Non Pharmacological Management Of Hypertension
Abstract
Hypertension is an insidious disease which predisposes to cardiovascular complications and if not treated
properly can lead to various serious complications.
Economic limitations, having additional benefits
with few or almost no side effects have made non‐pharmacological management of hypertension
an attractive approach for dealing
with hypertension, in developed and developing countries alike. A MEDLINE search was done for relevant references with emphasis on original studies, randomized controlled trials, and meta‐analyses for this review paper. Lifestyle modifications including changes in the dietary pattern, adopting special diets with low sodium, saturated fat and high calcium, magnesium and potassium and
trying the new methods like time restricted meal intake which work in tandem with the circadian rhythm
are opening new vistas in the field of
non‐pharmacological management of hypertension.
Lifestyle modifications that effectively
lower blood pressure are increased physical activity,
weight loss, limited alcohol consumption, relaxation techniques of Yoga, Acupuncture, Tai chi, mindfulness‐based stress‐reduction program, and Transcendental Meditation.
Air pollution of the surrounding air is linked with poor health outcomes and is a major contributor to the global burden of disease. Fine particulate matter <2.5 μm in diameter (PM2.5) is strongly associated with cardiovascular morbidity and mortality. Short‐term PM
exposure (hours to weeks) increases the likelihood
of adverse cardiovascular events including myocardial infarction, stroke, and heart failure, and longer‐term exposure multiplies that risk. KeNon‐pharmacological methods should be initiated early phase of disease and should be continued with medication
INTRODUCTION
Hypertension is one of the most important preventable
cardiovascular risk factor which impacts health, disease, is
and death.( 1 , 2 , 3 )It is prevalent in most of the developed,
underdeveloped, and developing countries. In Asia, the prevalence ranges from 20,8% in Taiwan to 50.3%
in Pakistan. (4) In India, the prevalence of hypertension is about 29.8% (95% confidence interval: 26.7‐33.0).
(also same prevalence in my paper) Significant
differences in prevalence are seen between rural
and urban areas, respectively (27.6% [23.2‐32.0] and 33.8% [29.7‐37.8]; P = .05]( 4)
Hypertension is one of the most common non‐communicable
disease treated in primary care and if not treated properly can lead to various serious complications like myocardial infarction, stroke, renal failure, and death.(5)
It is considered as a primary cause for cerebrovascular (51%) and cardiovascular (45%) mortality.( 6)
A reduction of just 5 mm of Hg SBP has been found to be associated with mortality reductions of 14% from
stroke, 9% from heart disease, and 7% from all‐cause mortality.( 7 )The latest American guidelines on
management of hypertension in 2017 introduced a lower
threshold of BP of ≥130/80 mmHg be the cut‐off point for a diagnosis of hypertension.
Although this lower threshold for diagnosis was introduced much to the alarm of many practitioners, the
American guidelines do not recommend ¡ therapy for such individuals diagnosed as hypertension
. In fact, it was specifically emphasized that life‐style modifications be instituted at this point and that only those with an global CV risk of ≥10% be treated pharmacologically on the top of life‐style modifications. That non‐pharmacological management was recommended was that there is good data that supports the use of non‐pharmacological interventions for reducing BP.
These non‐pharmacological modifications include weight loss, dietary modifications, increasing physical activity, and reducing alcohol intake. Other interventions
like tobacco cessation, meditation, acupuncture, biofeedback, home monitoring, dietary supplements (eg, garlic, cocoa, vitamin C,
coenzyme Q10, omega‐3 fatty acids, calcium, potassium, and magnesium), and the use of continuous positive airway pressure for patients with obstructive sleep apnoea
have also been examined.
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