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Erschienen in:

20.07.2023 | Implementation to Increase Blood Pressure Control: What Works? (J Brettler and K Reynolds, Section Editors)

Lifestyle Medicine as a Treatment for Resistant Hypertension

verfasst von: Fernando Ribeiro, Manuel Teixeira, Alberto J. Alves, Andrew Sherwood, James A. Blumenthal

Erschienen in: Current Hypertension Reports | Ausgabe 10/2023

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Abstract

Purpose of Review

Approximately 10% of the adults with hypertension fail to achieve the recommended blood pressure treatment targets on 3 antihypertensive medications or require ≥ 4 medications to achieve goal. These patients with ‘resistant hypertension’ have an increased risk of target organ damage, adverse clinical events, and all-cause mortality. Although lifestyle modification is widely recommended as a first-line approach for the management of high blood pressure, the effects of lifestyle modifications in patients with resistant hypertension has not been widely studied. This review aims to provide an overview of the emerging evidence on the benefits of lifestyle modifications in patients with resistant hypertension, reviews potential mechanisms by which lifestyles may reduce blood pressure, and discusses the clinical implications of the recent findings in this field.

Recent Findings

Evidence from single-component randomized clinical trials demonstrated that aerobic exercise, weight loss and dietary modification can reduce clinic and ambulatory blood pressure in patients with resistant hypertension. Moreover, evidence from multi-component trials involving exercise and dietary modification and weight management can facilitate lifestyle change, reduce clinic and ambulatory blood pressure, and improve biomarkers of cardiovascular risk.

Summary

This new evidence supports the efficacy of lifestyle modifications added to optimized medical therapy in reducing blood pressure and improving cardiovascular risk biomarkers in patients with resistant hypertension. These findings need to be confirmed in larger studies, and the persistence of benefit over extended follow-up needs further study.

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Titel: Lifestyle Medicine as a Treatment for Resistant Hypertension
verfasst von: Fernando Ribeiro
Manuel Teixeira
Alberto J. Alves
Andrew Sherwood
James A. Blumenthal
Publikationsdatum: 20.07.2023
Verlag: Springer US
Erschienen in: Current Hypertension Reports / Ausgabe 10/2023
Print ISSN: 1522-6417
Elektronische ISSN: 1534-3111
DOI: https://doi.org/10.1007/s11906-023-01253-5

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