Dietary and Physical Activity Approaches to the Management of High Blood Pressure

We appraise recent clinical trials, cohort studies, and meta-analyses on dietary and physical activity interventions for prevention and management of high blood pressure.

We identified several notable new findings. Using a new statistical model for estimation of treatment dose-response patterns, potassium supplementation demonstrated a U-curve relationship, in contrast to the linear association for other exposures studied. Recent salt substitute reports document substantial BP lowering and prevention of cardiovascular and all-cause mortality. A large and statistically powerful alcohol dose-response meta-analysis of prospective cohort studies suggests there is no beneficial or safe level for alcohol consumption. Finally, large meta-analyses suggest isometric resistance exercise has substantial capacity to lower BP. A major area of uncertainty remains how best to implement the desired dietary and physical activity interventions. In addition to confirming and expanding core knowledge for the role of diet and physical activity in the etiology, prevention and management of high blood pressure, reports during the last 5 years have added to our understanding of dose-response relationships for sodium, potassium, physical activity, and alcohol consumption with high blood pressure, have detailed the efficacy of new treatment options, and have ighlighted areas of continuing uncertainty.