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Lifestyle interventions

Lifestyle advice is key to the management of hypertension. Trials have shown a direct correlation between lifestyle interventions and blood pressure reduction. 

Targets

Diet

The NHS has developed the Eatwell Guide to provide members of the public with written and visual information on improving their diet. You can signpost people to the Eatwell guide on the NHS website or provide a leaflet to support them. 

The Dietary Approaches to Stop Hypertension (DASH) trial demonstrated that diets high in fruit and vegetables, including whole grains, poultry, fish and nuts as well as low-fat dairy, and small amounts of processed foods, red meat and sugary drinks, with decreased amounts of saturated fats and cholesterol has benefits in reducing blood pressure. 

Exercise

The NHS recommends that all adults do 150 minutes of moderate intensity exercise, or 75 minutes of vigorous exercise every week. Increased physical activity improves health in people with chronic conditions, as well as helping to prevent common medical conditions.

Smoking cessation

The link between cigarette smoking and hypertension has yet to be fully determined. Smoking does, however, contribute to atherosclerosis and high blood pressure accelerates this, which increases a person’s cardiovascular risk. NICE recommends that smoking cessation should be offered as a treatment.

Weight loss

Weight reduction should be offered to patients who are overweight or obese. NICE recommends group lifestyle-based interventions if the patient does not express a preference for an individual programme. Studies have shown that access to group-based weight loss programmes can increase a person’s weight loss compared to those who do it alone, by up to 3.5 kg more. 

Alcohol

The Chief Medical Officer recommends that no more than 14 units of alcohol are consumed per week by men and women. Everyone should be advised to have alcohol free days. People can calculate the number of units they drink using the calculator on Drinkaware site. 

Salt (sodium)

The Food Standards Agency recommends that adults and children over the age of 11 should have no more than 6g of salt a day. Reducing processed food and not adding salt during cooking or at the table can help to achieve this target. Action Salt reports that for every one gram of salt that is removed from a person’s diet, there would be 6,000 less deaths from stroke and heart attack every year in the UK.

When it comes to salt substitutes, NICE states: "Salt substitutes containing potassium chloride should not be used by older people, people with diabetes, pregnant women, people with kidney disease and people taking some antihypertensive drugs, such as ACE inhibitors and angiotensin-II receptor blockers. Encourage salt reduction in these groups."

Practice point

Healthcare professionals are encouraged to 'make every contact count'. 

How will you work towards making sure you achieve this? 

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