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41 PRACTICAL QUESTIONS AND ANSWERS ABOUT HYPERTENSION AND HYPERCHOLESTEROLEMIA - 2008

BLOOD PRESURE REDUCTION WITHOUT MEDICATIONS-LIFESTYLE CHANGES PREVIOUS QUESTION  QUESTIONS  NEXT QUESTION
  • Various therapeutic means, beyond drugs, may lead to some extent to blood pressure reduction. These means are useful in all hypertensive subjects, regardless of the use of blood pressure lowering drugs. If effectively applied, they may actually lead to a reduction in antihypertensive drug (fewer pills) or even, in some cases, to the complete withdrawal of any medication.
  • Unfortunately, controlling the patient's blood pressure is fraught with problems mainly due to the fact that the patient finds it difficult to follow the prescribed regime over a prolonged period of time.
  • Body weight reduction in obese hypertensive subjects is the most effective way to lower blood pressure without drugs. Even a relatively small reduction in body weight (e.g. 5 kg) may help the control of blood pressure effectively and also improve other risk factors (e.g. blood cholesterol and sugar levels) which are associated with the likelihood of a heart attack or a stroke.
  • A diet rich in fruits, vegetables and low-fat dairy products (known as DASH diet), in other words, a diet rich in potassium and calcium, may help to lower blood pressure lowering.
  • The restriction of diet salt intake lowers blood pressure mainly in elderly hypertensive persons. Moreover, it may increase the effectiveness of antihypertensive drug treatment, especially the angiotensin converting enzyme inhibitors and the angiotensin receptor blockers (see "Antihypertensive drugs").
  • Alcohol restriction (up to two drinks per day for men and one for women) lowers blood pressure in subjects with prior alcohol abuse.
  • Exercise (brisk walking or bicycling for at least half an hour most days of the week) may help to lower blood pressure as well as to improve other risk factors (e.g. blood cholesterol and glucose values) which are associated with cardiovascular incidents.
  • Smoking affects blood pressure very little, if at all. However, smoking cessation is the first goal of hypertensive subjects because it is at least as important as blood pressure itself in causing a myocardial infarction and a stroke.

WRITING GROUP
G. Stergiou, Chairman
A. Achimastos
E. Andreadis
I. Avramopoulos
M. Elissaf
N. Karatzas
T. Mountokalakis
D. Papadogiannis
K. Siamopoulos
E. Varsamis
K. Vemmos
D. Vlahakos