Patient discussions

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.[172] 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.[74][173] 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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