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

• Type of Material: Article
• Authors: Fadi J. Charchar, Federation University Australia; Priscilla R. Prestes, Federation University Australia; Charlotte Mills, University of Reading; Siew Mooi Ching, Universiti Putra Malaysia; Dinesh Neupane, Johns Hopkins University; Francine Z. Marques, Monash University; James E. Sharman, University of Tasmania; Liffert Vogt, University of Amsterdam; Louise M. Burrell, University of Melbourne; Lyudmila Korostovtseva, Almazov National Medical Research Centre; Manja Zec, University of Arizona, Tucson; Mansi Patil, Asha Kiran JHC Hospital; Martin G. Schultz, University of Amsterdam; Matthew P. Wallen, Flinders University; Nicolás F. Renna, National University of Cuyo; Sheikh Mohammed Shariful Islam, Deakin University; Swapnil Hiremath, University of Ottawa; Tshewang Gyeltshen, St. Luke's International University; Yook-Chin Chia, Sunway University; Abhinav Gupta, Acharya Shri Chander College of Medical Sciences and Hospital; Aletta E. Schutte, North-West University; Britt Klein, Federation University Australia; Claudio Borghi, University of Bologna; Colette J. Browning, Federation University Australia; Marta Czesnikiewicz-Guzik, University of Glasgow; Hae-Young Lee, Seoul National University; Hiroshi Itoh, Keio University; Mattias Brunström, Umeå University; Norm R.C. Campbell, University of Calgary; Olutope Arinola Akinnibossun, Federation University Australia; Praveen Veerabhadrappa, The Pennsylvania State University; Richard David Wainford, Emory University; Ruan Kruger, North-West University; Shane A. Thomas, Federation University Australia; Takahiro Komori, Jichi Medical University; Udaya Ralapanawa, University of Peradeniya; Véronique A. Cornelissen, KU Leuven; Vikas Kapil, Queen Mary University; Yan Li, Shanghai Jiaotong University; Yuqing Zhang, Chinese Academy of Medical Sciences; Tazeen H. Jafar, Duke University; Nadia Khan, University of British Columbia; Bryan Williams, University College London; George Stergiou, National and Kapodistrian University of Athens; Maciej Tomaszewski, University of Manchester
• Language: English
• Date: 2023-09-12
• Publisher: Wolters Kluwer
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1097/HJH.0000000000003563
• Title of Journal or Parent Work: Journal of Hypertension
• Volume: 42
• Issue: 1
• Start Page: 23
• End Page: 49
• Grant/Funding Information: F.J.C, P.R.P., B.K, C.J.B and S.A.T. are supported by the Regional Research Collaboration grant from the Australian Government. A.E.S. is supported by a National Health and Medical Research Council of Australia (NHMRC) Leadership Investigator Grant (2017504). D.N. is supported by Resolve to Save Lives. Resolve to Save Lives is funded by Bloomberg Philanthropies, the Bill and Melinda Gates Foundation, and Gates Philanthropy Partners, which is funded with support from the Chan Zuckerberg Initiative. F.Z.M. is supported by a Senior Medical Research Fellowship from the Sylvia and Charles Viertel Charitable Foundation, a National Heart Foundation Future Leader Fellowship (105663), and NHMRC Emerging Leader Fellowship (GNT2017382). M.G.S. is supported by a National Heart Foundation of Australia Future Leader Fellowship (reference 102553). M.T.'s work on hypertension is supported by British Heart Foundation and the NIHR Manchester Biomedical Research Centre (NIHR203308). R.D.W. is supported by the National Institutes of Health (NIH) R01 HL139867, R01 HL141406, R01 AG062515 and R01 AG075963. S.M.S.I. is funded by the NHMRC and received funding from the National Heart Foundation of Australia.
• Keywords: pollution; holistic approach; mindfulness; obesity; exercise; diet; lifestyle; nutrition; Blood pressure; hypertension
• Research Categories: Health Sciences, Public Health; Health Sciences, Nutrition

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.