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(Circulation. 2004;109:3081-3088.)
© 2004 American Heart Association, Inc.

Reviews: Clinical Cardiology: New Frontiers

Hypertensive Therapy: Part II

Veronica Franco, MD; Suzanne Oparil, MD; Oscar A. Carretero, MD

From the Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham (V.F., S.O.), and the Hypertension and Vascular Research Division, Heart and Vascular Institute, Henry Ford Hospital, Detroit, Michigan (O.A.C.).

Correspondence to Veronica Franco, MD, ZRB 1024, 703 19th St South, University of Alabama at Birmingham, Birmingham, AL 35294. E-mail vfranco@uab.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

If the incidence of hypertension in the population could be reduced through lifestyle modification, much of the morbidity and mortality associated with coronary heart disease, renal disease, and stroke might be prevented.^1–3 Randomized, controlled trials have shown that lifestyle modification can lower blood pressure (BP) in both hypertensive and high-risk normotensive (now called prehypertensive) persons and can prevent hypertension in the latter group. Accordingly, lifestyle modification is recommended for all persons (Table 1), either alone or in conjunction with pharmacological therapy (Table 2^1–34).

View this table: [in this window] [in a new window]   TABLE 1. Lifestyle Modifications to Manage Hypertension*

View this table: [in this window] [in a new window]   TABLE 2. Guidelines for Treatment of Hypertension Based on Compelling Indications for Individual Drug Classes

Lifestyle Modification

Weight Loss and Maintenance of Normal Body Weight
Weight loss is the most effective of all nonpharmacological measures to prevent and treat hypertension.³⁵ This effect is independent of sodium restriction and is seen in both obese and nonobese hypertensive individuals. Clinical trial evidence suggests that weight loss interventions produce BP benefits that persist even after cessation of active therapy.^3,36 Body mass index (BMI) should be maintained between 18.5 and 24.9 kg/m². Because sustained weight reduction is extremely difficult to achieve, emphasis should be placed on prevention of weight gain, particularly in younger individuals with prehypertension and in families with a high prevalence of hypertension.

Increased Physical Activity
At least 30 minutes of moderately intense physical activity, such as brisk walking, swimming, bicycling, or yard work, carried out at least 3 times per week (preferably once per day) can lower BP in both normotensive and hypertensive individuals. Studies suggest that such . . . [Full Text of this Article]

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