Importance of lifestyle for prevention and treatment of hypertension
Have you ever thought about changing your lifestyle to be healthier? By doing so, you may be preventing or treating high blood pressure.
Arterial hypertension in Portugal represents a serious health problem . In the long term, high blood pressure is one of the main risk factors for the development of:
• Stroke
• Heart attack
• Heart Failure
• Renal insufficiency
• Gradual loss of vision
• Erectile dysfunction
• Peripheral arterial disease
High blood pressure that cannot be controlled (130/80 mm Hg or higher) despite the use of three or more medications from different classes, including a diuretic to lower blood pressure, is a condition known as resistant hypertension.
It is estimated that resistant hypertension affects about 5% of the general global population and can affect 20% to 30% of adults with high blood pressure. Resistant hypertension is also associated with end-organ damage and a 50% increased risk of adverse cardiovascular events, including stroke, myocardial infarction (“heart attack”), and death.
Diet and physical activity are well-established treatments to combat hypertension. In June 2021, the American Heart Association (AHA) stated in a new scientific publication that the ideal first step in treating mild to moderately elevated blood pressure (BP) and cholesterol in healthy adults is to "prescribe" that the person spends less time sitting and moving more.
The first research study on the impact of lifestyle changes on resistant hypertension was published very recently.
140 people with resistant hypertension were recruited for this clinical trial called “Treating Resistant Hypertension Using Lifestyle Modification to Promote Health” (TRIUMPH). Participants were taking an average of 3.5 blood pressure lowering medications.
Results show that behavioral changes, including regular aerobic exercise, adoption of the DASH (Dietary Approaches to Stop Hypertension) diet, reduced salt intake, and weight loss, can significantly lower blood pressure and improve cardiovascular health in people with resistant hypertension. and reduce the risk of a heart attack or stroke.
The DASH diet is a flexible eating plan that reduces your intake of sugar and saturated fat and increases your consumption of vegetables, fruits, whole grains, fish, poultry, and pulses and aligns with the American Heart Association's nutritional recommendations.
Lifestyle changes (such as weight loss or increased physical activity) are generally recommended by most healthcare professionals before starting drug treatment. However, this study provides important reinforcement that combining lifestyle changes with medication is an effective strategy.
References:
Sousa Uva M, Victorino P, Roquette R, Machado A, Matias Dias C. Epidemiological research on the incidence and prevalence of arterial hypertension in the Portuguese population: a scoping review. Rev Port Cardiol. 2014 Jul-Aug;33(7-8):451-63
2018 ESC/ESH Clinical Practice Guidelines for the Management of Arterial Hypertension
Noubiap JJ, Nansseu JR, Nyaga UF, Sime PS, Francis I, Bigna JJ. Global prevalence of resistant hypertension: a meta-analysis of data from 3.2 million patients. Heart. 2019;105:98–105.
Daugherty SL, Powers JD, Magid DJ, Tavel HM, Masoudi FA, Margolis KL, O’Connor PJ, Selby JV, Ho PM. Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation. 2012;125:1635–1642.
BB Gibbs Physical Activity as a Critical Component of First-Line Treatment for Elevated Blood Pressure or Cholesterol: Who, What, and How?: A Scientific Statement From the American Heart Association
Blumenthal, J. A., et al. (2021) Effects of Lifestyle Modification on Patients With Resistant Hypertension: Results of the TRIUMPH Randomized Clinical Trial. Circulation
Dra. Thordis Berger
Chief Medical Officer Holmes Place