Lifestyle Interventions in Hypertension: International Society of Hypertension 2023 Position Paper
Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140mmHg and/or diastolic blood pressure (DBP) at least 90mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with an increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure, and stroke) and death.
An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as a first-line strategy to prevent and control hypertension in adulthood. These lifestyle changes are required to be continued along with blood pressure-lowering medications. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, and management of stress and sleep levels.
The lifestyle changes recommended in the position paper can be grouped around movement & body weight, food & drinks, body and mind, and other interventions.
The key interventions from the position paper include the following:
A. Movement and Body Weight
- Maintain a healthy weight such that waist to height ratio is <0.5. The paper reinforces minimizing sedentary behavior
- It is recommended to engage in aerobic exercises including,
- Moderate (brisk walking) for 30 minutes, 5 times a week,
- Vigorous (running) for 20 minutes, 3 times a week and
- Interval training, for 25 minutes, 3 times a week
- It is recommended to engage in dynamic resistance exercises (weight training) on two or more non-consecutive days
- It is recommended to engage in isometric resistance exercises (muscle tightening), four two-minute contractions on 3 non-consecutive days
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