As with most chronic conditions, hypertension requires a lifelong commitment from both patient and physician to pursue aggressive management with healthy lifestyle choices and medical therapy. Patients should be counseled about diet (Dietary Approaches to Stop Hypertension [DASH] diet, sodium ≤1.5 g/day, in consultation with a nutritionist).
Smoking raises blood pressure (BP) acutely and transiently, but long-term studies have not found an association between smoking and the risk of developing chronic hypertension. Nevertheless, smoking cessation should be encouraged to reduce cardiovascular risk.
Acute consumption of coffee and black tea has a mild pressor effect; however, long-term studies have found slightly lower BP in patients who consume caffeine daily. Therefore, moderate caffeine consumption is acceptable.
Patients should be advised to begin and maintain aerobic exercise, with a goal of at least 30 minutes of moderate intensity, dynamic aerobic exercise (walking, jogging, cycling, or swimming) 5 days per week to total 150 minutes as tolerated or recommended by a physician.
Medication adherence is important and it should be discussed with patients in whom drug therapy for hypertension is often a lifelong commitment.
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