Lifestyle modifications for patients with hypertension

Objectives: To review the lifestyle modification components listed in the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) from the National Heart, Lung, and Blood Institute (NHLBI) and discuss how the guidelines can be used by pharmacists in the treatment of patients with hypertension. Data sources: Published guidelines and abstracts identified through PubMed (May 1987 to April 2007) and Medline (January 1966 to April 2007) using the search terms hypertension, prehypertension, lifestyle modification, nutrition, physical activity, weight loss, weight control, behavior modification, smoking cessation, guidelines, and prevention, as well as the JNC 7 guidelines, NHLBI Obesity Guidelines, and Dietary Guidelines for Americans 2005. Data synthesis: Lifestyle modification strategies are recommended in the JNC 7 guidelines for the treatment and prevention of hypertension and cardiovascular disease. The primary strategies discussed are proper nutrition through the Dietary Approaches to Stop Hypertension (DASH) eating plan and sodium restriction, weight reduction, increased physical activity, and moderation of alcohol consumption. Patients with hypertension have been shown to decrease their resting blood pressure considerably by adopting one of more of these strategies. Conclusion: Pharmacists are in an ideal setting to care for patients with hypertension by managing their medications and lifestyle behaviors. Doing so provides patients a higher level of clinical care from their pharmacist.