Comprehensive effects of lifestyle reform, adherence, and related factors on hypertension control: A review
Open accessAbstract
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.
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In individuals with chronic conditions such as hypertension, adherence to lifestyle reform (diet, exercise, stress reduction) is associated with improved physiological parameters and better disease control.
“In individuals with chronic conditions such as hypertension, adherence to lifestyle reform—including diet, exercise, and stress reduction techniques—has been associated with improved physiological parameters and better disease control [91].”
From Chronic Stress and Autoimmunity: The Role of HPA Axis and Cortisol Dysregulation (2025) · cites this paper as [91]
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- Authors
- Ojangba, T., Boamah, S., Miao, Y., Guo, X., Fen, Y., Agboyibor, C., Yuan, J., & Dong, W.
- Affiliations
- Zhengzhou University (CN)
- Gansu Agricultural University (CN)
- Corresponding author
- Dong, Wenyong
- ORCID
- Venue
- The Journal of Clinical Hypertension
- Publisher
- Wiley
- Published
- 2023-05-09
- Volume
- 25
- Issue
- 6
- Pages
- 509-520
- ISSN
- 1524-6175 (ISSN-L)
- 1751-7176
- PMC
- PMC10246465
- OpenAlex
- W4376121652
- Cited by
- 136
- References
- 115
- Citations by year
- 2026: 55 · 2025: 58 · 2024: 19 · 2023: 4
- FWCI
- 7.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Clinical Hypertension (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Office for Philosophy and Social Sciences (21BGL222)
- 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 › Family Practice › Medication Adherence and Compliance
- Keywords
- hypertension, lifestyle modification, medication adherence, blood pressure control, cardiovascular disease prevention, antihypertensive drugs, dietary sodium, body mass index, smoking, alcohol consumption, physical activity, sedentary behavior, health education, insulin resistance, renin-angiotensin-aldosterone system, oxidative stress, visceral fat
- MeSH terms
- Antihypertensive Agents, Blood Pressure, Cardiovascular Diseases, Humans, Hypertension, Life Style, Sodium
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