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Ir J Med Sci. 2019 May;188(2):437-452. doi: 10.1007/s11845-018-1889-8. Epub 2018 Aug 22.

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

Author information

1
Department of Pharmacy, Quaid-i-Azam University, Islamabad, 45320, Pakistan.
2
Department of Pharmacy, Quaid-e-Azam University, Islamabad, 45320, Pakistan.
3
Department of Pharmacy, Quaid-i-Azam University, Islamabad, 45320, Pakistan. kushah@qau.edu.pk.
4
Department of Pharmacy, Quaid-e-Azam University, Islamabad, 45320, Pakistan. kushah@qau.edu.pk.
5
School of Pharmacy, Monash University, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.

Abstract

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.

KEYWORDS:

DASH diet; Exercise; Hypertension; Lifestyle modifications; Low salt diet; Non-pharmacological management

PMID:
30136222
DOI:
10.1007/s11845-018-1889-8
[Indexed for MEDLINE]

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