michigan hypertension core curriculum - State of Michigan

interestingly found only a 6.0/4.6 decrease in BP with a 10 kg loss of body weight, at two years of
follow-up, half of what would be expected from the Neter study. An important observation was that the
BP improvement was reduced if the weight loss was surgical in nature. 11
Aerobic exercise
Aerobic exercise has been shown to lower BP by an average of 3/2 mmHg. The effect
attenuates when you look at studies of longer duration and in studies with less stringent verification of
adherence. 12 In a study on the dose effect of exercise, greater hypotensive effect was found with 61-
90 minutes compared to 30-60 minutes a week. More than 90 minutes was not more effective than
61-90 minutes. While minutes/week did influence SBP, the diastolic pressure was not affected and the
frequency of exercise did not alter the BP effect. 13 In a separate study by the same team, increased age
attenuated the BP effects of exercise but gender did not. 14
Summary
Lifestyle modification provides an effective prevention in pre-hypertensives and is an adjunct to
therapy in established hypertensives. The findings of multiple investigators demonstrate that a variety
of modifications including dietary, exercise, sodium restriction and fish oil can have positive effects
on patients. 15 Even alcohol, with mixed outcomes can be adjusted to minimize BP and maximize
cardiovascular benefits. Lifestyle modification has a definite role to play in the control of BP and should
be included as part of the individualized management plan for every patient.
Post-Test
1. Which of the following are parts of the D.A.S.H. diet?
a. Low fat diet
b. High calcium intake
c. Low potassium intake
d. A and B (correct answer)
e. A, B, and C
176 Hypertension Core Curriculum