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Deep Dive: The best non-drug ways to lower blood pressure

Drugs are usually an effective way to lower blood pressure, but non-drug interventions can help a lot, too! This network meta-analysis looked at which non-drug methods are the best for lowering blood pressure.

Study under review: Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension

Introduction

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[1] 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[2] and exercise[3], 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[4] 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.

Figure 1: Systolic pressure reduction in people with SBP of at least 150 mmHg (with 95% confidence intervals)

References: Naci et al. Br J Sports Med. 2019 Jul.[5]
Juraschek et al. J Am Coll Cardiol. 2017 Dec.[4]

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.

What was studied?

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The bigger picture

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Other Articles in Issue #74 (December 2020)