Non-pharmacological treatment of hypertension

Aug 24, 2023

Non-pharmacological treatment of hypertension

Sometimes hypertension doesn’t mean that a patient should immediately start to take the drugs. Lifestyle modification may lead to long-term stabilization of the blood pressure. In this video non-pharmacological interventions for the treatment of hypertension according to the current guidelines are described.
Note: there are mistake: According to ESC recommendations, alcohol consumption should be limited up to 14 units a week for men and 8 units a week for women.
Less than 1.5 g of sodium a day is an important goal in normalization of the blood pressure.

Content

0.1 -> Sometimes hypertension doesn’t mean that a patient should immediately start to take the drugs.

5.16 ->

5.68 -> Lifestyle modification may lead to long-term stabilization of the blood pressure.

11.68 -> In this video we will speak about non-pharmacological interventions for the treatment of hypertension

17.94 -> according to the current guidelines.

26.84 -> According to current guidelines, lifestyle interventions should be used in treatment

31.62 -> of the hypertension or elevated blood pressure together with drugs or in some cases alone.

38.46 -> Lifestyle interventions can prevent or delay the onset of hypertension, prevent or delay the

45.039 -> need for the drug therapy, improve efficiency of the pharmacological therapy and reduce

51.799 -> the cardiovascular risk.

54.299 -> But many patients are poorly adherent to the lifestyle changes, and they stop it quickly.

62.129 -> Healthy diet shows the most significant effect on blood pressure lowering.

68.34 -> Diet is rich in vegetables, fruits, whole grains, fish, nut and unsaturated fatty acids.

76.64 -> Sugar-sweetened drinks should be restricted as they are associated with overweight, metabolic

83.03 -> syndrome, diabetes mellitus, and increased cardiovascular risk.

87.5 -> The views on coffee and tea consumption are controversial: despite the direct vasopressor

93.979 -> effect, their intake may be associated with better cardiovascular prognosis.

99.469 -> But tea has some blood pressure-lowering effect.

102.64 -> Products containing large amount of saturated fat as well as trans-fat should be restricted.

109.36 -> This all are characteristic to the DASH-diet that is commonly used in USA, and Mediterranean

117.02 -> diet that is widely used in Europe.

119.64 -> Such diet reduces blood pressure, glucose and lipid levels.

124.26 -> Dietary sodium restriction is also important.

127.6 -> High sodium intake is associated with increased risk of mortality and cardiovascular events.

135.24 -> Less than 1.5 g of sodium a day is an important goal in normalization of the blood pressure.

143.38 -> According to ESC recommendations, salt restriction to less than 5 g per day is recommended.

150.66 -> Enhanced intake of the dietary potassium is associated with blood pressure reduction and

156.58 -> reduced risk of cardiovascular diseases.

159.2 -> It’s recommended to intake from 3500 to 5500 mg of potassium a day, but it should

167.29 -> be not considered in the patients with an significantly impaired renal function.

173.3 -> Weight reduction is another important method of non-pharmacological interventions.

178.31 -> Ideal body weight should be the main target.

181.31 -> This means that body mass index should range from 20 to 25 kg/m2.

187.34 -> But at least 1 kg reduction in the body weight is very important for overweight people.

193.58 -> Moderation in the alcohol consumption is recommended to reduce blood pressure.

198.74 -> In the USA, consumption of alcohol is advised up to 2 drinks daily for men and up to 1 drink

204.991 -> daily for women.

206.19 -> 1 drink contains 14 grams of pure alcohol.

209.8 -> According to ESC recommendations, alcohol consumption should be limited up to 14 units

216.89 -> a week for men and 8 units a week for women.

221.11 -> 1 unit equals 10 mL of pure alcohol.

225.64 -> Smoking significantly increases risk of stroke, angina, myocardial infarction, peripheral

232.75 -> artery disease and cancer.

234.9 -> Also, regular physical activity should be recommended.

238.8 -> According to ACC/AHA guideline, aerobic dynamic exercises (for example, walking, swimming,

246.1 -> cycling) for 90-150 min a week is advised, for additional benefit in people with elevated

252.94 -> blood pressure gradual increase in duration of aerobic physical activity up to 300 min

259.32 -> a week is recommended; for these patients intensive aerobic physical

263.41 -> activity with duration of 150 min a week may be considered.

268.73 -> According to ESC guideline aerobic exercises at least 30 min of moderate dynamic exercise

276.16 -> on 5-7 days a week is recommended.

280.24 -> Dynamic resistance training with duration of 90-150 min a week is recommended.

286.4 -> Role of isometric exercises is less established.

289.48 -> They are performed for 4 exercises per session with the duration of 2 min of each exercise;

296.24 -> 1 min rest is spent between exercises.

300.19 -> 3 sessions per week are performed.

302.66 -> Regular physical activity is associated with a reduced mortality.

307.28 -> According to ESC guideline lifestyle advice is recommended for all patients with the blood

313.64 -> pressure of 130/85 mm Hg or higher.

317.7 -> In a patient with high-normal blood pressure (130-139/85-89 mm Hg) lifestyle changes are

321.38 -> recommended.

322.44 -> But if a patient has very high cardiovascular risk due to cardiovascular disease, pharmacological

327.84 -> treatment may be considered.

329.72 -> A patient with grade 1 hypertension (blood pressure of 140-159/90-99 mm Hg) should be

332.02 -> recommended to do lifestyle interventions.

334.68 -> If a patient has low or moderate cardiovascular risk without hypertension-mediated organ damage,

341.31 -> only lifestyle interventions should be advised.

344.5 -> But if this patient remains hypertensive after 3-6 months of lifestyle interventions, blood

350.78 -> pressure lowering drugs should be prescribed.

353.98 -> If a patient with grade 1 hypertension has high or very high cardiovascular risk, cardiovascular

360.33 -> disease, renal disease or hypertension-mediated organ damage, pharmacological treatment should

366.38 -> be used immediately in combination with lifestyle interventions.

371.2 -> Immediate blood pressure-lowering drug treatment in combination with lifestyle advice is recommended

376.58 -> for patients with grade 2 and grade 3 hypertension.

380.45 -> According to ACC/AHA guidelines, patients with elevated blood pressure are recommended

386.89 -> to do lifestyle interventions.

389.04 -> In patients with stage 1 hypertension (blood pressure 130-139/80-89 mm Hg) 10-year cardiovascular

392.49 -> risk should be estimated by ASCVD calculator.

396.46 -> If it’s less than 10% only lifestyle interventions with following reassessment in 3-6 months

402.889 -> should be recommended.

404.55 -> If it’s 10% and more lifestyle modifications should be combined with pharmacological treatment.

411.43 -> Combination of lifestyle modifications and pharmacological treatment is recommended for

416.24 -> patients with stage 2 hypertension.

420.2 -> It’s important that lifestyle interventions should never delay blood pressure-lowering

424.15 -> therapy, when it’s indicated.

426.56 -> In patients with white coat hypertension, lifestyle interventions should be recommended.

432.36 -> If masked hypertension is detected, lifestyle interventions in combination with blood pressure-lowering

437.99 -> treatment is recommended.

Source: https://www.youtube.com/watch?v=5YIlCDmgLjE