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Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension

Charchar FJ 1 , Prestes PR 1 , Mills C 2 , Ching SM 3 , Neupane D 4 , Marques FZ 5 Show all authors , Sharman JE 6 , Vogt L 7 , Burrell LM 8 , Korostovtseva L 9 , Zec M 10 , Patil M 11 , Schultz MG 7 , Wallen MP 12 , Renna NF 13 , Islam SMS 14 , Hiremath S 15 , Gyeltshen T 16 , Chia YC 17 , Gupta A 18 , Schutte AE 19 , Klein B 1 , Borghi C 20 , Browning CJ 1 , Czesnikiewicz-Guzik M 21 , Lee HY 22 , Itoh H 23 , Miura K 24 , Brunström M 25 , Campbell NRC 26 , Akinnibossun OA 1 , Veerabhadrappa P 27 , Wainford RD 28 , Kruger R 29 , Thomas SA 1 , Komori T 30 , Ralapanawa U 31 , Cornelissen VA 32 , Kapil V 33 , Li Y 34 , Zhang Y 35 , Jafar TH 36 , Khan N 37 , Williams B 38 , Stergiou G 39 , Tomaszewski M 40

Affiliations 

  • 1 Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
  • 2 Department of Food and Nutritional Sciences, University of Reading, Reading, UK
  • 3 Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang
  • 4 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
  • 5 Hypertension Research Laboratory, School of Biological Sciences, Monash University
  • 6 Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
  • 7 Department of Internal Medicine, Section Nephrology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands
  • 8 Department of Medicine, University of Melbourne, Austin Health, Melbourne, Australia
  • 9 Department of Hypertension, Almazov National Medical Research Centre, St Petersburg, Russia
  • 10 School of Nutritional Sciences and Wellness, University of Arizona, Tucson, USA
  • 11 Department of Nutrition and Dietetics, Asha Kiran JHC Hospital, Chinchwad
  • 12 Caring Futures Institute, Flinders University, Adelaide, Australia
  • 13 Unit of Hypertension, Hospital Español de Mendoza, School of Medicine, National University of Cuyo, IMBECU-CONICET, Mendoza, Argentina
  • 14 Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
  • 15 Department of Medicine, University of Ottawa and the Ottawa Hospital, Ottawa, Canada
  • 16 Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
  • 17 Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Selangor
  • 18 Department of Medicine, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, India
  • 19 School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, New South Wales, Australia
  • 20 Department of Medical and Surgical Sciences, Faculty of Medicine, University of Bologna, Bologna, Italy
  • 21 School of Medicine, Dentistry and Nursing-Dental School, University of Glasgow, UK
  • 22 Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
  • 23 Department of Internal Medicine (Nephrology, Endocrinology and Metabolism), Keio University, Tokyo
  • 24 NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
  • 25 Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
  • 26 Libin Cardiovascular Institute, Department of Medicine, University of Calgary, Calgary, Canada
  • 27 Kinesiology, Division of Science, The Pennsylvania State University, Reading, Pennsylvania
  • 28 Department of Pharmacology and Experimental Therapeutics, The Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston
  • 29 Hypertension in Africa Research Team (HART), North-West University, Potchefstroom
  • 30 Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
  • 31 Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
  • 32 Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
  • 33 William Harvey Research Institute, Centre for Cardiovascular Medicine and Devices, NIHR Barts Biomedical Research Centre, BRC, Faculty of Medicine and Dentistry, Queen Mary University London
  • 34 Department of Cardiovascular Medicine, Shanghai Institute of Hypertension, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai
  • 35 Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Chinese Hypertension League, Beijing, China
  • 36 Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
  • 37 Department of Medicine, University of British Columbia, Vancouver, Canada
  • 38 University College London (UCL), Institute of Cardiovascular Science, National Institute for Health Research (NIHR), UCL Hospitals Biomedical Research Centre, London, UK
  • 39 Hypertension Centre STRIDE-7, School of Medicine, Third Department of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Athens, Greece
  • 40 Division of Cardiovascular Sciences, Faculty of Medicine, Biology and Health, University of Manchester
J Hypertens, 2024 Jan 01;42(1):23-49.
PMID: 37712135 DOI: 10.1097/HJH.0000000000003563

Abstract

Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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