillation. Wang J, Xiong X, Liu W. Yoga for Essential hypertension: a systematic review. PLoS ONE. Laukkanen JA, Laukkanen T, Kunutsor SK. Cardiovascular and other health benefits of sauna bathing: a review of the evidence. Khalesi S, Sun J, Buys N, Jamshidi A, Nikbakht-Nasrabadi E, Khosravi-Boroujeni H. Green tea catechins and blood pressure: a systematic review and meta-analysis of randomised controlled trials. Eur J Nutr. Greyling A, Ras RT, Zock PL, Lorenz M, Hopman MT, Thijssen DHJ, et al. The effect of black tea on blood pressure: a systematic review with meta-analysis of randomized controlled trials. Laukkanen T, Kunutsor SK, Zaccardi F, et al. Acute effects of sauna bathing on cardiovascular function. J Hum Hypertens. These findings highlight the potential benefits for nontraditional approaches to blood pressure lowering. Dickinson HO, Campbell F, Beyer FR, Nicolson DJ, Cook JV, Ford GA, et al. Relaxation therapies for the management of primary hypertension in adults: a Cochrane review. J Human Hypertens. Canter PH, Ernst E. Insufficient evidence to conclude whether or not transcendental meditation decreases blood pressure. Nagele E, Jeitler K, Horvath K, Semlitsch T, Posch N, Herrmann KH, et al. Clinical effectiveness of stress-reduction techniques in patients with hypertension. Burke LE, Ma J, Azar KMJ, Bennett GG, Peterson ED, Zheng Y, et al. Current science on consumer use of mobile health for cardiovascular disease prevention. Walsh JA, Topol EJ, Steinhubl SR. Novel wireless devices for cardiac monitoring. ASM M, Yoo I, Sheets L. A systematic review of healthcare applications for smartphones. BMC Med Inform Decis Mak. Perez MV, Mahaffey KW, Hedlin H, Rumsfeld JS, Garcia A, Ferris T, et al. Large-scale assessment of a smartwatch to identify atrial fibrillation. Andre N, Wibawanti R, Siswanto BB. Mobile phone-based intervention in hypertension management. Int J Hypertens. Xu H, Long H. The effect of smartphone app—based interventions for patients with hypertension: systematic review and meta-analysis. JMIR mHealth and uHealth. This study highlights the potential usefulness of mobile health technology for blood pressure control and medication adherence. Chandler J, Sox L, Kellam K, Feder L, Nemeth L, Treiber F. Impact of a culturally tailored mHealth medication regimen self-management program upon blood pressure among hypertensive Hispanic adults. Int J Environ Res Public Health. Persell SD, Peprah YA, Lipiszko D, Lee JY, Li JJ, Ciolino JD, et al. Effect of home blood pressure monitoring via a smartphone hypertension coaching application or tracking application on adults with uncontrolled hypertension: a randomized clinical trial. JAMA Network Open. Download references. Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, North Wolfe Street, Blalock A, Baltimore, MD, , USA. Michael R. Goetsch, Anjali A. Wagle, Eva M. Valilis, John W. McEvoy, Roger S. Emory University School of Medicine, Atlanta, GA, USA. National Institute for Prevention and Cardiovascular Health, National University of Ireland Galway School of Medicine, Galway, Ireland. You can also search for this author in PubMed Google Scholar. Correspondence to Seamus P. This article does not contain any studies with human or animal subjects performed by any of the authors. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Reprints and permissions. Goetsch, M. et al. Dietary and Lifestyle Modification for the Prevention and Treatment of Hypertension. Curr Cardiovasc Risk Rep 15 , 21 Download citation. Accepted : 30 June Published : 10 August Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Abstract Purpose of Review To examine the evidence for nonpharmacologic dietary and lifestyle interventions to lower blood pressure. Recent Findings In addition to aerobic exercise, resistance exercise training also significantly reduces blood pressure, especially when performed using large muscle groups and among persons with hypertension. Access this article Log in via an institution. Article CAS Google Scholar Whelton PK, Carey RM, Aronow WS, Casey de Jr, Collins KJ, Dennison Himmelfarb C, et al. Article Google Scholar Virani SS. Article Google Scholar Muntner P, Hardy ST, Fine LJ, Jaeger BC, Wozniak G, Levitan EB, et al. Article Google Scholar He J, Tell GS, Tang YC, Mo PS, He GQ. Article CAS Google Scholar Mueller NT, Noya-Alarcon O, Contreras M, Appel LJ, Dominguez-Bello MG. Article Google Scholar Fagard RH, Cornelissen VA. Article Google Scholar Santos LP, Moraes RS, Vieira PJC, Ash GI, Waclawovsky G, Pescatello LS, et al. 