Nonpharmacologic treatment of hypertension: does it work?

Abundant clinical and epidemiological data suggest that hypertension, or high blood pressure is a disease of high prevalence in industrialized societies, with cardiovascular morbidity and mortality directly related to the level of blood pressure. Although efficacious pharmacologic approaches to the control of high blood pressure are available, concern about risk versus benefit in the use of antihypertensive drug therapy for patients with mild hypertension has led to renewed interest in nonpharmacologic interventions. In the U.S.A. the National High Blood Pressure Education Program, an organization comprised of research scientists and a variety of other professionals concerned with the control of high blood pressure, has through a consensus process, recommended some nonpharmacologic approaches to the treatment of hypertension. The pros and cons of nutritional interventions, exercise and biobehavioral treatments are discussed. Nonpharmacologic recommendations in the treatment of hypertension for which there appear to be sufficient requisite data include weight reduction for the obese, moderate sodium restriction (although this is controversial) and restriction of alcohol consumption to less than 57 g of ethanol daily.