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Non-pharmacological factors for hypertension management: a systematic review of international guidelines.

European journal of preventive cardiology
January 1, 1970
Carmela Maniero et al. (6 authors)
Journal ArticleSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to systematically review hypertension guidelines to assess recommendations on non-pharmacological factors, including salt intake, for hypertension prevention and treatment.

Results Summary

The guidelines consistently recommended reduced salt intake as part of lifestyle modifications for hypertension management, highlighting its importance in prevention and treatment. Some areas of disagreement were noted regarding other factors, but salt reduction was widely supported.

Population

General population and hypertensive patients.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (13)
InterventionDirectionEndpointPopulationDosageImpactClaim #
reduced salt intake
decrease
hypertension prevention and treatment
hypertensive patients and general population
-
consistent in recommendations
#1
weight management
decrease
hypertension prevention and treatment
hypertensive patients and general population
-
consistent in recommendations
#2
dietary patterns
neutral
hypertension prevention and treatment
hypertensive patients and general population
-
consistent in recommendations
#3
increased physical activity
increase
hypertension prevention and treatment
hypertensive patients and general population
-
consistent in recommendations
#4
smoking cessation
decrease
hypertension prevention and treatment
hypertensive patients and general population
-
consistent in recommendations
#5
limiting alcohol intake
decrease
hypertension prevention and treatment
hypertensive patients and general population
-
consistent in recommendations
#6
stress management
neutral
hypertension prevention and treatment
-
-
areas of disagreement were identified
#7
air pollution reduction
neutral
hypertension prevention and treatment
-
-
areas of disagreement were identified
#8
alcohol intake thresholds
neutral
hypertension prevention and treatment
-
-
areas of disagreement were identified
#9
meat consumption
neutral
hypertension prevention and treatment
-
-
areas of disagreement were identified
#10
coffee consumption
neutral
hypertension prevention and treatment
-
-
areas of disagreement were identified
#11
tea consumption
neutral
hypertension prevention and treatment
-
-
areas of disagreement were identified
#12
refined sugars consumption
neutral
hypertension prevention and treatment
-
-
areas of disagreement were identified
#13
Abstract

Lifestyle modifications are one of the cornerstones of hypertension prevention and treatment. We aimed to systematically review hypertension guidelines on their recommendations on non-pharmacological factors including lifestyle interventions, to highlight strength of evidence, similarities, and differences. This systematic review was registered with the international Prospective Register of Systematic Reviews (CRD42021288815). Publications in MEDLINE and EMBASE databases over 10 years since January 2010 to June 2020 were identified. We also included the search from websites of organizations responsible for guidelines development. Two reviewers screened the titles and abstracts to identify relevant guidelines. Two reviewers independently assessed rigour of guideline development using the AGREE II instrument, and one reviewer extracted recommendations. Of the identified guidelines, 10 showed good rigour of development (AGREE II ≥ 60%) and were included in the systematic review. The guidelines were consistent in most recommendations (reduced salt intake, weight, dietary patterns, increased physical activity and smoking cessation, and limiting alcohol intake). Some areas of disagreement were identified, regarding recommendations on novel psychological and environmental factors such as stress or air pollution, alcohol intake thresholds, meat, coffee and tea consumption and refined sugars. Current guidelines agree on the importance of lifestyle in the treatment and prevention of hypertension. Consensus on smoking cessation, limited salt intake, increased physical activity support their integration in management of hypertensive patients and in public health measurements in general population as preventative measurements. Further research into the role of environmental and psychological factors may help clarify future recommendations.

Medical Subject Headings (MeSH)
HumansHypertensionPublic HealthSodium Chloride, DietaryHealthy LifestyleHealth Behavior
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality90/10
Citation Metrics
Total Citations21
Citations/Year10.5
Relative Citation Ratio5.74
NIH Percentile94.4%
Research Impact Scores
APT Score0.75
Weight Score1.88
Normalized Score0.72
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