People with hypertension who are overweight should be advised to lose weight by:
Whelton PK, Carey RM, Aronow WS, Casey Jr DE, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith Jr SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams Sr KA, Williamson JD, Wright Jr JT, 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults, Journal of the American College of Cardiology (2017), doi: 10.1016/j.jacc.2017.11.006
1. Weight loss is recommended to reduce BP in adults with elevated BP or hypertension who are overweight or obese (1-4).
Leung AA, Nerenberg K, Daskalopoulou SS, et al. Hypertension Canada’s 2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension. Can J Cardiol. 2016; 32(5): 569-588. doi: 10.1016/j.cjca.2016.02.066.
1. For nonhypertensive or stage 1 hypertensive individuals, the use of resistance or weight training exercise (such as free weight lifting, fixed weight lifting, or handgrip exercise) does not adversely influence BP (Grade D). For nonhypertensive individuals (to reduce the possibility of becoming hypertensive) or for hypertensive patients (to reduce their BP), prescribe the accumulation of 30-60 minutes of moderate-intensity dynamic exercise (eg, walking, jogging, cycling, or swimming) 4-7 days per week in addition to the routine activities of daily living (Grade D). Higher intensities of exercise are not more effective (Grade D).
1. Height, weight, and waist circumference should be measured and body mass index calculated for all adults (Grade D).
2. Maintenance of a healthy body weight (body mass index 18.5-24.9, and waist circumference < 102 cm for men and < 88 cm for women) is recommended for nonhypertensive individuals to prevent hypertension (Grade C) and for hypertensive patients to reduce BP
(Grade B). All overweight hypertensive individuals should be advised to lose weight (Grade B).
3. Weight loss strategies should use a multidisciplinary approach that includes dietary education, increased physical activity, and behavioural intervention (Grade B).
Mancia G, Fagard R, Narkiewicz K, et al. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens. 2013; 31(10): 1925–1938. DOI:10.1097/HJH.0b013e328364ca4c
Lifestyle changes, particularly weight loss and physical exercise, are to be recommended to all individuals with the metabolic syndrome. These interventions improve not only BP, but the metabolic components of the syndrome and delay diabetes onset.
Australian Dietary Guidelines. Available from: www.eatforhealth.gov.au/guidelines
The five recommendations are:
1. To achieve and maintain a healthy weight, be physically active and choose amounts of
nutritious food and drinks to meet your energy needs.
2. Enjoy a wide variety of nutritious foods from these 5 food groups everyday
(Vegetables, Fruit, Grain Foods, Dairy, Meats/Legumes)
3. Limit intake of foods containing saturated fat, added salt, added sugar and alcohol
4. Encourage, support and promote breast feeding
5. Care for your food; prepare and store it safely
The Australian Dietary Guidelines apply to all healthy Australians, as well as those with common
health conditions such as being overweight. They do not apply to people who need special dietary
advice for a medical condition, or to the frail elderly.
Exercise and Sports Science Australia. Exercise Intensity Guidelines. Available from: https://www.essa.org.au/wp-content/uploads/2014/06/Exercise-Intensity-Guildines.pdf