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CHEP Recommendations Details Lifestyle Management
CHEP Recommendations Details Lifestyle Management
Lifestyle Management
- Physical Exercise
- For nonhypertensive individuals (to reduce the possibility of becoming hypertensive) or for hypertensive patients (to reduce their blood pressure), prescribe the accumulation of 30 to 60 minutes of moderate intensity dynamic exercise (such as walking, jogging, cycling or swimming) four to seven days per week in addition to the routine activities of daily living (Grade D). Higher intensities of exercise are no more effective (Grade D).
- Weight Reduction
- Height, weight, and waist circumference should be measured and body mass index calculated for all adults (Grade D).
- Maintenance of a healthy body weight (body mass index 18.5 to 24.9 kg/m² and waist circumference less than 102 cm for men and less than 88 cm for women) is recommended for non-hypertensive individuals to prevent hypertension (Grade C) and for hypertensive patients to reduce blood pressure (Grade B). All overweight hypertensive individuals should be advised to lose weight (Grade B).
- Weight loss strategies should employ a multidisciplinary approach that includes dietary education, increased physical activity and behavioral intervention (Grade B).
- Alcohol Consumption
- To reduce blood pressure, alcohol consumption should be in accordance with Canadian low-risk drinking guidelines in both normotensive and hypertensive individuals. Healthy adults should limit alcohol consumption to two drinks or less per day, and consumption should not exceed 14 standard drinks per week for men and nine standard drinks per week for women (Grade B). (Note: one standard drink is considered 13.6 g or 17.2 ml of ethanol, or approximately 44 mL [1.5 oz] of 80 proof [40%] spirits, 355 mL [12 oz] of 5% beer or 148 mL [5 oz] of 12% wine.)
- Dietary Recommendations
- It is recommended that hypertensive patients and normotensive individuals at increased risk of developing hypertension consume a diet that emphasizes fruits, vegetables and low-fat dairy products, dietary and soluble fiber, whole grains and protein from plant sources and that is reduced in saturated fat and cholesterol (Dietary Approaches to Stop Hypertension [DASH] diet) see (Table 1) (Grade B).
- Salt Intake
- For prevention and treatment of hypertension, a dietary sodium intake of 1500 mg (65 mmol) per day is recommended for adults age 50 years or less; 1300 mg (57 mmol) per day if age 51 to 70 years; and 1200 mg (52 mmol) per day if age greater than 70 years (Grade B).
- Potassium, Calcium and Magnesium Intake
- Supplementation of potassium, calcium and magnesium is not recommended for the prevention or treatment of hypertension (Grade B).
- Stress management
- In hypertensive patients in whom stress may be contributing to blood pressure elevation, stress management should be considered as an intervention (Grade D). Individualized cognitive behavioural interventions are more likely to be effective when relaxation techniques are used (Grade B).