Comprehensive Management of Hypertension: Enhancing Non-Pharmacological Treatments

Main Article Content

Cholid Tri Tjahjono Astrid Pramudya

Abstract

Background: In the entire world, cardiovascular diseases (CVD) are primarily brought on by hypertension, or elevated blood pressure. From 4.5% (0.9 billion adults) in 2000 to 7% (1.6 billion adults) in 2010, the prevalence of hypertension has increased in relation to the global burden of diseases. Comprehensive management including non-pharmacological and pharmacological strategies of hypertension.


 


Healthy lifestyle choices can lower cardiovascular risk and postpone or prevent the onset of high blood pressure. Additionally, the first line of antihypertensive therapy is lifestyle change. One of the best way of life adjustments for lowering blood pressure is weight loss. Physical activity on a regular basis can reduce high blood pressure by 5 to 8 mm Hg. Every day, try to engage in at least 30 minutes of moderate exercise, such as walking, running, cycling, swimming, or dancing. High-intensity interval training is an alternative option. Short bursts of intense exercise are interspersed with slower intervals of activity during this form of training. A diet low in saturated fat, salt, and cholesterol and high in whole grains, fruits, vegetables, and low-fat dairy products can reduce high blood pressure by up to 11 mm Hg. It is possible to reduce blood pressure by roughly 4 mm Hg by limiting alcohol consumption to fewer than one drink per day for women and two drinks per day for males. Quitting smoking can potentially extend life by lowering blood pressure, lowering the risk of heart disease, and improving general health. The quality of your sleep can affect your blood pressure. Chronic (long-term) emotional stress may be a factor in high blood pressure. Controlling blood pressure also requires taking it at home and going to the doctor frequently. Strong social networks of family and friends are crucial for health. Following lifestyle changes, pharmacological therapy should be started. The choice of medication is based on the patient's age, general cardiovascular risk, and co-morbidities. The pharmaceutical treatment plans suggested here are generally in line with the most recent US and European recommendations.


 


Conclusion: The optimal initial treatment strategy for hypertension should be comprehensive hypertension management, which focuses on lowering total cardiovascular risk through lifestyle changes, BP lowering, and lipid management.

Keywords: Hypertension, lifestyle management, exercise, non-pharmacological

Article Details

How to Cite
TJAHJONO, Cholid Tri; PRAMUDYA, Astrid. Comprehensive Management of Hypertension: Enhancing Non-Pharmacological Treatments. Medical Research Archives, [S.l.], v. 11, n. 3, mar. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3678>. Date accessed: 04 dec. 2024. doi: https://doi.org/10.18103/mra.v11i3.3678.
Section
Research Articles

References

1. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet, 2005;365(9455):217-23.
2. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 2012;380(9859):2224-60
3. Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D.L., Coca, A., De Simone, G., Dominiczak, A. and Kahan, T., 2018. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European heart journal, 39(33), pp.3021-3104.
4. Kario K, Shimbo D, Hoshide S, Wang JG, Asayama K, Ohkubo T, Imai Y, McManus RJ, Kollias A, Niiranen TJ, Parati G. Emergence of home blood pressure-guided management of hypertension based on global evidence. Hypertension. 2019 Aug;74(2):229-36.
5. Hodgkinson J, Mant J, Martin U, Guo B, Hobbs FD, Deeks JJ, Heneghan C, Roberts N, McManus RJ. Relative effectiveness of clinic and home blood pressure monitoring compared with ambulatory blood pressure monitoring in diagnosis of hypertension: systematic review. BMJ 2011;342:d3621.
6. Vinyoles E, Felip A, Pujol E, de la Sierra A, Dura R, del Rey RH, Sobrino J, Gorostidi M, de la Figuera M, Segura J, Banegas JR, Ruilope LM. Clinical characteristics of isolated clinic hypertension. J Hypertens 2008;26:438–445
7. Cohen JB. Hypertension in Obesity and the Impact of Weight Loss. Curr Cardiol Rep. 2017 Aug 24;19(10):98. doi: 10.1007/s11886-017-0912-4. PMID: 28840500; PMCID: PMC5606235.
8. Urrico P. Nonpharmacological Interventions in the Management of Hypertension in the Adult Population with Type 2 Diabetes Mellitus. Can J Diabetes. 2018 Apr;42(2):196-198.
9. Garcia-Rios A, Ordovas JM, Lopez-Miranda J, Perez-Martinez P. New diet trials and cardiovascular risk. Curr Opin Cardiol. 2018 Jul;33(4):423-428
10. Girardin, E.; Caverzasio, J.; Iwai, J.; Bonjour, J.P.; Muller, A.F.; Grandchamp, A. Pressure natriuresis in isolated kidneys from hypertension-prone and hypertension-resistant rats (Dahl rats). Kidney Int. 1980, 18, 10–19.
11. Dajnowiec, D.; Langille, B.L. Arterial adaptations to chronic changes in haemodynamic function: Coupling vasomotor tone to structural remodelling. Clin. Sci. 2007, 113, 15–23. [CrossRef]
12. Dumont, O.; Pinaud, F.; Guihot, A.L.; Baufreton, C.; Loufrani, L.; Henrion, D. Alteration in flow (shear stress)-induced remodelling in rat resistance arteries with aging: Improvement by a treatment with hydralazine. Cardiovasc. Res. 2008, 77, 600–608. [CrossRef] [PubMed]
13. Groppelli A, Giorgi DM, Omboni S, Parati G, Mancia G. Persistent blood pressure increase induced by heavy smoking. J Hypertens 1992; 10: 495-9.
14. Cryer PE, Haymond MW, Santiago JV, Shah SD. Norepinephrine and epinephrine release and adrenergic mediation of smoking- associated hemodynamic and metabolic events. N Engl J Med 1976; 295: 573-7.
15. Baer L, Radichevich I. Cigarette smoking in hypertensive patients. Blood pressure and endocrine responses. Am J Med 1985; 78: 564
16. St-Onge MP, Grandner MA, Brown D, Conroy MB, Jean-Louis G, Coons M, Bhatt DL; American Heart Association Obesity, Behavior Change, Diabetes, and Nutrition Committees of the Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; and Stroke Council. Sleep duration and quality: impact on lifestyle behaviors and cardiometabolic health: a scientific statement from the American Heart Association. Circulation. 2016;134:e367–e386. doi: 10.1161/CIR.0000000000000444 Crossref. PubMed.
17. Makarem N, Shechter A, Carnethon MR, Mullington JM, Hall MH, Abdalla M. Sleep duration and blood pressure: recent advances and future directions. Curr Hypertens Rep. 2019;21:33. doi: 10.1007/s11906-019-0938-7 Crossref. PubMed.
18. Makarem N, Alcántara C, Williams N, Bello NA, Abdalla M. Effect of sleep disturbances on blood pressure. Hypertension. 2021 Apr;77(4):1036-46.
19. Ridho, M., Frethernety, A. ., & Widodo, T. . (2021). THE RELATIONSHIP OF STRESS WITH HYPERTENSION. Jurnal Kedokteran Universitas Palangka Raya, 9(2), 1366–1371. https://doi.org/10.37304/jkupr.v9i2.3571
20. Kario K, Tomitani N, Kanegae H, Yasui N, Nagai R, Harada H. The further development of out-of-office BP monitoring: Japan’s ImPACT Program Project’s achievements, impact, and direction. J Clin Hypertens (Greenwich). 2019;21:344–349. doi: 10.1111/jch.13495 Crossref. PubMed.
21. Awotidebel TO, Adedoyini RA (2014). Knowledge, attitude and Practice of Exercise for blood pressure control: A cross-sectional survey. Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Journal of Exercise Scien- ce andPhysiotherapy 10(1): 1-10.
22. Nugraha BK (2014). Hubungan Tingkat Pengetahuan Keluarga dengan Sikap Pencegahan Komplikasi pada Pasien Hipertensi di Wilayah Kerja Puskes- masSangkrah Surakarta. Skripsi. Universitas Muhammadiyah Surakarta.