Ozemek Cemal, Phillips Shane A, Popovic Dejana, Laddu-Patel Deepika, Fancher Ibra S, Arena Ross, Lavie Carl J
aDepartment of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA bClinic for Cardiology, University Clinical Center Serbia, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia cDivision of Pulmonary, Department of Medicine, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, Illinois, USA dDepartment of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, Louisiana, USA.
Curr Opin Cardiol. 2017 Jul;32(4):381-388. doi: 10.1097/HCO.0000000000000406.
Nonpharmacologic lifestyle modification interventions (LMIs), such as increasing physical activity, dietary modification, weight-loss, reducing alcohol consumption and smoking cessation, are effective strategies to lower resting blood pressures (BPs) in prehypertensive or hypertensive patients. However, the limited time shared between a physician and a patient is not adequate to instill an adoption of LMI. The purpose of this review is to therefore highlight evidence-based BP lowering, LMI strategies that can feasibly be implemented in clinical practices.
Interventions focusing on modifying physical activity, diet, weight-loss, drinking and smoking habits have established greater efficacy in reducing elevated BP compared with providing guideline recommendations based on national guidelines. Alone greater reductions in BP can be achieved through programmes that provide frequent contact time with exercise, nutrition and/or wellness professionals. Programmes that educate individuals to lead peer support groups can be an efficient method of ensuring compliance to LMI.
Evidence of a multidisciplinary approach to LMI is an effective and attractive model in managing elevated BP. This strategy is an attractive model that provides the necessary patient attention to confer lifestyle maintenance.
非药物生活方式改变干预措施（LMI），如增加体力活动、饮食调整、减肥、减少酒精摄入和戒烟，是降低高血压前期或高血压患者静息血压（BP）的有效策略。然而，医生与患者相处的时间有限，不足以促使患者采用LMI。因此，本综述的目的是强调基于证据的降血压LMI策略，这些策略可在临床实践中切实可行地实施。
与基于国家指南提供指导建议相比，专注于改变体力活动、饮食、体重、饮酒和吸烟习惯的干预措施在降低血压升高方面已显示出更高的疗效。仅通过与运动、营养和/或健康专业人员频繁接触的项目就能实现更大程度的血压降低。教育个人领导同伴支持小组的项目可能是确保遵守LMI的有效方法。
LMI多学科方法的证据是管理血压升高的一种有效且有吸引力的模式。该策略是一种有吸引力的模式，能给予患者必要的关注以维持生活方式。
