The common potassium supplementation interventions in hypertensive individuals include increasing potassium intake from fruit and vegetables or using potassium supplements [ 19 , 62 ]. Studies examined the effects of potassium-rich diet e. DASH diet and combined interventions that promoted potassium-rich diet, physical activity, and salt reduction on blood pressure.

A study conducted in a primary care unit in Finland investigated the effect of a behavioural intervention consisting of a nurse-led counselling session to increase intake of dietary potassium, promote physical activity, and reduce salt intake on blood pressure among hypertensive patients [ 61 ].

They found no significant effects of the intervention on potassium intake and blood pressure [ 61 ]. Most of the potassium supplementation trials were conducted in controlled clinical settings rather than in primary care settings [ 62 ]. Therefore, there is a dearth of information relating to the implementation and cost of potassium supplementation interventions in primary care.

Cohn et al. Patients with a comorbid condition such as congestive heart failure or chronic kidneys diseases who need to strictly maintain a given potassium level and those who use non—potassium-sparing diuretics should take precautions before commencing with potassium supplementation [ 89 ].

Recently, potassium-enriched salt substitutes were found to be effective in reducing high blood pressure [ 90 , 91 ]. A study conducted in sample of 20, adults found that low-sodium high-potassium salt substitute not only reduced blood pressure by on average 3.

Potassium-enriched salt substitute is a promising strategy to deal with both high dietary sodium intake and low potassium intake, while ensuring higher patient adherence, compared with low salt-high potassium diets. However, further studies are required to confirm its safety and long-term benefits in the context of hypertension.

Brief Intervention and exercise referral schemes are two common physical activity promoting approaches in primary care patients. Such interventions are mostly delivered by primary care practitioners such as exercise professionals, general practitioners, health coaches, health visitors, mental health professionals, midwives, pharmacists, physiotherapists, and general practice nurses [ 63 ].

A systematic review found that Brief advice on physical activity is more effective than usual care in increasing physical activity among patients [ 63 ]. The brief intervention is also cost-effective [ 65 ]. However, there is insufficient evidence regarding its effect on blood pressure, feasibility, and acceptability [ 92 ].

An exercise referral scheme, that is, a referral by a primary care or allied health professional to a physical activity specialist or service [ 93 ] was also found to be effective in increasing physical activity [ 64 , 94 ].

The patients who received exercise referral increased their time in physical activity on average by 55 min more than the patients who received usual care [ 64 ]. Evidence also suggests that the compliance to physical activity recommendations following exercise referral is higher than for brief interventions [ 94 ].

However, further studies are required to confirm its cost-effectiveness. Importantly, there is a lack of evidence on the impact of exercise referral on blood pressure in hypertensive patients.

It is also challenging to provide a generic recommendation for the use of exercise referral schemes in primary care, because various forms of exercise referral are being practised globally [ 95 ]. Several other types of interventions have been utilised with the aim to increase physical activity in primary care.

However, they generally showed inconsistent results in increasing physical activity and lowering blood pressure. For example, three out of five studies included in the systematic review by Eden et al.

In another systematic review, an intervention delivered face-to-face by health professionals was not found to be effective in increasing physical activity among patients [ 97 ].

However, for a similar intervention implemented by non-health professionals peer health facilitators, exercise trainers this review found a significant positive effect on physical activity [ 97 ]. Likewise, a recently published pilot study suggested that physical activity counselling for 14 weeks increases the number of steps taken per day, but has no effect on the blood pressure of hypertensive patients [ 98 ].

Significant effects on blood pressure of hypertensive patients can be expected when physical activity is combined with dietary counselling [ 99 ]. A systematic review showed that behavioural counselling on physical activity and diet reduces systolic blood pressure by on average 4.

Healthcare workers reported a lack of time and limited resources as key barriers for promoting physical activity among their patients [ 66 ].

The key influencing factors at the patients level are related to their motivation, the level of understanding and recall of the received advice on physical activity, fitness level, cost, lack of time, and professional, peer, family and social support [ 63 , 67 ]. To address some of the barriers to promoting physical activity, Patrick et al.

