NONPHARMACOLOGICAL THERAPY OF HYPERTENSION

Weight reduction, moderate sodium restriction and alcohol reduction al l lower blood pressure significantly in the short-term, and appear fea sible in the long-term. Dynamic exercise may have a useful role in sel ected patients. Cessation of cigarette smoking has no important effect on blood pressure itself but is likely to improve the prognosis. No o ther non-pharmacological intervention warrants a place in routine mana gement on present evidence. Regimens involving combined reduction in w eight, salt and alcohol have proved less effective than drug therapy i n terms of blood pressure reduction. Hypertensive patients may be shif ted from just above some arbitrary intervention level to just below it by non-pharmacological treatment, and the perceived benefits of non-p harmacological management may be offset by an increased risk of vascul ar complications related to suboptimal blood pressure control. Moreove r even simple measures such as moderate sodium restriction may affect some aspects of quality of life adversely. Non-pharmacological measure s should generally be regarded as useful adjuncts to antihypertensive drug therapy rather than alternatives to it.