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Article CAS PubMed PubMed Central Google Scholar Jones NRV, Forouhi NG, Khaw K-T, Wareham NJ, Monsivais P. Article Google Scholar Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, et al. PubMed Google Scholar Doménech M, Roman P, Lapetra J, García de la Corte FJ, Sala-Vila A, de la Torre R, et al. Article Google Scholar Evans CEL, Greenwood DC, Threapleton DE, Cleghorn CL, Nykjaer C, Woodhead CE, et al. pub2 Khalesi S, Irwin C, Schubert M. In high-risk patients, a medical check must be performed in advance, and exercise should be restricted or provided if necessary. Exercise should not be restricted owing to old age alone, but a prior medical check is particularly necessary in elderly persons. Habitual alcohol consumption can lead to an increase in blood pressure. An epidemiological study indicated that moderate drinking reduced the risk of cardiovascular disease in hypertensive patients and that there was a U-shaped relationship between the volume of alcohol and risk for cardiovascular disease. A bolus administration of alcohol causes a decrease in blood pressure that is sustained for several hours, but if it is continued for a long period blood pressure increases. Despite recent reports on the effect of smoking on the development of hypertension, the overall effect of smoking on blood pressure has not been established. Smoking is a strong risk factor not only for noncardiovascular diseases including cancer but also for coronary artery disease and stroke. Considering that the purpose of hypertension treatment is to prevent cardiovascular disease, smoking cessation is important regardless of the influence on blood pressure. Non-smokers around smokers are also affected, and even passive smoking increases these risks. It is reported that, in passive smokers, h blood pressure is high, and the incidence of masked hypertension is also high. Smoking cessation-assisting drugs varenicline, nicotine replacement therapy should also be considered if necessary. If patients meet specific conditions, therapy for smoking cessation is covered by health insurance in Japan. Exposure to cold elevates blood pressure, which, consequently, is increased during winter. The cardiovascular mortality rate during winter is greater when protective measures against the cold are inadequate. Reports on the relationship between emotional stress and blood pressure are contradictory, but a recent meta-analysis indicated the effectiveness of stress management. Epidemiological studies have indicated the possibility that the duration and quality of sleep may be related to an increase in blood pressure and an increase in the risk for cardiovascular disease. When bathing, the water should not be too hot. The water temperature of sento Japanese bathhouses is often too high. Hypertensive patients should avoid bathing in cold water and using saunas. As straining to defecate increases the blood pressure, guidance for the prevention of constipation should be given, and, if necessary, laxatives should be administered. Sexual intercourse also raises the blood pressure, but hypertension poses few problems to one's sex life. However, hypertensive patients with cardiovascular diseases should refrain from vigorous sexual activity. The DASH and DASH-Sodium studies suggested that combined improvements in diet facilitate a marked decrease in blood pressure. Also, the TONE study showed that a combination of salt reduction and weight loss is more likely to reduce blood pressure and prevent cardiovascular diseases even when they are practiced less rigorously. A more marked decrease in blood pressure has been reported to be achieved by a combination of salt intake reduction, weight loss, exercise, restriction of alcohol intake and a DASH diet. Lifestyle modifications should be started