For example, healthcare centre-based screening and advice on physical activity, followed by community support, could be a viable strategy to promote physical activity among primary care patients. Behaviour change interventions and restrictive diet are commonly used with the aim to reduce weight of primary care patients.

For example, a meta-analysis of 15 randomised controlled trials found an average weight reduction of 1. The behavioural change interventions are usually delivered by primary care physicians and nurses, psychologists, health educators, and nutritionists [ 68 ]. They encompass self-monitoring of diet and exercise behaviour, followed by behavioural goal setting and barrier identification or problem-solving [ 68 ].

Likewise, a brief counselling provided by a primary care physician resulted in an average weight loss of around 2. Daumit et al. by telephone than in person. The former was found to be more cost-effective for the routine treatment of obesity in healthcare settings [ 71 ].

Evidence also indicates that low-energy diets are more effective for weight reduction in the short term, compared with behavioural therapy [ 69 , 71 , ].

However, their use is recommended only when a rapid weight reduction is required, and they should only be provided by trained professionals and alongside regular medical monitoring to prevent adverse events [ 69 ].

This may reduce their feasibility in the primary care setting. Although restrictive diets are associated with a reduction in blood pressure [ , , ], very little is known about their long-term impact on other aspects of health of people with hypertension [ ].

A lack of self-motivation, a lack of self-control, inability to afford healthy foods and exercise equipment, inability to resist the temptation for unhealthy foods, competing priorities, and comorbidities are some of the impediments for weight loss [ 72 , 73 ].

By contrast, higher self-motivation, incentives, rewards, and peer, professional and social support could facilitate weight loss in the long term [ 72 ]. Primary care-based weight-reduction interventions consisting of both reduced energy intake and increased physical activity are more effective than interventions with any of these components individually [ ].

Enabling access to dieticians and exercise professionals, and addressing barriers at the levels of providers and patients should be a priority in future interventions.

Heart-healthy diets typically include the diets with high intake of fruits and vegetables, low fat intake, consumption of whole grains, and low sodium intake. The two most commonly used dietary approaches for hypertension control are DASH and Mediterranean diet [ 28 , ].

They are mostly delivered by dietary education through face-to-face counselling [ 60 ] or via telephone or email [ 59 ]. They are usually delivered by primary care physicians [ ], nurses, dieticians [ 59 ], nutritionists [ 60 ], and other health workers [ ]. The dietary interventions are often combined with exercise, weight loss, and salt reduction interventions to achieve better results [ , ].

The effectiveness of DASH diet for reducing blood pressure in primary care is limited. Recent studies from Brazil [ 60 ] and Hong Kong [ ] did not find a significant effect of dietary counselling on blood pressure in primary care patients. Furthermore, while implementing dietary intervention in a primary care setting it may be challenging to provide heart-healthy meals to patients and adequate counselling [ 55 ].

In addition, it is found that adherence to dietary recommendations is relatively low among patients [ ]. Some of the reasons for non-adherence to DASH diet as perceived by the healthcare providers are low patient motivation, lack of provider time, and lack of educational resources for patients [ 75 ].

The physicians from Canada also stated that the use of electronic medical record tools that support dietary screening or counselling, access to dietitian support, and nutrition education as part of medical training would help them provide dietary advice to patients [ 76 ].

Emerging evidence suggests that other non-pharmacological interventions such as yoga, stress reduction, and healthy drinks could be beneficial for reducing blood pressure [ 27 , 30 , 34 ]. A systematic review suggested that a mindfulness-based stress reduction program is a promising behavioural therapy for reducing blood pressure in people with hypertension [ ].

Studies also suggested that moderate consumption of coffee and green tea could be beneficial for reducing blood pressure [ , ]. However, evidence on the effectiveness of these interventions in the primary care setting is limited.

Only a few studies investigated the effects of yoga interventions delivered in the primary care setting on blood pressure of hypertensive patients while utilising a primary care physician to provide yoga instruction.

