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April 23/30, 2003

Lifestyle Modification and Blood Pressure ControlIs the Glass Half Full or Half Empty?

Author Affiliations

Author Affiliation: Integrative and Behavioral Cardiovascular Health Program, Marie-Josee and Henry R. Kravis Cardiac Health Center, Mount Sinai Medical Center, New York, NY.

JAMA. 2003;289(16):2131-2132. doi:10.1001/jama.289.16.2131

The idea that lifestyle modifications can ameliorate mild hypertension has been popular for many years and was given a huge boost by the publications of results obtained with the Dietary Approaches to Stop Hypertension (DASH) diet.1,2 At last, there was convincing evidence that a nondrug form of treatment could reduce blood pressure (averaging decreases of 11.4/5.5 mm Hg in hypertensive patients and 5.5/3.0 mm Hg in those with borderline blood pressure) as much as some drugs.1 A second study (DASH Sodium) combined the DASH diet with sodium restriction and reported a blood pressure reduction of 5.9/2.9 mm Hg with the DASH diet in patients with borderline hypertension and 8.9/4.5 mm Hg with a combination of the DASH diet and sodium restriction.2 In a subsequent study, the Diet, Exercise, and Weight Loss-Intervention Trial (DEW-IT),3 overweight hypertensive individuals who had been treated with drugs reported a net change of 9.5/5.3 mm Hg in ambulatory pressure and 7.4/5.7 mm Hg in clinic pressure using a low-calorie version of the DASH diet in combination with weight loss.

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