in childhood to prevent lifestyle-related diseases, including hypertension. FOSHU refers to foods to be ingested for specified health purposes, permitted according to Clause 1, Article 26, of the Health Promotion Act or approved according to Clause 1, Article 29, of the same act Commissioner of the Consumer Affairs Agency , the packages containing which describe that food consumption may achieve the health purpose. Food with health function that is not substantiated by scientific evidence that meets the level of FOSHU, or food with certain effectiveness but without the established mechanism of the effective element for the function, will be approved as qualified FOSHU. They are expressed with marks shown in Figure In addition, physicians must instruct pregnant women and patients with nephropathy to pay attention to the recommended daily intake. Patients must also be informed that the intake of FOSHU cannot be a substitute for antihypertensive medication. A warning to consult a physician should be given to patients already on antihypertensive medication if they wish to use such foods. We recommend that any citations to information in the Guidelines are presented in the following format:. The Japanese Society of Hypertension Guidelines for the Management of Hypertension JSH Hypertens Res ; 37 : — Miura K chief investigator. Intersalt Cooperative Research Group. Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. BMJ ; : — Article Google Scholar. The Ministry of Health, Labour, and Welfare. The results of the National Health and Nutrition Survey in Japan. Appel LJ, Champagne CM, Harsha DW, Cooper LS, Obarzanek E, Elmer PJ, Stevens VJ, Vollmer WM, Lin PH, Svetkey LP, Stedman SW, Young DR. Writing Group of the PREMIER Collaborative Research Group. Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA ; : — PubMed Google Scholar. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH, Karanja N. DASH Collaborative Research Group. A clinical trial of the effects of dietary patterns on blood pressure. New Engl J Med ; : — Article CAS PubMed Google Scholar. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller 3rd ER, Simons-Morton DG, Karanja N, Lin PH. DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension DASH diet. New Engl J Med ; : 3 — Ando K, Kawarazaki H, Miura K, Matsuura H, Watanabe Y, Yoshita K, Kawamura M, Kusaka M, Kai H, Tsuchihashi T, Kawano Y. Scientific Statement] Report of the Salt Reduction Committee of the Japanese Society of Hypertension 1 Role of salt in hypertension and cardiovascular diseases. Hypertens Res ; 36 : — He FJ, MacGregor GA. Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. J Hum Hypertens ; 16 : — Dickinson HO, Mason JM, Nicolson DJ, Campbell F, Beyer FR, Cook JV, Williams B, Ford GA. Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials. J Hypertens ; 24 : — Espeland MA, Whelton PK, Kostis JB, Bahnson JL, Ettinger WH, Cutler JA, Appel LJ, Kumanyika S, Farmer D, Elam J, Wilson AC, Applegate WB. TONE Cooperative Research Group. Predictors and mediators of successful long-term withdrawal from antihypertensive medications. Arch Fam Med ; 8 : — Miura K, Ando K, Tsuchihashi T, Yoshita K, Watanabe Y, Kawarazaki H, Matsuura H, Kusaka M, Kai H, Kawamura M, Kawano Y. Scientific Statement Report of the Salt Reduction Committee of the Japanese Society of Hypertension 2 Goal and strategies of dietary salt reduction in the management of hypertension. Guideline: Sodium intake for adults and children. World Health Organization: Geneva Matsuura H, Nakahigashi N. Report of the Working Group for Dietary Salt Reduction of the Japanese Society of Hypertension. Recipes of low-salt diet for hypertensive patients. The Japanese Society of Hypertension: Tokyo, Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ ; : b Article PubMed PubMed Central Google Scholar. Salt reduction lowers cardiovascular risk: meta-analysis of outcome trials. Lancet ; : — Article PubMed Google Scholar. Cook NR, Cutler JA, Obarzanek E, Buring JE, Rexrode KM, Kumanyika SK, Appel LJ, Whelton PK. