Journal of the American Society of Hypertension 9(2) (2015) 161–163
American Society of Hypertension Self-Assessment Guide
Treatment: special conditions Prevention/public health strategies Paul K. Whelton, MB, MD, MSc To purchase and complete the ASH Hypertension Self-Assessments please use the following link: https://secure.ptcny.com/webtest
Primary prevention of high blood pressure (BP) provides an opportunity to reduce cardiovascular risk and interrupt the continuing costly cycle of managing hypertension and its consequences. It can be accomplished by complementary application of non–drug strategies aimed at a modest downward shift in the distribution of BP in the general population and more intensive use of the same strategies in individuals and groups at higher risk for development of hypertension.1 The latter includes persons with a high normal BP, a family history of hypertension, African– American ancestry, and those with one or more lifestyle attributes known to increase the risk of developing hypertension (overweight or obesity, sedentary lifestyle, excess intake of dietary sodium, insufficient intake of potassium, or excess consumption of alcohol). In addition to being mutually reinforcing, mathematical models suggest the general population and more intensive targeted strategies provide similar levels of cardiovascular disease prevention. The best proven non–drug interventions for treatment and prevention of hypertension are weight loss, reduced dietary sodium and increased dietary potassium, physical activity, moderation in alcohol consumption, and modification of eating patterns (Table 1).
Weight Loss More than one–third of US adults have a body mass index (BMI) 30 kg/m2 (obese) and more than two-thirds have a BMI 25 kg/m (overweight). Overweight and obesity are particularly prevalent in minority populations, persons with a lower income or education, and older women. Observational studies identify a strong positive relationship This article is part of the American Society of Hypertension Self-Assessment Guide series. For other articles in this series, visit the JASH home page at www.ashjournal.com. *Corresponding author: Paul K. Whelton, MB, MD, MSc. E-mail: [email protected]
between body weight and BP, type II diabetes, lipid abnormalities, arthritis, certain cancers, and all–cause mortality. Pooling of weight reduction trials identifies a decrease of approximately 1 mm Hg per kg of weight loss, with greater decrements in those with more weight loss and/or a higher starting level of BP.2 Maintenance of weight loss is a major challenge, although beneficial BP effects can persist despite substantial weight regain.
Sodium Reduction and Potassium Supplementation Most adults consume levels of sodium far greater than their physiologic need and the amount recommended by national health agencies and professional societies (1500 mg/d in those with high BP, African–Americans, and/or middle-age or older adults and 2300 mg/d in all Table 1 Goals for best proven non–drug interventions to treat or prevent hypertension Weight loss: Achieve and maintain a body mass index
American Society of Hypertension Self-Assessment Guide
Treatment: special conditions Prevention/public health strategies Paul K. Whelton, MB, MD, MSc To purchase and complete the ASH Hypertension Self-Assessments please use the following link: https://secure.ptcny.com/webtest
Primary prevention of high blood pressure (BP) provides an opportunity to reduce cardiovascular risk and interrupt the continuing costly cycle of managing hypertension and its consequences. It can be accomplished by complementary application of non–drug strategies aimed at a modest downward shift in the distribution of BP in the general population and more intensive use of the same strategies in individuals and groups at higher risk for development of hypertension.1 The latter includes persons with a high normal BP, a family history of hypertension, African– American ancestry, and those with one or more lifestyle attributes known to increase the risk of developing hypertension (overweight or obesity, sedentary lifestyle, excess intake of dietary sodium, insufficient intake of potassium, or excess consumption of alcohol). In addition to being mutually reinforcing, mathematical models suggest the general population and more intensive targeted strategies provide similar levels of cardiovascular disease prevention. The best proven non–drug interventions for treatment and prevention of hypertension are weight loss, reduced dietary sodium and increased dietary potassium, physical activity, moderation in alcohol consumption, and modification of eating patterns (Table 1).
Weight Loss More than one–third of US adults have a body mass index (BMI) 30 kg/m2 (obese) and more than two-thirds have a BMI 25 kg/m (overweight). Overweight and obesity are particularly prevalent in minority populations, persons with a lower income or education, and older women. Observational studies identify a strong positive relationship This article is part of the American Society of Hypertension Self-Assessment Guide series. For other articles in this series, visit the JASH home page at www.ashjournal.com. *Corresponding author: Paul K. Whelton, MB, MD, MSc. E-mail: [email protected]
between body weight and BP, type II diabetes, lipid abnormalities, arthritis, certain cancers, and all–cause mortality. Pooling of weight reduction trials identifies a decrease of approximately 1 mm Hg per kg of weight loss, with greater decrements in those with more weight loss and/or a higher starting level of BP.2 Maintenance of weight loss is a major challenge, although beneficial BP effects can persist despite substantial weight regain.
Sodium Reduction and Potassium Supplementation Most adults consume levels of sodium far greater than their physiologic need and the amount recommended by national health agencies and professional societies (1500 mg/d in those with high BP, African–Americans, and/or middle-age or older adults and 2300 mg/d in all Table 1 Goals for best proven non–drug interventions to treat or prevent hypertension Weight loss: Achieve and maintain a body mass index
