Great importance is being given to life style modifications because of definite benefits observed in patients who follow this. Life style changes have advantages not only in the control of hypertension, but also in the management of dyslipidemia and diabetes.
General Measures: Diet, Weight, Alcohol, Smoking
1) While the major effects of tobacco are in the development of atherosclerotic heart disease, its role in management of hypertension cannot be forgotten. The pressure effect of tobacco is so strong that the blood pressure comes down immediately after stoppage of smoking. Tobacco is one of the agents that induces clustering of risk factors.
2) Body weight: Lowering of excess body weight can lower BP. In one of the studies it was found that a decrease of 1 kg of body weight is associated with an average fall of 1.6 mmHg. Indeed in many instances, it would be possible to discontinue medications after effective weight control.
3) Dietary Sodium: Restriction of dietary sodium is one of the most useful methods of controlling hypertension. This fact should be emphasized because of the increasing use of fast foods which have high salt content. It has to be admitted that this cannot be achieved easily. Norman Kaplan gives these practical suggestions:
a) Do not add salt during cooking or at the table
b) If salt is desired, add half sodium and half potassium chloride preparations
c) Avoid fast foods
d) Be careful about the sodium content of some medications
4) Alcohol: Alcohol consumption of more than 1 oz of ethanol is found to increase blood pressure. Hence moderation is recommended. One of the major hazards of drinking is the usual, associated consumption of high salt savouries, which are an unseen source of salt.
5) Regular physical exercise has been found to induce reduction in blood pressure in hypertensives.
6) Relaxation techniques: There have been various reports as to the efficacy of yoga, transcendal meditation, etc., but none of these have been been accepted by on the basis of statistical studies. However, it is widely accepted that relaxation techniques along with other reduction in risk factors do definitely decrease the incidence of cardiovascular complications.