Hypertension- Non pharmacological measures

Following lifestyle modifications for blood pressure control are recommended:
1. The Dietary Approaches to Stop Hypertension (DASH) eating pattern should be preferred.
2. Reducing sodium intake.
3. Alcohol consumption to be reduced.
4. Exercise regularly.
5. Lose weight.
6. Smoking cessation.
7. Stress busters e.g. meditation

DIETARY CHANGES
The DASH diet suggests a diet rich in fruits and vegetables, high in potassium, magnesium, and calcium, and low in fats. Following this plan helps reduce systolic and diastolic blood pressure.
Although the studies are not conclusive, moderate intake of dark chocolate may lower BP. This is because it helps stabilize the inside of the blood vessels. Similarly, many studies propagate the advantages and benefits of diets rich in fructose for the metabolic syndrome and hypertension

SODIUM REDUCTION
The recommended salt consumption for patients of hypertension and prehypertension is such that sodium should be less than 100 mEq per L per day. A graded blood pressure response is usually found with a greater blood pressure reduction with a lower salt consumption. Reduction is salt intake is important in middle-aged to elderly people who have family members with hypertension.

REDUCE ALCOHOL CONSUMPTION
Reducing alcohol consumption may reduce blood pressure -systolic as well as diastolic. . A graded blood pressure response is usually found with a greater blood pressure reduction with lower alcohol consumption.

EXERCISE
It is clear that patients who exercise for at least 30 minutes or more daily, especially aerobic exercise have a reduced systolic as well as diastolic blood pressure. Aerobic exercise also helps reduce weight and the cardiovascular risk overall. One of the biggest problems with an exercise regime is that people may start with a great interest. But the interest gradually wanes. Therefore, patients need to find an exercise which they enjoy so that they stick to the plan longer. Also, if one has no time to exercise, a brisk walk at lunch may help.

WEIGHT LOSS
The fat distribution around abdomen may predispose to insulin resistance and hypertension. For reducing blood pressure, weight loss is an important step. A graded blood pressure response is usually found with a greater blood pressure reduction with a greater weight loss. Weight loss also helps reduce the risk of developing diabetes.
Weight loss with DASH diet results in improving the left ventricular mass. By this it helps reduce the stress on the heart.

SMOKING CESSATION
Smoking cigarettes releases Nicotine. This raises blood pressure by stimulating sympathetic nervous system. This releases norepinephrine and epinephrine that help raise the blood pressure. Complications of Hypertension e.g. cardiovascular disease and stroke increase in those who smoke.

DIETARY SUPPLEMENTS
The confirmatory data is low but Vitamin C and omega-3 fatty acids may reduce blood pressure.

STRESS BUSTERS
Stress is a cause of high blood pressure. Therefore a variety of stress busters are useful for reducing blood pressure. This may include any relaxing technique that may include music, books, meditation etc. Meditation is an age old well designed techniques that help reduce blood pressure. Other benefits of meditation are well known.

For all the above, large number of studies have been done periodically, and the standard guidelines also recommend these. more