Non-Pharmacological Methods to Lower Blood Pressure

Every set of hypertension guidelines recommends that all individuals with elevated blood pressure (BP, either prehypertensive or frankly hypertensive) begin and sustain lifestyle modifications, either as definitive or adjunctive therapy for their condition. Since most pharmacists are intensively involved in the ongoing care of hypertensive patients, but typically have received little background or training about the non-drug therapies that can lower BP, it may be useful, particularly in the setting of cognitive services, to review some of the recent data about the various modalities that can be useful to the 37% of the American adult population that is prehypertensive, and the 30% who are hypertensive. Even if a person’s BP is “normal,” many of these non-drug modalities are likely to be helpful in improving or maintaining health, since the most recent epidemiological survey of US adults show about 75% to be obese or overweight, only 13% of adults eat < 2400 mg/d of sodium (most of which comes from prepared foods), only 7% of adults consume “adequate” potassium, and < 40% of adults have an “adequate” calcium intake.

• Name, in descending order of efficacy, five (5) non-pharmacological methods that may lower blood pressure, as shown in clinical trials in humans of over 2 months’ duration.
• Expand the acronym for the specific diet that has been recommended by the U.S. Federal authorities, including the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, on the basis of its blood pressure lower efficacy in short-term feeding studies.
• Identify the lifestyle modification that may reduce not only blood pressure, but also the long-term (10-15 year) risk of cardiovascular morbidity, as demonstrated by follow-up participants in two clinical trials sponsored by the National Institutes of Health.
• Name three devices that can lower blood pressure in short-term studies (typically of two-months' duration,)the two that are now sometimes found in pharmacies, and the one that has been approved by the U.S. FDA for both stress reduction and lowering blood pressure.
• Name the non-pharmacological intervention or interventions that was/were the most successful in allowing people with abnormal blood pressures to avoid reinstitution of antihypertensive drugs over three years of follow-up in an NIH-sponsored, multi-center, randomized, clinical trial.