Impact of lifestyle modification on blood pressure in hypertensive patients and their impact on pharmacological treatment choices

Abstract

Hypertension is one of the greatest global health issues, necessitating lifelong treatment. Lifestyle changes can be made for patients on drugs. Nevertheless, it is not yet clear how these changes impact blood pressure control and medication use in hypertensive patients. The objective of this narrative review was to summarize the available evidence on how different lifestyle modifications affect blood pressure (BP) among hypertensive individuals and their impact on anti-hypertensive prescription. 52 studies were selected through a comprehensive database search to perform this narrative review, including randomized controlled trials and observational studies carried out in that area. This variety involved dietary changes like the Dietary Approaches to Stop Hypertension (DASH) diet and reduced sodium intake; physical activity; weight reduction; and minimizing alcohol consumption, among others. From the summary of evidence, it is evident that a DASH diet, low-sodium diets, as well as regular aerobic exercise routines, when combined with weight loss, were able to decrease systolic blood pressures by between 5 and 10 mm Hg on average. It also appeared that combining several lifestyle improvements had cumulative effects concerning BP reduction. There was far less evidence supporting the advantages of either drinking less or managing stress. Most importantly, these lifestyles have been effective at reducing the need for anti-hypertensive medications, sometimes resulting in blood pressure being managed without any medications. However, maintaining such revised ways of living is generally very poor, which shows how important motivation with ongoing support has been in helping them persist over time. This review concludes by highlighting that there are significant clinical reductions in blood pressure brought about by lifestyle modifications, which could lead to decreased use of anti-hypertensive drugs. Multiple lifestyle modifications seem to be the most impact approach