Lifestyle changes reduce the need for drugs for hypertension

Lifestyle changes are the first step in reducing blood pressure according to the 2017 recommendations of the American College of Cardiology / American Heart Association.

"Lifestyle changes, including healthier eating and regular physical activity, can dramatically reduce the number of patients requiring medication, especially in people with systolic blood pressure between 130 and over. and 160 mmHg and between 80 and mmHg diastolic, "said study author Alan Hinderliter, MD, an associate professor of medicine at the University of North Carolina at Chapel Hill.

The researchers studied 129 overweight or obese men and women aged 40 to 80 years with high blood pressure. Patients' blood pressure ranged from 130 to 160 / 80-99 mmHg, but they did not take medication to lower blood pressure at the time of the study. According to recent guidelines, more than half of the patients were candidates for antihypertensive treatment at the start of the study.

The researchers randomly assigned each patient to one of three 16-week interventions. Participants in one group changed the content of their diet and participated in a weight management program including behavioral counseling and three times a week of supervised exercises. They changed their eating habits to that of the DASH plan, a proven nutritional approach to lowering blood pressure. DASH focuses on low-fat fruits, vegetables and dairy products and minimizes the consumption of red meat, salt and sweets. Participants in the second group switched diets only by focusing on the DASH diet with the help of a nutritionist. The third group did not change his exercises or eating habits.

The researchers found:

• Those who followed the DASH diet and participated in the weight management group lost an average of 19 pounds and had reduced blood pressure averaging 16 mmHg and diastolic 10 mmHg at the end of 16 weeks.
• The blood pressure of people who only follow the DASH diet decreased by 11 mmHg systolic / 8 diastolic on average.
• Adults who did not change their eating habits or exercise habits experienced a minimum blood pressure decrease of 3 mm systolic / 4 diastolic on average.
• By the end of the study, only 15% of those who had altered their diet and exercise habits needed antihypertensives, as recommended by the AHA / ACC recommendations. of 2017, compared to 23% in the group having only modified their diet. However, there was no change in the need for drugs in those who did not change their diet or exercise habits – nearly 50% continued to meet the criteria for drug treatment.

Hinderliter suspects that lifestyle modifications would be equally useful for those at higher risk of cardiovascular disease and for patients taking antihypertensive medications, but that future studies will need to confirm.

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