Box 4.

Recommendation and Suggestion for first line treatment of hypertension

1- It is recommended that lifestyle modification be considered the first therapeutic intervention in people with prehypertension, and in individuals with hypertension, both non-pharmacological and pharmacological treatment be considered General recommendations for lifestyle modification include the following: - Body mass index and waist circumference should be measured and it is recommended to keep both within a healthy range - The total daily intake of salt should be less than 5 g, the consumption of salty foods and adding salt during cooking should be limited, and using salt shaker should be avoided - Diet should contain fruits and vegetables, low-fat dairy products, whole grains, fish, poultry, vegetable protein, such as beans and oil nuts that are rich in magnesium, potassium, calcium, and fiber. In the diet of these people, saturated and trans fats, meat, sweets, and soft b drinks should be reduced - The use of potassium, calcium, and magnesium supplements is not recommended for the treatment of hypertension - Adults should perform at least 150–300 min of moderate-intensity aerobic physical activity or at least 75–150 min of vigorous-intensity aerobic physical activity in a week, or an equivalent combination of moderate-intensity and vigorous-intensity activity - Adults should do at least two days a week of moderate- or high-intensity activities that engage all major muscle groups - Any type of tobacco (e.g., cigarettes and hookah) and alcohol should be refrained in any amount, and in case of previous use, it should be stopped 2- It is suggested to consider stress coping methods, such as relaxation and yoga, as an intervention 3- It is suggested that people suffering from prehypertension and hypertension not to be exposed to polluted air 4-It is suggested that people suffering from prehypertension and hypertension and their families be educated on how to measure and monitor blood pressure as well as on adherence to drug treatment and lifestyle modification