Lifestyle Modifications to Manage Hypertension and Prehypertension

Key modification: DASH

Recommendations are as follows:

  • • Focus on heart-healthy fats: that is, polyunsaturated and monounsaturated fats (sources include olive oil, canola oil, etc.)
  • • Eat at least 5 servings of fruits and vegetables every day
  • • Consume 2-3 servings of low-fat or reduced-fat dairy per day
  • • Reduce Na intake to 2400 mg/day or NaCl to 6 g/day
  • • Maintain adequate K intake if not taking K-sparing medications (sources include bananas, kiwi, avocado, potatoes with skin, nuts, yogurt)
  • • Among all grains consumed, half should be whole grains
  • • Limit red meat: Consume moderate amounts of lean unprocessed meats, poultry, and fish (2 servings of fish per week)

Key modification: Physical activity Recommendations are as follows:

  • • Avoid isometric exercises that may raise BP unless professionally supervised—for example, weight lifting
  • • At least 30 min of moderate-intensity physical activity for 5 days a week— for example, brisk walking (this can be spaced into three bouts of 10 min exercise throughout the day)

Key modification: Reducing Na intake Recommendations are as follows:

  • • Choose foods that say “sodium-free,” “very low sodium,” “reduced sodium,” “light in sodium,” “unsalted”
  • • Restrict the use of table salt
  • • Be spicy, not salty! Use alternative herbs and spices for flavoring—for example, bay leaves, nutmeg, basil, oregano, curry powder, ginger, garlic, and so on
  • • Avoid smoked, cured, frozen, canned, processed, and fast foods. When using canned foods, rinse them thoroughly with water

Key modification: Limit alcohol consumption Recommendations are as follows:

• No more than two standard drinks per day for men and one standard drink per day for women

Key modification: Reading and understanding food labels Recommendations are as follows:

  • • Reduced or less calories: At least 25% fewer calories per serving than the regular version
  • • Trans fat-free foods are not trans fat free: <0.5 g trans fat per serving can be labeled as “trans fat free.” Food low in trans fat may be high in saturated fat, so be sure to check
  • • Only products that state “no hydrogenated oil” or “hydrogenated oil free” have 0 g trans fats
  • • Fat free: <0.5 g/serving
  • • Low saturated fat: <1 g/serving
  • • Low fat: <3 g/serving
  • • Reduced fat: At least 25% less fat per serving than the regular version
  • • Light (in fat): Half the fat of the regular version
  • • Low cholesterol: <20 mg/serving; saturated fat: <2 g/serving
  • • Low sodium: <140 mg/serving
  • • Lean: <10 g of fat, <4.5 g of saturated fat, <95 mg of cholesterol per serving
  • • Extra Lean: <5 g of fat, <2 g of saturated fat, <95 mg of cholesterol per serving
  • • Calorie free: <5 calories/serving
  • • Low calorie: <40 calories/serving

Key modification: Weight loss and maintenance Recommendations are as follows:

  • • A 1% loss in body weight decreases systolic BP by 1 mm Hg
  • • Achieve and maintain BMI <25 kg/m3; waist circumference <94 cm for men and <80 cm for women (Huang et al. 2008)
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