Nonpharmacologic approaches to hypertension. Weight, sodium, alcohol, exercise, and tobacco considerations.

Weight loss decreases blood pressure, and this change can be sustained over the long-term when the lower weight is maintained. Salt restriction may be effective in blood pressure control only in salt-sensitive individuals. Heavy drinkers (those who drink more than three drinks [30 mL] daily) experience deleterious effects such as hypertension and more cardiovascular risk factors. Consequently, they should be advised to reduce alcohol intake to less than 30 mL daily. Endurance training with dynamic exercise appears to be beneficial for hypertensive patients, although recommendation guidelines are still imprecise. Finally, smoking cessation has not been proven to decrease blood pressure levels but should nonetheless be recommended because of its favorable effects on cardiovascular morbidity and mortality.