Department of Social Science and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China.
Henan Research Center for HTA, Zhengzhou, China.
J Clin Hypertens (Greenwich). 2023 Jun;25(6):509-520. doi: 10.1111/jch.14653. Epub 2023 May 9.
Despite the effectiveness of currently available antihypertensive medications, there is still a need for new treatment strategies that are more effective in certain groups of hypertensive and for additional resources to combat hypertension. However, medication non-adherence was previously recognized as a major problem in the treatment of hypertension. The mechanisms behind the positive impacts of lifestyle changes might occur in different ways. In comparison with other studies, the efficacy and effectiveness of lifestyle modifications and antihypertensive pharmaceutical treatment for the prevention and control of hypertension and concomitant cardiovascular disease have been demonstrated in randomized controlled trials. However, in this review, the attitudinal lifestyle modifications and barriers to blood pressure control were elaborated on. An effective method for reducing blood pressure (BP) and preventing cardiovascular events with antihypertensive medications has been outlined. Maintaining healthy lifestyle factors (body mass index, diet, smoking, alcohol consumption, sodium excretion, and sedentary behavior) could lower systolic blood pressure BP by 3.5 mm Hg and reduce the risk of cardiovascular disease (CVD) by about 30%, regardless of genetic susceptibility to hypertension. Conducting a lifestyle intervention using health education could improve lifestyle factors, such as reducing salt, sodium, and fat intake, changing eating habits to include more fruits and vegetables, not smoking, consuming less alcohol, exercising regularly, maintaining healthy body weight, and minimizing stressful conditions. Each behavior could affect BP by modulating visceral fat accumulation, insulin resistance, the renin-angiotensin-aldosterone system, vascular endothelial function, oxidative stress, inflammation, and autonomic function. Evidence of the joint effect of antihypertensive medications and lifestyle reforms suggests a pathway to reduce hypertension.
尽管目前可用的降压药物有效，但仍需要新的治疗策略，这些策略在某些高血压人群中更为有效，并且需要额外的资源来对抗高血压。然而，以前人们认识到，药物不依从性是高血压治疗中的一个主要问题。生活方式改变产生积极影响的机制可能以不同的方式发生。与其他研究相比，生活方式改变和降压药物治疗在预防和控制高血压及相关心血管疾病方面的功效和有效性已在随机对照试验中得到证实。然而，在这篇综述中，阐述了态度性的生活方式改变和控制血压的障碍。本文概述了一种有效降低血压（BP）和预防心血管事件的降压药物方法。维持健康的生活方式因素（体重指数、饮食、吸烟、饮酒、钠排泄和久坐行为）可以使收缩压降低 3.5mmHg，并降低约 30%的心血管疾病（CVD）风险，无论高血压的遗传易感性如何。通过健康教育进行生活方式干预可以改善生活方式因素，如减少盐、钠和脂肪的摄入，改变饮食习惯以增加更多的水果和蔬菜，不吸烟，少饮酒，定期锻炼，保持健康的体重，尽量减少紧张的情况。每种行为都可以通过调节内脏脂肪堆积、胰岛素抵抗、肾素-血管紧张素-醛固酮系统、血管内皮功能、氧化应激、炎症和自主神经功能来影响血压。降压药物和生活方式改革联合作用的证据表明了一种降低高血压的途径。
Zotero 插件