For example, Wolf et al. conducted two such studies in Sweden [ , ]. Their first study found an average reduction in diastolic blood pressure of around 4 mmHg, following a 12 weeks intervention.

However, in their subsequent study, they did not find a statistically significant effect [ ]. Dhungana et al. found that a health worker-led 3-month yoga intervention significantly reduced systolic blood pressure in hypertensive patients on average by 7.

Regarding stress reduction, a private clinic-based study found that participation in eight 2. Although there is a dearth of evidence on the effect of stress reduction interventions on blood pressure in primary care settings, a number of studies indicated that mindfulness-based interventions are promising for improving mental health and are feasible to be implemented in primary care settings [ , ].

Studies have also explored the potential role of green and black tea for blood pressure reduction [ ]. However, no studies have investigated their applicability by physicians and health care providers for hypertension management in primary care.

Non-pharmacological interventions for the treatment of hypertension in primary care with proven effectiveness include alcohol reduction. Intervention for sodium intake reduction, physical activity, and weight reduction is effective for blood pressure reduction, but it requires more pragmatic, clinically feasible, and logistically simple method in outpatients setting.

Given that studies have estimated only the overall cost-effectiveness of implementing non-pharmacological interventions e. reduced alcohol intake, increased physical activity, weight loss , there is a lack of specific information on the cost-effectiveness of these interventions in the treatment of hypertension.

Based on the current evidence, healthcare providers should consider implementing alcohol reduction, sodium intake reduction, physical activity, and weight reduction interventions for blood pressure reduction in the primary care setting.

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Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure.

When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure. Your blood pressure reading uses these two numbers. Usually the systolic number comes before or above the diastolic number.

High blood pressure usually has no symptoms. So the only way to find out if you have it is to get regular blood pressure checks from your health care provider. Your provider will use a gauge, a stethoscope or electronic sensor, and a blood pressure cuff.

He or she will take two or more readings at separate appointments before making a diagnosis. For children and teens, the health care provider compares the blood pressure reading to what is normal for other kids who are the same age, height, and gender.

Anyone can develop high blood pressure, but there are certain factors that can increase your risk:. If you already have high blood pressure, it is important to prevent it from getting worse or causing complications.

You should get regular medical care and follow your prescribed treatment plan. Your plan will include healthy lifestyle habit recommendations and possibly medicines.

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health. How to Prevent High Blood Pressure Also called: Lowering High Blood Pressure.

On this page Basics Summary Start Here Prevention and Risk Factors. Learn More Related Issues Specifics Genetics. See, Play and Learn Videos and Tutorials Test Your Knowledge. Research Clinical Trials Journal Articles. Resources Find an Expert. For You Patient Handouts.

What is blood pressure? How is high blood pressure diagnosed? Blood Pressure Category Systolic Blood Pressure Diastolic Blood Pressure Normal Less than and Less than 80 High Blood Pressure no other heart risk factors or higher or 90 or higher High Blood Pressure with other heart risk factors, according to some providers or higher or 80 or higher Dangerously high blood pressure - seek medical care right away or higher and or higher For children and teens, the health care provider compares the blood pressure reading to what is normal for other kids who are the same age, height, and gender.

Who is at risk for high blood pressure? After age 55, women are more likely than men to develop it. Lifestyle - Certain lifestyle habits can raise your risk for high blood pressure, such as eating too much sodium salt or not enough potassium, lack of exercise, drinking too much alcohol, and smoking.

Family history - A family history of high blood pressure raises the risk of developing high blood pressure How can I prevent high blood pressure? You can help prevent high blood pressure by having a healthy lifestyle.

This means: Eating a healthy diet. To help manage your blood pressure, you should limit the amount of sodium salt that you eat and increase the amount of potassium in your diet.

It is also important to eat foods that are lower in fat, as well as plenty of fruits, vegetables, and whole grains. The DASH eating plan is an example of an eating plan that can help you to lower your blood pressure.

