. Author manuscript; available in PMC: 2021 Aug 9.

Published in final edited form as: Circulation. 2019 Mar 17;140(11):e563–e595. doi: 10.1161/CIR.0000000000000677

Table 7.

Best Proven Nonpharmacological Interventions for Prevention and Treatment of Hypertension^*

	Nonpharmacological Intervention	Goal	Approximate Impact on SBP
	Nonpharmacological Intervention	Goal	Hypertension	Normotension	Reference
Weight loss	Weight/body fat	Best goal is ideal body weight, but aim for at least a 1-kg reduction in body weight for most adults who are overweight. Expect about1 mm Hg for every 1-kg reduction in body weight.	−5 mm Hg	−2/3 mm Hg	(S4.4–2)
Healthy diet	DASH dietary pattern^†	Consume a diet rich in fruits, vegetables, whole grains, and low-fat dairy products, with reduced content of saturated and total fat.	−11 mm Hg	−3 mm Hg	(S4.4–7, S4.4–8)
Reduced intake of dietary sodium	Dietary sodium	Optimal goal is <1500 mg/d, but aim for at least a 1000-mg/d reduction in most adults.	−5/6 mm Hg	−2/3 mm Hg	(S4.4–12, S4.4–10)
Enhanced intake of dietary potassium	Dietary potassium	Aim for 3500–5000 mg/d, preferably by consumption of a diet rich in potassium.	−4/5 mm Hg	−2 mm Hg	(S4.4–14)
Physical activity	Aerobic	• 90–150 min/wk • 65%–75% heart rate reserve	−5/8 mm Hg	−2/4 mm Hg	(S4.4–19, S4.4–20)
	Dynamic resistance	• 90–150 min/wk • 50%–80% 1 rep maximum • 6 exercises, 3 sets/exercise, 10 repetitions/set	−4 mm Hg	−2 mm Hg	(S4.4–19)
	Isometric resistance	• 4 × 2 min (hand grip), 1 min rest between exercises, 30%–40% maximum voluntary contraction, 3 sessions/wk • 8–10 wk	−5 mm Hg	−4 mm Hg	(S4.4–21, S4.4–63)
Moderation in alcohol intake	Alcohol consumption	In individuals who drink alcohol, reduce alcohol^‡ to: • Men: ≤2 drinks daily • Women: ≤1 drink daily	−4 mm Hg	−3 mm Hg	(S4.4–20, 54.4– 24, 54.4–25)

Type, dose, and expected impact on BP in adults with a normal BP and with hypertension.

^†

Detailed information about the DASH diet is available via the NHLBI (S4.4–65) and Dashdiet.org (S4.4–66).

^‡

In the United States, 1 “standard” drink contains roughly 14 g of pure alcohol, which is typically found in 12 oz of regular beer (usually about 5% alcohol), 5 oz of wine (usually about 12% alcohol), and 1.5 oz of distilled spirits (usually about 40% alcohol) (S4.4–64).

BP indicates blood pressure; DASH, Dietary Approaches to Stop Hypertension; NHLBI, National Heart, Lung, and Blood Institute; and SBP, systolic blood pressure.