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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
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Best proven nonpharmacologic interventions for prevention and treatment of hypertension*

Best proven nonpharmacologic interventions for prevention and treatment of hypertension*
  Nonpharmacologic intervention Dose Approximate impact on SBP
Hypertension Normotension Reference
Weight loss Weight/body fat
  • Best goal is ideal body weight, but aim for at least a 1 kg reduction in body weight for most adults who are overweight. Expect about 1 mmHg for every 1 kg reduction in body weight.
 –5 mmHg –3 mmHg [1]
Healthy diet DASH dietary pattern
  • Consume a diet rich in fruits, vegetables, whole grains, and low-fat dairy products, with reduced content of saturated and total fat.
 –11 mmHg –3 mmHg [2,3]
Reduced intake of dietary sodium Dietary sodium
  • Optimal goal is <1500 mg/day, but aim for at least a 1000 mg/day reduction in most adults.
 –5 to –6 mmHg –2 to –3 mmHg [4,5]
Enhanced intake of dietary potassium Dietary potassium
  • Aim for 3500 to 5000 mg/day, preferably by consumption of a diet rich in potassium.
 –4 mmHg –2 mmHg [6]
Physical activity Aerobic
  • 90 to 150 minutes/week.
  • 65 to 75% heart rate reserve.
 –5 to –8 mmHg –2 to –4 mmHg [7,8]
Dynamic resistance
  • 90 to 150 minutes/week.
  • 50 to 80% of maximum 1 repetition weight.
  • 6 exercises, 3 sets/exercise, 10 repetitions/set.
 –4 mmHg –2 mmHg [7]
Isometric resistance
  • 4 × 2 minutes (hand grip), 1 minute rest between exercises, 30 to 40% maximum voluntary contraction, 3 sessions/week.
  • 8 to 10 weeks.
 –5 mmHg –4 mmHg [9,10]
Moderation in alcohol intake Alcohol consumption
  • In individuals who drink alcohol, reduce alcohol to:
    • Men: ≤2 drinks daily.
    • Women: ≤1 drink daily.
 –4 mmHg –3 mmHg [11-13]

DASH: Dietary Approaches to Stop Hypertension; SBP: systolic blood pressure.

* Type, dose, and expected impact on BP in adults with a normal BP and with hypertension.

¶ In the United States, one "standard" drink contains roughly 14 g of pure alcohol, which is typically found in 12 oz of regular beer (usually about 5% alcohol), 5 oz of wine (usually about 12% alcohol), and 1.5 oz of distilled spirits (usually about 40% alcohol).[14]
Resources:

References:

  1. Neter JE, Stam BE, Kok FJ, et al. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2003; 42:878.
  2. Appel LJ, Champagne CM, Harsha DW, et al. Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA 2003; 289:2083.
  3. Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997; 336:1117.
  4. Aburto NJ, Ziolkovska A, Hooper L, et al. Effect of lower sodium intake on health: systematic review and metaanalyses. BMJ 2013; 346:f1326.
  5. He FJ, Li J, MacGregor GA. Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ 2013; 346:f1325.
  6. Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 1997; 277:1624.
  7. Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc 2013; 2:e004473.
  8. Whelton SP, Chin A, Xin X, et al. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med 2002; 136:493.
  9. Carlson DJ, Dieberg G, Hess NC, et al. Isometric exercise training for blood pressure management: a systematic review and meta-analysis. Mayo Clin Proc 2014; 89:327.
  10. Inder JD, Carlson DJ, Dieberg G, et al. Isometric exercise training for blood pressure management: a systematic review and meta-analysis to optimize benefit. Hypertens Res 2016; 39:88.
  11. Whelton SP, Chin A, Xin X, et al. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med 2002; 136:493.
  12. Xin X, He J, Frontini MG, et al. Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2001; 38:1112.
  13. Roerecke M, Kaczorowski J, Tobe SW, et al. The effect of a reduction in alcohol consumption on blood pressure: a systematic review and meta-analysis. Lancet Public Health 2017; 2:e108.
  14. National Institute on Alcohol Abuse and Alcoholism (NIAAA). What Is A Standard Drink? https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/what-standard-drink (Accessed on August 16, 2017).

Reproduced from: Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol 2017. Table used with the permission of Elsevier Inc. All rights reserved.

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