a systematic review of randomized controlled trials suggests patients with elevated blood ...

A systematic review of randomized controlled trials suggests patients with elevated blood pressure should follow a weight-reducing diet, take regular exercise, and restrict alcohol and salt intake

The purpose of this study was to quantify effectiveness of lifestyle interventions for hypertension. Data was derived from electronic bibliographic databases from 1998 onwards, existing guidelines, systematic reviews. The researchers included randomized, controlled trials with at least 8 weeks' follow-up, comparing lifestyle with control interventions, enrolling adults with blood pressure at least 140/85 mmHg. Primary outcome measures were systolic and diastolic blood pressure.

They categorized trials by type of intervention and used random effects meta-analysis to combine mean differences between endpoint blood pressure in treatment and control groups in 105 trials randomizing 6805 participants. Robust statistically significant effects were found for improved diet, aerobic exercise, alcohol and sodium restriction, and fish oil supplements: mean reductions in systolic blood pressure of 5.0 mmHg, 4.6 mmHg, 3.8 mmHg, 3.6 mmHg and 2.3 mmHg, respectively, with corresponding reductions in diastolic blood pressure. Relaxation significantly reduced blood pressure only when compared with non-intervention controls. They found no robust evidence of any important effect on blood pressure of potassium, magnesium or calcium supplements.

The researchers concluded: “Patients with elevated blood pressure should follow a weight-reducing diet, take regular exercise, and restrict alcohol and salt intake. Available evidence does not support relaxation therapies, calcium, magnesium or potassium supplements to reduce blood pressure.”

Journal of Hypertension. 24(2):215-233, February 2006. © 2006 Lippincott Williams & Wilkins, Inc.
Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials, Dickinson, Heather O, Mason, James M, Nicolson, Donald J, Campbell, Fiona, Beyer, Fiona R, Cook, Julia V, Williams, Bryan, Ford, Gary A.

Category K. Circulatory, T. Endocrine/Metabolic/Nutritional. Keywords: lifestyle interventions, blood pressure, hypertension, weight reducing diet, exercise, alcohol, salt, systematic review
Synopsis edited by Dr Stephen Wilkinson, Melbourne. Posted on Global Family Doctor 29 March 2006