2.4.0.0 Treat­ment Strate­gies

2.4.1.0 Lifestyle In­ter­ven­tion

Lifestyle man­age­ment is an im­por­tant com­po­nent of hy­per­ten­sion treat­ment be­cause it low­ers blood pres­sure, en­hances the ef­fec­tiveness of some an­ti­hy­per­ten­sive med­i­ca­tions, pro­motes other as­pects of metabol­ic and vas­cu­lar health, and gen­er­ally leads to few ad­verse ef­fects. Lifestyle ther­a­py con­sists of re­duc­ing ex­cess body weight through caloric re­stric­tion, re­strict­ing sodi­um in­take (<2,300 mg/‍day), in­creas­ing con­sump­tion of fruits and veg­eta­bles (8–10 serv­ings per day) and low-‍fat dairy prod­ucts (2–3 serv­ings per day), avoid­ing ex­cessive al­co­hol con­sump­tion (no more than 2 serv­ings per day in men and no more than 1 serv­ing per day in women) (46), and in­creas­ing ac­tiv­i­ty lev­els (47).

These lifestyle in­ter­ven­tions are rea­son­able for in­di­vid­u­als with di­a­betes and mild­ly el­e­vat­ed blood pres­sure (sys­tolic >120 mmHg or di­as­tolic >80 mmHg) and should be ini­ti­at­ed along with phar­ma­co­log­ic ther­a­py when hy­per­ten­sion is di­ag­nosed (Fig. 10.1) (47). A lifestyle ther­a­py plan should be de­vel­oped in col­lab­o­ra­tion with the pa­tient and dis­cussed as part of di­a­betes man­age­ment.

Figure 10.1—Recommendations for the treatment of confirmed hypertension in people with diabetes