Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ HYPERTENSION (HTN) +++ Population ++ – Persons at risk for developing HTN.a +++ Recommendations +++ ACC/AHA 2017, ESC/ESH 2018, Hypertension Canada 2018, JNC 8, ICSI 2018 ++ – Lose weight toward or maintain normal BMI <25, restrict sodium intake <2 g/d, moderate alcohol consumption <14 drinks/wk for men, <8–9 drinks/wk for women, increase physical exercise 30 min/d 5–7 days/wk, emphasize smoking cessation. – Consume diet rich in vegetables, fruit, fish, nuts, whole grains, low-fat dairy products, and unsaturated fats. – Do not supplement calcium or magnesium for the prevention or treatment of HTN. +++ Hypertension Canada 2018 ++ – For patients not at risk of hyperkalemia, increase dietary potassium intake to reduce BP. – Recommend stress management including relaxation techniques for patients whose stress might be contributing to high BP. +++ Sources ++ – ACC/AHA. J Am Coll Cardiol. 2018;71:e127-e248. – USPSTF. Ann Int Med. 2015;163(10):778-787. – ESC/ESH. Eur Heart J. 2018;39:3021-3104. – Can J Cardiol. 2018;34:506-525. – JAMA. 2014;311(5):507-520. – ICSI Hypertension Work Group: 2018 Commentary. +++ Population ++ – Patients age ≥65 y. +++ Comments ++ A 10-mmHg reduction in SBP or 5-mmHg reduction in DBP would decrease all major cardiovascular events by 20%, all-cause mortality by 10–15%, stroke by 35%, coronary events by 20%, heart failure by 40%. (ESC/ESH. Eur Heart J. 2018;39:3021-3104) For overweight patients, expect 1-mmHg reduction in SBP for every 1-kg reduction in body weight. (ACC/AHA. J Am Coll Cardiol. 2018;71:e127-e248) ++ Table Graphic Jump Location | 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 2000 mg sodium/d (approximately 5 g of sodium chloride). 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 or 90–150 min/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. Isometric exercise, eg, hand grip 4×2 min, 1 min rest between exercises, 3 sessions/wk shown to reduce 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 ... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth