Table 4.

Six Best Proven Nonpharmacological Recommendations for Prevention and Management of Hypertension.

Recommendation	Intervention	Regimen and Dosage	Approximate SBP Lowering (mm Hg)
			Hypertension	No hypertension
Healthy diet	DASH diet is the best studied/proven healthy diet for BP lowering	Fruits, vegetables, whole grains, low-fat dairy products, with reduced saturated and total fat content. Limited dose-response information.	−5	−3
Weight loss	Calorie reduction and physical activity	Optimal goal is to achieve ideal body wight but any weight loss is desirable. Linear dose-response relationship. Expect about 1 mm Hg reduction in SBP for every 1 Kg weight loss.	−5	−3
Reduced dietary sodium intake	Dietary change	Optimal dietary intake goal is <1500 mg sodium/day, but any reduction is desirable. Linear dose-response relationship. Expect about 1-3 mm Hg reduction in SBP for a 1,000 mg reduction in sodium intake in adults with/without hypertension	−5	−3
Increased dietary potassium intake	Dietary change (preferred over pill supplementation)	Optimal goal of 3500 – 5000 mg potassium/day. Greater BP lowering identified in those consuming more dietary sodium. Nonlinear U-shaped dose-response relationship. Quality of evidence lower than for sodium reduction.	−5	−3
Physical activity	Aerobic exercise (best evidence)	Exercise such as brisk walking, 5-7 times /week (30-60 minutes/session), aiming for at least 150 minutes/week. Gradual start up. Warm up at start and cool down at end of each session.	−5	−3
	Dynamic resistance exercise (evidence less robust)	Exercise such as weight-lifting or circuit training, at least 2-3 times/week. Generally requires guidance/supervision by exercise professional. Often used as a supplement to aerobic exercise.	−4	−2
	Isometric resistance exercise (evidence least robust)	Exercise such as hand-grip training regimens, at least 3-4 times/week.	−4	−2
Moderation in alcohol intake	Reduction in alcohol consumption	In adults who drink alcohol, intake goal: Men: ≤2 standard drinks/day Women: ≤1 standard drink/day	−4	−3

DASH, dietary approaches to stop hypertension; SBP, systolic blood pressure.