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Study under review: Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension
Hypertension, a condition characterized by elevated blood pressure, is one of the largest modifiable risk factors for cardiovascular disease. Hypertension is prevalent in almost 30% of the entire U.S. population, with both men and women affected equally. Blood pressure management is one of the primary interventions used to reduce the risk of cardiovascular disease and stroke. While pharmacotherapy with antihypertensive drugs is effective for managing blood pressure, other nondrug interventions such as diet, exercise, and stress management have also been shown to be effective.
Numerous randomized controlled trials of nondrug interventions, such as diet and exercise, have shown efficacy for lowering blood pressure. The effects of these interventions have previously been compared to drug based interventions and some, as shown in Figure 1, have been demonstrated to be as effective as drug based therapies alone, at least in people with systolic blood pressures above 150 mmHg. While these interventions have been compared to pharmacotherapy before, the effectiveness of the different nondrug interventions have not been systematically compared to each other. The present study was a meta-analysis comparing various nondrug interventions and their absolute and relative effectiveness at lowering blood pressure in people with primary hypertension and prehypertension.
Hypertension affects up to 30% of the entire U.S. population and is one of the leading risks for cardiovascular disease. Reduced blood pressure can be achieved through antihypertensive drugs, or through various nondrug interventions, such as diet, exercise, and stress management. The present meta-analysis under review compared the effectiveness of various nondrug interventions on lowering blood pressure in people with primary hypertension and prehypertension.
Other Articles in Issue #74 (December 2020)
Deep Dive: Comparing different protein sources' impact on bone turnover
Eating more plants can be healthy but may negatively impact bone health due to lower protein, calcium, and vitamin D intake. This trial examined how the same amount of protein from animal or plant sources affected bone turnover.
Deep Dive: Does low protein intake slow down chronic kidney disease progression?
Very low protein diets seem to slow progression but don't affect mortality, raising the question of whether there's a risk-benefit tradeoff. Higher quality, larger trials could shed more light on this issue.
Deep Dive: How does alternate-day fasting compare to no diet or other diets?
ADF helps people lose weight and lower cholesterol, but there's no clear advantage over continuous energy restriction based on the current evidence. Larger, longer studies are needed, though.
Mini: Dietary approaches and supplements to combat chronic pain
What nutritional interventions impact different chronic pain conditions? This NERD Mini summarizes the evidence from a systematic review released earlier this year.
Interview: Jeff Rothschild, RD, CSSD, PhD(c)
What should we eat before exercise? To find out, we picked the lead author's brain of a recent review that answers that exact question!
Deep Dive: Will nitrates improve your training performance? It depends!
Nitrates provide a small but significant performance boost, but dose, timing, and your baseline aerobic fitness matters.
Deep Dive: Determining the per-kilogram effects of weight loss on lipid levels
How much do blood lipids change for each kilogram of weight lost? This study aimed to answer this question, while also exploring whether the method of weight loss (through lifestyle, drugs, or bariatric surgery) matters much.