Several studies have demonstrated that treating patients to lower their blood pressure significantly decreases their risk for developing disabling and potentially deadly complications like heart attack, sudden death, heart failure, stroke, and kidney failure.
The goal of treatment for most patients is to lower the systolic blood pressure below 140 mm Hg and the diastolic blood pressure below 90 mm Hg. In some patients, such as those with diabetes, it is recommended that blood pressure be lowered even further, to a systolic pressure below 130 mm Hg and a diastolic pressure below 85 mm Hg.
In some patients, particularly those whose blood pressure is moderately elevated, life style modifications alone may achieve treatment goals. Patients who require pharmacological therapy may reduce the number and doses of medications through life style modification. The following modifications in diet and physical activity should be discussed with a doctor or health care provider.
- Weight loss. Overweight patients can reduce blood pressure by losing weight. Gradual weight loss through modified calorie intake and increased physical activity is a good approach. A goal of losing 10-15 pounds is reasonable for many patients.
- Physical activity. Regular, moderate aerobic exercise can modestly decrease blood pressure and has many other beneficial effects. A program of gradually increased activity is most prudent, such as taking a brisk, 20–30 minute walk, 3–5 times a week. All persons with chest pain (angina) and known or suspected heart disease should talk to their doctor before beginning a exercise program.
- Salt (sodium chloride) restriction. Excessive salt intake can contribute to hypertension in some people. Even modest restriction of salt may decrease blood pressure. Generally, many doctors advise those with high blood pressure to avoid salty food and to limit daily sodium intake to no more than approximately 2.4 grams. (Doctors use the words "salt" and "sodium" interchangeably.)
- Limited alcohol consumption. Moderate alcohol intake (one or two glasses of an alcoholic beverage a day) does not appear to cause hypertension; however, chronic heavy alcohol use elevates blood pressure. This is the most common reversible cause of high blood pressure. Therefore, hypertension patients who drink alcohol excessively should discuss this issue with their health care provider and reduce their consumption of alcohol.