J Hum Hypertens. 1993 Apr;7(2):159-64.
Nonpharmacological approaches lower medication requirements in patients with hypertension. A decreased salt intake to a sodium value of about 80 mmol/day lowers BP in the presence of diuretics, beta-blockers, converting enzyme antagonists and sympatholytics but apparently not in patients treated solely with calcium antagonists. A reduced medication requirement is seen in about half of the patients suggesting that the phenomenon of 'salt-sensitivity' still applies. Weight loss is an effective adjunctive therapy and simultaneously improves other cardiovascular risk factors. A high alcohol consumption is a confounding factor in the drug treatment of hypertension. Reducing the alcohol intake of hypertensive heavy drinkers significantly lowers their BPs and drug requirements. Aerobic exercise is an effective nonpharmacological treatment which simultaneously fosters weight loss and improves risk factors. Potassium supplementation does not decrease medication requirements in drug-treated patients who are ingesting a low salt diet but may do so in those eating large amounts of salt. Nonpharmacological approaches should be included in the management of all hypertensive patients irrespective of their drug therapy. These should include weight reduction through decreased food and alcohol consumption as well as regular, programmed exercise. Patients should be instructed in a low calorie diet rich in fresh rather than processed products and high in fruits and vegetables. Such a diet will contain relatively little salt, reduced fat, and ample amounts of potassium and calcium. However, physicians should not lose sight of the fact that cigarette smoking remains the most important risk factor to be addressed in their hypertensive patients.
非药物治疗方法可降低高血压患者的药物需求。将盐摄入量降至钠含量约80 mmol/天，在使用利尿剂、β受体阻滞剂、转化酶拮抗剂和交感神经抑制剂的情况下可降低血压，但在仅用钙拮抗剂治疗的患者中显然无效。约一半的患者药物需求减少，这表明“盐敏感性”现象仍然存在。体重减轻是一种有效的辅助治疗方法，同时可改善其他心血管危险因素。大量饮酒是高血压药物治疗中的一个混杂因素。减少高血压酗酒者的酒精摄入量可显著降低他们的血压和药物需求。有氧运动是一种有效的非药物治疗方法，同时有助于体重减轻并改善危险因素。在摄入低盐饮食的药物治疗患者中，补充钾并不能降低药物需求，但在摄入大量盐的患者中可能有效。所有高血压患者的管理都应包括非药物治疗方法，无论其药物治疗情况如何。这些方法应包括通过减少食物和酒精摄入量以及定期有计划的运动来减轻体重。应指导患者采用低热量饮食，富含新鲜而非加工食品，且水果和蔬菜含量高。这样的饮食将含有相对较少的盐、减少的脂肪以及充足的钾和钙。然而，医生不应忽视吸烟仍然是其高血压患者中需要解决的最重要危险因素这一事实。
