A 61-year-old man with a history of hypertension asks what measures he can take from a nonpharmacologic perspective to manage his hypertension. The patient reports that he drinks 1 to 2 beers per day and smokes a half pack of cigarettes per day.
Which of the following lifestyle modifications has been shown to result in the greatest reduction in blood pressure?
A. Dietary Approaches to Stop Hypertension (DASH) dietWeight loss. The seventh report of the Joint National Committee (JNC 7) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends all patients with hypertension (blood pressure of 140/90 mmHg or higher) or prehypertension (blood pressure of 120/80 to 139/ 89 mmHg) execute five lifestyle modifications: Reducing dietary sodium to less than 2.4 g/d; increasing exercise to at least 30 min/d (4 d/wk); limiting alcohol consumption to 2 drinks or less per day for men and 1 drink or less per day for women; following the Dietary Approaches to Stop Hypertension (DASH) diet (high in fruits, vegetables, potassium, calcium, and magnesium; low in fat and salt); and achieving a weight loss goal of 4.5 kg (10 lb) or more. Of these, weight loss has shown to have the highest reduction in systolic blood pressure (reduction from 5 to 20 mmHg) in overweight patients. (A, C, D) These three lifestyle modifications are also recommended and do have a substantial effect on reduction of systolic pressure, just not as much as weight loss does. (E) Smoking cessation should always be encouraged as part of any comprehensive lifestyle modification plan.