Reducing blood pressure

Lifestyle advice to help patients diagnosed with hypertension is almost identical to the advice associated with reducing cardiovascular risk.

• Reducing weight and increasing physical exercise has been shown to reduce blood pressure.
  - Low calorie diets can reduce systolic and diastolic blood pressure by up to 5-6mmHg.
  - Aerobic exercise for 30-60 minutes three to five times a week can achieve a 2-3mm Hg reduction in systolic and diastolic BP.⁷
• Reducing dietary salt intake to no more than 6g daily may reduce blood pressure by between 2-3 mmHg.⁷
• Patients should be advised to moderate their consumption of alcohol as excessive consumption is associated with elevated blood pressure.
• Moderating consumption of coffee and caffeine containing drinks. Small increases in systolic and diastolic blood pressure (2/1mmHg) have been linked to drinking five or more cups of coffee each day.⁷
• Patients who smoke should be encouraged and supported to quit.
• Relaxation techniques or therapies may help patients to reduce their blood pressure. Relaxation therapies may include stress management, meditation, cognitive therapies, muscle relaxation or biofeedback.⁷

NICE advises that calcium, magnesium or potassium supplements should not be recommended to patients to assist in reducing their blood pressure due to lack of clinical evidence of efficacy.⁷

Reducing blood cholesterol

Dietary changes can have a small but significant impact on cholesterol levels. Dietary changes can lead to a 3-6% reduction in total cholesterol whilst stringent low fat diets can reduce total cholesterol by up to 15%.⁹

Dietary changes that can positively impact cholesterol levels were discussed earlier in this module. Dietary changes along with increased physical activity can reduce cholesterol levels.

Appropriate lifestyle advice that can be given to patients to help them reduce their cholesterol levels includes moderating alcohol consumption, increasing physical activity, stopping smoking, and maintaining a healthy weight.

NICE advises that statin therapy, usually atorvastatin, should be offered to any patient with a 10% or greater risk of developing CVD over the next ten years.