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Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials
Open accessAbstract
PURPOSE: To quantify effectiveness of lifestyle interventions for hypertension. DATA SOURCES: Electronic bibliographic databases from 1998 onwards, existing guidelines, systematic reviews. STUDY SELECTION AND DATA ABSTRACTION: We included randomized, controlled trials with at least 8 weeks' follow-up, comparing lifestyle with control interventions, enrolling adults with blood pressure at least 140/85 mmHg. Primary outcome measures were systolic and diastolic blood pressure. Two independent reviewers selected trials and abstracted data; differences were resolved by discussion. RESULTS: We categorized trials by type of intervention and used random effects meta-analysis to combine mean differences between endpoint blood pressure in treatment and control groups in 105 trials randomizing 6805 participants. Robust statistically significant effects were found for improved diet, aerobic exercise, alcohol and sodium restriction, and fish oil supplements: mean reductions in systolic blood pressure of 5.0 mmHg [95% confidence interval (CI): 3.1-7.0], 4.6 mmHg (95% CI: 2.0-7.1), 3.8 mmHg (95% CI: 1.4-6.1), 3.6 mmHg (95% CI: 2.5-4.6) and 2.3 mmHg (95% CI: 0.2-4.3), respectively, with corresponding reductions in diastolic blood pressure. Relaxation significantly reduced blood pressure only when compared with non-intervention controls. We found no robust evidence of any important effect on blood pressure of potassium, magnesium or calcium supplements. CONCLUSIONS: Patients with elevated blood pressure should follow a weight-reducing diet, take regular exercise, and restrict alcohol and salt intake. Available evidence does not support relaxation therapies, calcium, magnesium or potassium supplements to reduce blood pressure.
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“They are rich in crucial fatty acids, particularly with a high omega-3 to omega-6 ratio, linked to reduced BP and a lower risk of CVD [43–45]. A 100-g serving of chia provides significant amounts of magnesium, potassium, and calcium, all potent vasodilators and vascular smooth muscle contraction inhibitors, effectively reducing BP [46–49]. Additionally, chia seeds contain flavonoids such as querc”
From Effects of chia seed (Salvia hispanica L.) supplementation on cardiometabolic health in overweight subjects: a systematic review and meta-analysis of RCTs (2024) · cites this paper as [48]
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2013 ESH/ESC Guidelines for the management of arterial hypertension
Authors Task Force Members, Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., Christiaens, T., Cífková, R., Backer, G. D., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht151 · Cited by 13,739
2018 ESC/ESH Guidelines for the management of arterial hypertension
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Self-citationWhelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000065 · Cited by 7,391
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2007 Guidelines for the Management of Arterial Hypertension
Mancia, G., Backer, G. D., Dominiczak, A. F., Cífková, R., Fagard, R. H., Germanò, G., Grassi, G. M., Heagerty, A. M., Kjeldsen, S. E., Laurent, S., et al. (2007) · Journal of Hypertension · doi:10.1097/hjh.0b013e3281fc975a · Cited by 5,870
Metadata
- Authors
- Dickinson, H. O., Mason, J. M., Nicolson, D. J., Campbell, F., Beyer, F. R., Cook, J. V., Williams, B., & Ford, G. A.
- Affiliations
- National Institute for Health and Care Excellence (GB)
- Durham University (GB)
- University of Leeds (GB)
- University of Leicester (GB)
- Royal Victoria Infirmary (GB)
- Corresponding author
- Dickinson, Heather O
- Venue
- Journal of Hypertension
- Published
- 2006-02
- Volume
- 24
- Issue
- 2
- Pages
- 215-233
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W2092678169
- Cited by
- 759
- References
- 165
- Citations by year
- 2026: 9 · 2025: 24 · 2024: 25 · 2023: 19 · 2022: 26 · 2021: 29 · 2020: 52 · 2019: 46 · 2018: 39 · 2017: 32 · 2016: 39 · 2015: 43 · 2014: 58 · 2013: 61 · 2012: 55
- FWCI
- 6.95
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Leicester Research Archive (University of Leicester) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- hypertension, lifestyle intervention, blood pressure reduction, dietary intervention, aerobic exercise, alcohol restriction, sodium restriction, fish oil supplements, relaxation training, mineral supplements, weight loss diet
- MeSH terms
- Administrative Personnel, Blood Pressure, Calcium, Dietary, Diet, Fish Oils, Humans, Hypertension, Life Style, Magnesium, Potassium, Exercise, Randomized Controlled Trials as Topic
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