Diet in the treatment and prevention of hypertension
- Norman M Kaplan, MD
Norman M Kaplan, MD
- Editor-in-Chief — Nephrology
- Section Editor — Hypertension
- Clinical Professor of Internal Medicine
- University of Texas Southwestern Medical Center
- John P Forman, MD, MSc
John P Forman, MD, MSc
- Senior Deputy Editor — UpToDate
- Deputy Editor — Nephrology
- Assistant Professor of Medicine
- Harvard Medical School
A variety of dietary modifications are beneficial in the treatment of hypertension, including reduction of sodium intake, moderation of alcohol, weight loss in the overweight or obese, and a diet rich in fruits, vegetables, legumes, and low-fat dairy products and low in snacks, sweets, meat, and saturated fat. Individual dietary factors may also reduce blood pressure (BP) .
Nondietary modalities of lifestyle modification should also be considered, including cessation of smoking and institution of an aerobic exercise regimen. (See "Smoking and hypertension" and "Exercise in the treatment and prevention of hypertension".)
Most of the studies on nonpharmacologic therapy evaluated only a single factor to prove its efficacy (eg, weight reduction without sodium restriction). In making recommendations to the individual patient, however, the clinician will try to modify all of the factors that may be contributing to the elevation in BP, although it is uncertain if the effects of different modifications are additive.
In those with prehypertension or stage 1 hypertension, lifestyle changes may control the BP adequately . However, in those with either higher BP or additional risk (eg, diabetes or chronic kidney disease), drug therapies should first be used to more quickly and effectively control the BP. Once BP is well controlled, lifestyle changes should be strongly advised. If these are successfully achieved, reduction of medications may be possible.
This topic will review the effect of comprehensive dietary modification, as well as the effects of individual dietary interventions on BP.
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- COMPREHENSIVE DIETARY MODIFICATION
- Treatment of Mild Hypertension Study
- Dietary Approaches to Stop Hypertension trial
- Low-sodium DASH
- PREMIER trial
- Diet versus antihypertensive agents
- SALT RESTRICTION AND WEIGHT REDUCTION
- OTHER DIETARY INTERVENTIONS
- Fish oil
- - Fish intake
- High-fiber diet
- Protein intake
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS