Nutrition, lifestyle, and hypertension
Hypertension is a major risk factor for coronary heart disease, stroke, and premature death and a leading risk factor for global disease burden. Prevalence for those 18 years and older in the United States has remained around 29% since 1999 with little improvement. Further, approximately one-third of U.S. adults have prehypertension, which is also associated with a graded, increased risk of cardiovascular disease and progression to hypertension. The overall evidence that diet modification can prevent and treat hypertension is strong. The current national guideline of lifestyle modification for blood pressure control includes the DASH eating pattern, sodium reduction, weight loss, increased physical activity, and moderate consumption of alcohol. Concurrent adherence to several recommendations is likely to hold the greatest promise for preventing and treating hypertension and has been shown to be feasible. In addition to addressing unresolved nutritional hypotheses, future research should focus on strategies to motivate and maintain lifestyle changes long term for blood pressure control. At both the population and individual levels, success in dietary and lifestyle intervention relies on multiple levels of support ranging from clinicians to government agencies to private institutes and industries. In particular, partnering with industry to improve the nutritional quality of the food supply, such as reducing sodium, sugar, and saturated and trans fat content of processed foods, and promoting foods and nutrients consistent with the DASH dietary pattern will play a critical role in implementing dietary and lifestyle modifications. Consistent efforts to educate and promote adherence to dietary and lifestyle guidelines by dietetic and other health care professionals are also instrumental to the prevention and management of hypertension.