Getting regular exercise. Exercise can help you maintain a healthy weight and lower your blood pressure. You should try to get moderate-intensity aerobic exercise at least 2 and a half hours per week, or vigorous-intensity aerobic exercise for 1 hour and 15 minutes per week.

Aerobic exercise, such as brisk walking, is any exercise in which your heart beats harder and you use more oxygen than usual. Being at a healthy weight. Being overweight or having obesity increases your risk for high blood pressure. Maintaining a healthy weight can help you control high blood pressure and reduce your risk for other health problems.

Limiting alcohol. Drinking too much alcohol can raise your blood pressure.

Sex-specific associations between alcohol consumption and incidence of hypertension: a systematic review and meta-analysis of cohort studies. J Am Heart Assoc. Article CAS PubMed PubMed Central Google Scholar. Association of urinary sodium and potassium excretion with blood pressure.

N Engl J Med. Article PubMed Google Scholar. Kieneker LM, Gansevoort RT, Mukamal KJ, de Boer RA, Navis G, Bakker SJ, Joosten MM. Urinary potassium excretion and risk of developing hypertension: the prevention of renal and vascular end-stage disease study.

Article CAS PubMed Google Scholar. Al Tunaiji H, Davis JC, Mansournia MA, Khan KM. Population attributable fraction of leading non-communicable cardiovascular diseases due to leisure-time physical inactivity: a systematic review.

BMJ Open Sport Exerc Med. Article PubMed PubMed Central Google Scholar. Jayedi A, Rashidy-Pour A, Khorshidi M, Shab-Bidar S. Body mass index, abdominal adiposity, weight gain and risk of developing hypertension: a systematic review and dose-response meta-analysis of more than 2.

Obes Rev. Schwingshackl L, Schwedhelm C, Hoffmann G, Knüppel S, Iqbal K, Andriolo V, Bechthold A, Schlesinger S, Boeing H. Food groups and risk of hypertension: a systematic review and dose-response meta-analysis of prospective studies. Advances in nutrition Bethesda, Md. Jayedi A, Soltani S, Abdolshahi A, Shab-Bidar S.

Healthy and unhealthy dietary patterns and the risk of chronic disease: an umbrella review of meta-analyses of prospective cohort studies. Br J Nutr. Zhang Y, Zhang DZ. Red meat, poultry, and egg consumption with the risk of hypertension: a meta-analysis of prospective cohort studies.

J Hum Hypertens. Xin X, He J, Frontini Maria G, Ogden Lorraine G, Motsamai Oaitse I, Whelton Paul K. Effects of alcohol reduction on blood pressure. Roerecke M, Kaczorowski J, Tobe SW, Gmel G, Hasan OSM, Rehm J.

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Institute for Health and Sport, Victoria University, Melbourne, Australia. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia. You can also search for this author in PubMed Google Scholar. RRD and ZP conceptualised the study. RRD interpreted the findings and prepared the first draft.

MdC and ZP interpreted the findings, revised the draft and contributed to writing the manuscript. All authors read and approved the final manuscript.

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search close. PREV Jun 1, NEXT. C 1 , 7 5 to 20 Eat a diet high in fruits and vegetables and low in fat. C 1 , 9 , 11 , 12 2 to 8 Get 30 minutes of aerobic activity at least four days per week.

C 1 , 13 4 to 9 Men should have no more than two alcoholic drinks per day, and women no more than one alcoholic drink per day. Recommended Lifestyle Modifications.

SODIUM REDUCTION. DIETARY CHANGES. WEIGHT LOSS. Other Lifestyle Interventions. SMOKING CESSATION. RANDY WEXLER, M. He completed a residency in family medicine at Mt.

Carmel Medical Center in Columbus, Ohio, and received his master's degree in public health from Ohio State University School of Public Health. He also is director of the Division of Integrative Medicine, Department of Family Medicine, and medical director of Ohio State University Center for Integrative Medicine.

wexler osumc.