Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials

Abstract

Patients with elevated blood pressure should follow a weight-reducing diet, take regular exercise, and restrict alcohol and salt intake. Available evidence does not support relaxation therapies, calcium, magnesium or potassium supplements to reduce blood pressure.

Reducing the Blood Pressure–Related Burden of Cardiovascular Disease: Impact of Achievable Improvements in Blood Pressure Prevention and Control

“…Interventions targeted to populations with blood pressure above goal will therefore become less effective in lowering CVD incidence as blood pressure awareness, treatment, and control continue to improve, limiting the target population 40. Conversely, population‐wide lifestyle approaches to blood pressure reduction, as encouraged by the 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk, have been successful in reducing CVD across a wide range of blood pressures 15, 16, 44. For example, prior population‐wide intervention studies of salt reduction demonstrated decreases in morbidity, mortality, and healthcare costs with as little as 1 g less of salt per day (equivalent to 1/6 of a teaspoon)15 and are feasible, as evidenced by recent dietary salt reduction programs in the United Kingdom focused on manufactured food that decreased mean sodium content in the food supply by 7% 13.…”

“…These models provided estimates of the IRDs for CHD, stroke, or HF associated with a 1 mm Hg decrement in SBP at study baseline potentially achievable after lifestyle interventions were fully implemented16, 17, 33, 34, 35; estimates for a 2‐mm Hg reduction were obtained by multiplying the SBP regression coefficient by 2.…”

“…Among blood pressure–related deaths, published estimates suggest that approximately one third of excess CHD and all‐cause mortality can be attributed to elevated systolic blood pressure (SBP) at levels designated as nonhypertensive,6, 7 indicating that benefits achieved from decreases in blood pressure are not limited to populations with hypertension 8, 9, 10, 11, 12. Experimental and observational studies have also demonstrated the efficacy of lifestyle‐based blood pressure interventions, such as increased physical activity and the Dietary Approaches to Stop Hypertension (DASH) diet, for CVD prevention 13, 14, 15, 16, 17. This body of evidence supports the development of population‐wide interventions to reduce blood pressure alongside interventions targeted to populations with blood pressure above goal for CVD reduction 18…”

The antihypertensive effect of fermented milk in individuals with prehypertension or borderline hypertension

“…2 Lifestyle interventions as improved diet, physical exercise, salt and alcohol restriction have been shown to reduce SBP by 2-5 mm Hg. 3 FM as functional food might be a useful lifestyle intervention and deserves careful consideration.…”

Accumulation of 30 min of moderately intense physical activity is a clinically meaningful treatment to reduce systolic blood pressure in prehypertension

“…3 Most exercise trials comprised three to five supervised sessions of 30-60 min of aerobic exercise. 4 Although exercise reduced blood pressure to a greater extent in patients with elevated blood pressure level at baseline, exercise also lowered blood pressure in individuals who had normal baseline levels. 5 In accordance with these data, a public health perspective for the primary prevention of hypertension recommends regularly engaging in aerobic physical activity such as brisk walking, jogging or cycling for at least 30 min on most days of the week.…”