Lifestyle Modifications

Beginning with a BP of 115/75 mmHg, cardiovascular disease (CVD) risk doubles for each increased increment of 20/10 mmHg. Those who are normotensive (BP <120/80 mmHg), at age 55 will have a 90% lifetime risk of developing HTN and adoption of a healthy lifestyle is critical to reduce this risk.14 Patients with Elevated BP (BP 120-129/<80) are not candidates for drug therapy and should be firmly and unambiguously advised of health-promoting lifestyle modifications to reduce their risk of progressive rise of BP in the future.14,18 Table 7 presents recommended lifestyle modifications to reduce the risk of developing HTN.14,18

Table 7. Recommended Lifestyle Modifications to Reduce the Risk of Developing Hypertension.
Modification Recommendation
Weight Loss Target ideal body weight. But aim for at least a 1-kg reduction in body weight for most adults who are overweight. Expect about 1 mm Hg for every 1-kg reduction in body weight.
Healthy diet Consume a diet rich in fruits, vegetables, whole grains, and low-fat dairy products. Reduce intake saturated and total fat.
Reduced intake of dietary sodium Target goal is <1500 mg/d, but aim for at least a 1000-mg/d reduction in most adults.
Enhanced intake of dietary potassium Aim for 3500–5000 mg/d, preferably by consumption of a diet rich in potassium.
Physical activity Aerobic
  • 90–150 min/wk
  • 65%–75% heart rate reserve
Dynamic Resistance
  • 90–150 min/wk
  • 50%–80% 1 rep maximum
  • 6 exercises, 3 sets/exercise, 10 repetitions/set
Isometric Resistance
  • 4 × 2 min (hand grip), 1 min rest between exercises
  • 30%–40% maximum voluntary contraction, 3 sessions/wk, 8–10 wk
Moderation in alcohol intake In individuals who drink alcohol, reduce alcohol to:
  • Men: ≤2 drinks daily
  • Women: ≤1 drink daily
One “standard” drink contains roughly 14 g of pure alcohol, which is typically found in 12 oz of regular beer (usually about 5% alcohol), 5 oz of wine (usually about 12% alcohol), and 1.5 oz of distilled spirits (usually about 40% alcohol)