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention TOHP. General Information from the Salt Restriction Committee of The Japanese Society of Hypertension. Importance of salt restriction and the Salt Restriction Committee's activities in Japanese. The Japanese Society of Hypertension. Accessed 24 December Tsuchihashi T, Kai H, Kusaka M, Kawamura M, Matsuura H, Miura K, Ando K, Maruyama S, Hayabuchi H, Takagi Y, Nakahigashi N, Sato T, Kawano Y. Scientific Statement Report of the Salt Reduction Committee of the Japanese Society of Hypertension 3 Assessment and application of salt intake in the management of hypertension. Anderson CA, Appel LJ, Okuda N, Brown IJ, Chan Q, Zhao L, Ueshima H, Kesteloot H, Miura K, Curb JD, Yoshita K, Elliott P, Yamamoto ME, Stamler J. Dietary sources of sodium in China, Japan, the United Kingdom, and the United States, women and men aged 40 to 59 years: the INTERMAP study. J Am Diet Assoc ; : — Article CAS PubMed PubMed Central Google Scholar. Geleijnse JM, Hofman A, Witteman JC, Hazebroek AA, Valkenburg HA, Grobbee DE. Long-term effects of neonatal sodium restriction on blood pressure. Hypertension ; 29 : — Morinaga Y, Tsuchihashi T, Ohta Y, Matsumura K. Salt intake in 3-year-old Japanese children. Hypertens Res ; 34 : — Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM. American Heart Association. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension ; 47 : — Fujita T, Ando K. Hemodynamic and endocrine changes associated with potassium supplementation in sodium-loaded hypertensives. Hypertension ; 6 : — Kawano Y, Minami J, Takishita S, Omae T. Effects of potassium supplementation on office, home, and h blood pressure in patients with essential hypertension. Am J Hypertens ; 11 : — Yang Q, Liu T, Kuklina EV, Flanders WD, Hong Y, Gillespie C, Chang MH, Gwinn M, Dowling N, Khoury MJ, Hu FB. Sodium and potassium intake and mortality among US adults: prospective data from the Third National Health and Nutrition Examination Survey. Arch Intern Med ; : — Guideline: Potassium intake for adults and children. The Ministry of Health, Labour and Welfare and Ministry of Agriculture, Forestry and Fisheries: Dietary Balance Guide—Food Guide tentative name Review Board's report in Japanese. Daiichi Shuppan Co, Ltd: Tokyo, Accessed 20 December Akita S, Sacks FM, Svetkey LP, Conlin PR, Kimura G. DASH-Sodium Trial Collaborative Research Group. Effects of the Dietary Approaches to Stop Hypertension DASH diet on the pressure-natriuresis relationship. Hypertension ; 42 : 8 — Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi T, Azizi F. 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| Lifestyle and Hypertension: An Evidence-Based Review | Sign in to ask the community. Home About Us Best Practices Coordinating Services for Cardiovascular Events Engaging Organizations to Promote Cardiovascular Health Implementing Technology-Based Strategies to Optimize Cardiovascular Care Leveraging Community and Clinical Public Health Workforces Supporting Patients in Cardiovascular Disease Self-Management Discussion Board Contact Us Request Web Support Submit Feedback on Best Practices. Details Title. Lifestyle Modification Programs to Control Hypertension. Lifestyle modification programs simultaneously address multiple CVD risk factors and show some evidence of effectiveness to lower blood pressure, although behavior change approaches and program components vary. Information Resource URL. URL Name. Lifestyle Modification. HEALTH EQUITY. BEST PRACTICES IN ACTION. Bookmark this article. Share this article via Email. Related Resources Evidence of Effectiveness for Lifestyle Modification Programs Number of Views Number of Views Curr Opin Cardiol. Cornelissen VA, Arnout J, Holvoet P, Fagard RH. Influence of exercise at lower and higher intensity on blood pressure and cardiovascular risk factors at older age. Zomer E, Gurusamy K, Leach R, Trimmer C, Lobstein T, Morris S, et al. Interventions that cause weight loss and the impact on cardiovascular risk factors: a systematic review and meta-analysis. Obes Rev. Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK, et al. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. Flack KD, Hays HM, Moreland J, Long DE. Exercise for weight loss: further evaluating energy compensation with exercise. Ikramuddin S, Korner J, Lee W-J, Connett JE, Inabnet WB, Billington CJ, et al. Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and hyperlipidemia. Pedersen JS, Borup C, Damgaard M, Yatawara VD, Floyd AK, Gadsbøll N, et al. Early hour blood pressure response to Roux-en-Y gastric bypass in obese patients. Scand J Clin Lab Invest. Rhee NA, Vilsbøll T, Knop FK. Current evidence for a role of GLP-1 in Roux-en-Y gastric bypass-induced remission of type 2 diabetes. Diabetes Obes Metab. Article CAS PubMed Google Scholar. Osto E, Doytcheva P, Corteville C, Bueter M, Dörig C, Stivala S, et al. Rapid and body weight-independent improvement of endothelial and high-density lipoprotein function after Roux-en-Y gastric bypass: role of glucagon-like peptide Rubino F. Is type 2 diabetes an operable intestinal disease? A provocative yet reasonable hypothesis. Diabetes Care. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, et al. A clinical trial of the effects of dietary patterns on blood pressure. 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Adrogué HJ, Madias NE. Sodium and potassium in the pathogenesis of hypertension. Whelton PK, Appel LJ, Sacco RL, Anderson CAM, Antman EM, Campbell N, et al. Sodium, blood pressure, and cardiovascular disease. Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. ISo N. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Official Journal of the International Society of Nephrology KDIGO. Guideline: Sodium Intake for Adults and Children. World Health Organization; Filippini T, Malavolti M, Whelton PK, Naska A, Orsini N, Vinceti M. Blood pressure effects of sodium reduction: dose-response meta-analysis of experimental studies. The association between sodium intake and blood pressure was stronger for persons with hypertension compared to those with normal blood pressure. Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, van Horn L, et al. Department of Agriculture, Agricultural Research Service. Nutrient intakes from food and beverages: mean amounts consumed per individual, by gender and age, what we eat in America, NHANES Anderson CAM, Appel LJ, Okuda N, Brown IJ, Chan Q, Zhao L, et al. Dietary sources of sodium in China, Japan, the United Kingdom, and the United States, women and men aged 40 to 59 years: the INTERMAP study. J Am Diet Assoc. Umemura S, Arima H, Arima S, Asayama K, Dohi Y, Hirooka Y, et al. The Japanese Society of Hypertension guidelines for the management of hypertension JSH Hypertens Res. Hisamatsu T, Segawa H, Kadota A, Ohkubo T, Arima H, Miura K. Epidemiology of hypertension in Japan: beyond the new Japanese guidelines. Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM, et al. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. 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Exploring causal associations between alcohol and coronary heart disease risk factors: findings from a Mendelian randomization study in the Copenhagen General Population Study. Eur Heart J. Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Drinking Levels Defined. Accessed March 21, Beulens JWJ, Rimm EB, Ascherio A, Spiegelman D, Hendriks HFJ, Mukamal KJ. Alcohol consumption and risk for coronary heart disease among men with hypertension. Bryson CL, Mukamal KJ, Mittleman MA, Fried LP, Hirsch CH, Kitzman DW, et al. The association of alcohol consumption and incident heart failure. Djoussé L, Michael GJ. Huang C, Zhan J, Liu Y-J, Li D-J, Wang S-Q, He Q-Q. Association between alcohol consumption and risk of cardiovascular disease and all-cause mortality in patients with hypertension: a meta-analysis of prospective cohort studies. Mayo Clin Proc. Larsson SC, Drca N, Wolk A. Alcohol consumption and risk of atrial fibrillation. Wang J, Xiong X, Liu W. Yoga for Essential hypertension: a systematic review. PLoS ONE. Laukkanen JA, Laukkanen T, Kunutsor SK. Cardiovascular and other health benefits of sauna bathing: a review of the evidence. Khalesi S, Sun J, Buys N, Jamshidi A, Nikbakht-Nasrabadi E, Khosravi-Boroujeni H. |
| Changes You Can Make to Manage High Blood Pressure | Clinical center staff then Lidestyle participants of their Lifestyle modifications for hypertension management group. Specific Aims and Outcomes. It is ffor known the deleterious effect of alcohol abuse on liver, heart, pancreas, modificatipns Lifestyle modifications for hypertension management and other organ systems. Aburto NJ, Hanson S, Gutierrez H, Hooper L, Elliott P, Cappuccio FP. Muntner P, Hardy ST, Fine LJ, Jaeger BC, Wozniak G, Levitan EB, et al. The reduction of pressure values obtained after onset of regular exercise training could lead in some cases to reduce or to stop the use of antihypertensive drugs [ 97 ]. Vitamin and mineral supplement use was not an exclusion. |
| Dietary and Lifestyle Modification for the Prevention and Treatment of Hypertension | You should not drink more than the recommended amount. Currently the maximum recommended amount for men and women is no more than 14 units of alcohol per week. Units should be spread out through the week and there should be at least two alcohol-free days a week. Pregnant women should not drink at all. One unit is in about half a pint of normal-strength beer, or two thirds of a small glass of wine, or one single pub measure of spirits. Cutting back on heavy drinking improves health in various ways. It can also have a direct effect on blood pressure. For example, if you are drinking heavily, cutting back to the recommended limits can lower a high systolic blood pressure. Smoking does not directly affect the level of your blood pressure. However, smoking greatly adds to your health risk if you already have high blood pressure hypertension. You should make every effort to stop smoking. If you smoke and are having difficulty in stopping, see your practice nurse for help and advice. Hypertension in adults: diagnosis and management ; NICE August - last updated March He FJ, Li J, Macgregor GA ; Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. doi: Description of the DASH Dietary Approaches to Stop Hypertension Eating Plan ; National Institutes of Health. Ettehad D, Emdin CA, Kiran A, et al ; Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Epub Dec UK Chief Medical Officers' Physical Activity Guidelines, Lipid modification - CVD prevention ; NICE CKS, August UK access only. Alcohol and drug misuse - Prevention and treatment guidance ; GOV. Hi i am on medication for high blood pressure which is normally well controlled. Ive started having episodes where it spikes for no reason despite the meds then drops low. During these episodes i Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions. In this series. In this series: High Blood Pressure Hypertension Blood Pressure Medication Thiazide Diuretics. In this series High Blood Pressure Hypertension Blood Pressure Medication Thiazide Diuretics. In this article How can lifestyle changes help lower blood pressure? Physicians also could suggest that patients listen to books on tape while walking, which may help to maintain interest level. It is recommended that patients with prehypertension or hypertension exercise for 30 minutes on most days of the week. Limiting alcohol consumption is an important lifestyle modification for reducing blood pressure. One meta-analysis 14 indicated a dose-response relationship between decreased alcohol consumption and blood pressure reduction. Pooled results showed reductions of 3 mm Hg in systolic blood pressure and 2 mm Hg in diastolic blood pressure for patients in the alcohol reduction groups average reduction of 67 percent from an average intake of three to six drinks per day at baseline. The DASH eating plan outlines a diet rich in fruits and vegetables; high in low-fat dairy products, potassium, magnesium, and calcium; and low in total saturated fats Table 1. In the PREMIER clinical trial, 15 researchers assessed the impact on blood pressure of comprehensive lifestyle changes i. Participants in the lifestyle changes only group had a greater reduction in blood pressure than those in the usual care group, and this was further enhanced with the addition of the DASH eating plan. This was the first trial to demonstrate that all recommended lifestyle changes can be combined to reduce blood pressure successfully. Potassium and sodium fluctuate antagonistically—a decrease in potassium leads to sodium retention, whereas an increase in potassium leads to sodium excretion, thereby promoting diuresis and natriuresis. Weight loss is an important lifestyle modification in reducing blood pressure. A reduction of 10 lb can help reduce blood pressure or prevent hypertension. Nicotine released while smoking cigarettes is believed to impact blood pressure through arousal of the sympathetic nervous system followed by the release of norepinephrine and epinephrine. Hypertension is a well-documented risk factor for cardiovascular disease and stroke. Studies have shown that men with high blood pressure who smoke have an increased risk of total, ischemic, and hemorrhagic stroke, and that this risk is related to the number of cigarettes smoked. Vitamin C, omega-3 fatty acids, coenzyme Q10, and magnesium have been purported to reduce blood pressure. However, their use in management of hypertension is not recommended because of the lack of data from well-designed randomized controlled trials. Meditation includes a variety of techniques, such as repetition of a word or phrase the mantra and careful attention to the process of breathing, to achieve a state of inner calm, detachment, and focus. Meditation was shown to reduce blood pressure in one well-designed study that addressed baseline blood pressure measurements adequately, 23 although other studies have been inconsistent. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. American Heart Association. Heart disease and stroke statistics— update. Dallas, Tex. Fields LE, Burt V, Cutler JA, Hughes J, Roccella EJ, Sorlie P. The burden of adult hypertension in the United States to a rising tide. Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, — Berlowitz DR, Ash AS, Hickey EC, Friedman RH, Glickman M, Kader B, et al. Inadequate management of blood pressure in a hypertensive population. N Engl J Med. Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA, et al. Primary prevention of hypertension: clinical and public health advisory from the National High Blood Pressure Education Program. He J, Whelton PK, Appel LJ, Charleston J, Klag MJ. Long-term effects of weight loss and dietary sodium reduction on incidence of hypertension. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, et al. A clinical trial of the effects of dietary patterns on blood pressure. Vollmer WM, Sacks FM, Ard J, Appel LJ, Bray GA, Simons-Morton DG, et al. Effects of diet and sodium intake on blood pressure: subgroup analysis of the DASH-sodium trial. Ann Intern Med. National Heart, Lung, and Blood Institute. The DASH eating plan. Bethesda, Md. Department of Health and Human Services, Whelton PK, Appel LJ, Espeland MA, Applegate WB, Ettinger WH, Kostis JB, et al. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of non-pharmacologic interventions in the elderly TONE [published correction appears in JAMA ;]. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension DASH diet. Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Appel LJ, Champagne CM, Harsha DW, Cooper LS, Obarzanek E, Elmer PJ, et al. Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. Gallen IW, Rosa RM, Esparaz DY, Young JB, Robertson GL, Batlle D, et al. On the mechanism of the effects of potassium restriction on blood pressure and renal sodium retention. Am J Kidney Dis. Krishna GG, Kapoor SC. Potassium depletion exacerbates essential hypertension. |
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POINT 4 1 Lifestyle modifications are important for ameliorating hypertension, both before and after the start of antihypertensive drug therapy. Recommendation grade: A, Evidence level: I 6 Reduction of alcohol intake: Alcohol intake should be restricted.
Recommendation grade: A, Evidence level: I 7 Quitting smoking: Smoking cessation should be promoted, and passive smoking must be avoided. Recommendation grade: A, Consensus, Evidence level: IVa 8 Others: Exposure to cold should be avoided.
Recommendation grade: C1, Evidence level: IVa 9 Comprehensive lifestyle modifications are more effective. Recommendation grade: B, Evidence level: II Lifestyle modifications can lead to a mild decrease in blood pressure, increasing the actions of antihypertensive drugs, thus contributing to a reduction in the dose.
Table 1 Points of lifestyle modifications Full size table. Figure Full size image. SALT REDUCTION Observational studies including the INTERSALT 51 have indicated the association between excessive salt intake and an increase in blood pressure. Table 2 Guidelines for evaluation of salt intake Full size table.
NUTRIENTS AND FOODS In the United States, an interventional study of the DASH diet, which is rich in vegetables, fruit and low-fat dairy products low in saturated fatty acids and cholesterol and high in Ca, K, Mg and dietary fiber , was conducted.
EXERCISE The hypotensive effect of aerobic exercise has been established. REDUCTION OF ALCOHOL INTAKE Habitual alcohol consumption can lead to an increase in blood pressure. SMOKING CESSATION Despite recent reports on the effect of smoking on the development of hypertension, the overall effect of smoking on blood pressure has not been established.
FOODS FOR SPECIFIED HEALTH USES FOSHUs FOSHU refers to foods to be ingested for specified health purposes, permitted according to Clause 1, Article 26, of the Health Promotion Act or approved according to Clause 1, Article 29, of the same act Commissioner of the Consumer Affairs Agency , the packages containing which describe that food consumption may achieve the health purpose.
Marks of foods for specified health uses. References Miura K chief investigator. E-III Intersalt Cooperative Research Group. E-II Article Google Scholar The Ministry of Health, Labour, and Welfare. E-III Appel LJ, Champagne CM, Harsha DW, Cooper LS, Obarzanek E, Elmer PJ, Stevens VJ, Vollmer WM, Lin PH, Svetkey LP, Stedman SW, Young DR.
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II Article CAS PubMed Google Scholar Ando K, Kawarazaki H, Miura K, Matsuura H, Watanabe Y, Yoshita K, Kawamura M, Kusaka M, Kai H, Tsuchihashi T, Kawano Y. GL Article CAS PubMed Google Scholar He FJ, MacGregor GA. I Article CAS PubMed Google Scholar Dickinson HO, Mason JM, Nicolson DJ, Campbell F, Beyer FR, Cook JV, Williams B, Ford GA.
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Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. Show references Feehally J, et al. Nonpharmacologic prevention and treatment of hypertension. In: Comprehensive Clinical Nephrology.
Elsevier; Accessed April 20, Hypertension adult. Mayo Clinic; Hall ME, et al. Weight-loss strategies for prevention and treatment of hypertension: A scientific statement from the American Heart Association. Shimbo D, et al. Self-measured blood pressure monitoring at home: A joint policy statement from the American Heart Association and the American Medical Association.
Department of Health and Human Services and U. Department of Agriculture. Accessed April 23, Libby P, et al. Systemic hypertension: Mechanisms, diagnosis, and treatment.
In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. Sleep deprivation and deficiency: Healthy sleep habits. National Heart, Lung, and Blood Institute.
Managing stress to control high blood pressure. American Heart Association. Products and Services A Book: Mayo Clinic on High Blood Pressure Blood Pressure Monitors at Mayo Clinic Store The Mayo Clinic Diet Online.
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Modicications examine the evidence for nonpharmacologic dietary and Lifestyle modifications for hypertension management interventions to lower blood pressure. In addition to aerobic exercise, resistance exercise training also managemrnt reduces blood pressure, especially Lifeztyle performed using Sodium content in foods muscle Lifestyle modifications for hypertension management and among persons with hypertension. Plant-based diets modivications as the lacto-ovo vegetarian diet and intermittent fasting are associated with blood pressure improvement similar to or greater than the Dietary Approaches to Stop Hypertension DASH diet. Nontraditional lifestyle approaches for blood pressure lowering such as meditation, sauna use, and yoga have shown promising results but need further study. Mobile health technology may be a useful tool to promote medication adherence and blood pressure lowering. This is a preview of subscription content, log in via an institution to check access. Rent this article via DeepDyve.
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