Skip to Main Content
Home Books CURRENT Practice Guidelines in Primary Care 2019

Chapter 14: Cardiovascular Disorders

HYPERTENSION (HTN)

Population

  • –Persons at risk for developing HTN.a

Recommendations

CHEPb 2015, JNC 8, 2014, ICSI 15th Ed 2014, ESC 2013

  • –Recommend weight loss, reduced sodium intake, moderate alcohol consumption, increased physical activity, potassium supplementation, and modification of eating patterns.

  • –Above the normal replacement levels, supplementation of K, Ca, and Mg is not recommended for the prevention or treatment of HTN.

Sources

  • –Hypertension Canada.

  • –JAMA. 2014;311(5):507-520.

  • –Kenning I, Kerandi H, Luehr D, et al. Institute for Clinical Systems Improvement. Hypertension Diagnosis and Treatment. 2014.

  • –Eur Heart J. 2013;34:2159-2219.

Population

  • –Patients age >65 y.

Recommendation

ACCF/AHA 2011

  • –Lifestyle management is effective in all ages.

Source

  • –J Am Coll Cardiol. 2011;57(20):2037-2114.

Comments

  1. A 5 mm Hg reduction in systolic blood pressure in the population would result in a 14% overall reduction in mortality from stroke, a 9% reduction in mortality from CHD, and a 7% decrease in all-cause mortality.

  2. Weight loss of as little as 10 lb (4.5 kg) reduces blood pressure and/or prevents HTN in a large proportion of overweight patients.

Favorite Table | Download (.pdf) | Print
LIFESTYLE MODIFICATIONS FOR PREVENTION OF HYPERTENSION

  • Maintain a healthy body weight for adults (BMI, 18.5–24.9 kg/m2; waist circumference <102 cm for men and <88 cm for women).

  • Reduce dietary sodium intake to no more than 100 mmol/d (approximately 6 g of sodium chloride or 2.4 g of sodium/d). Per CHEP 2015: adequate intake 2000 mg daily (all >19-y-old) (80% in processed foods; 10% at the table or in cooking); 2000 mg sodium (Na) = 87 mmol sodium (Na)= 5 g of salt (NaCl) ~1 teaspoon of table salt.

  • Engage in regular aerobic physical activity, such as brisk walking, jogging, cycling, or swimming (30–60 min per session, 4–7 d/wk), in addition to the routine activities of daily living. Higher intensities of exercise are not more effective. Weight training exercise does not adversely influence BP.

  • Limit alcohol consumption to no more than 2 drinks (eg, 24 oz [720 mL] of beer, 10 oz [300 mL] of wine, or 3 oz [90 mL] of 100-proof whiskey) per day in most men and to no more than one drink per day in women and lighter-weight persons.

  • Maintain adequate intake of dietary potassium (>90 mmol [3500 mg]/d). Above the normal replacement levels, supplementation of potassium, calcium, and magnesium is not recommended for prevention or treatment of hypertension.

  • Daily K dietary intake >80 mmol.

  • Consume a diet that is rich in fruits and vegetables and in low-fat dairy products with a reduced content of saturated and total fat (Dietary Approaches to Stop Hypertension [DASH] ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

This site uses cookies to provide, maintain and improve your experience. MHE Privacy Center Close