Non-pharmacological treatment mainly refers to lifestyle interventions, i.e., the removal of behaviors and habits that are detrimental to physical and mental health. It not only prevents or delays the onset of hypertension, but also lowers blood pressure and improves the efficacy of antihypertensive medications, thereby reducing cardiovascular risk.
1. Reduce sodium intake
Sodium can significantly raise blood pressure as well as the risk of hypertension, while potassium salt can counteract the role of sodium in raising high blood pressure. Sodium intake is significantly higher than the current World Health Organization recommendation of less than 6 grams per day, and potassium intake is severely inadequate. The main measures include.
Minimizing the use of salt in cooking, with the use of a rationable salt spoon recommended ;
Reduce the amount of sodium-containing condiments such as MSG and soy sauce;
Reduce or not to eat processed foods with high sodium content, such as salted vegetables, ham, sausages and fried foods;
Increase the intake of vegetables and fruits;
For those with good kidney function, use cooking salt containing potassium.
2.Control weight
Overweight and obesity is one of the important reasons for the rise of blood pressure, and central obesity with abdominal fat accumulation as a typical feature will further increase the risk of cardiovascular and metabolic diseases such as hypertension, appropriate reduction of elevated body weight, reduce body fat content, can significantly reduce blood pressure.
The easiest and most commonly used physiological measures of overweight and obesity are body mass index [calculated as: weight (kg)/height (m)2] and waist circumference. The former usually reflects the degree of general obesity, and the latter mainly reflects the degree of central obesity. The normal body mass index of adults is 18,5-23,9 kg/m2, in 24-27,9 kg/m2 is overweight, suggesting the need for weight control; BMI 328 kg/m2 is obese and should be reduced. Adults with normal waist circumference <90/85 cm (M/F), such as waist circumference 390/85 cm (M/F), similarly suggest the need for weight control, such as waist circumference 395/90 cm (M/F), should also lose weight [5].
The most effective weight reduction measures are controlling energy intake and increasing physical activity. In terms of diet, it is important to follow the principle of a balanced diet, control the intake of high-calorie foods (high-fat foods, sugary drinks and alcohol, etc.), and control the amount of staple foods (carbohydrates) appropriately. In terms of exercise, regular, moderate intensity aerobic exercise is an effective way to control weight. The rate of weight loss varies from person to person, usually 0.5~1kg per week is appropriate. For non-drug measures to reduce weight is not ideal for patients with severe obesity, should be under the guidance of a doctor, the use of weight loss drugs to control weight.
3. Do not smoke
Smoking is an unhealthy behavior, is one of the main risk factors for cardiovascular disease and cancer. Passive smoking can also significantly increase the risk of cardiovascular disease. Smoking can cause endothelial damage and significantly increase the risk of atherosclerotic disease in patients with hypertension. The benefits of quitting smoking are very certain and can be beneficial at any age. Tobacco dependence is a chronic addictive disease that is not only difficult to quit, but also has a high relapse rate. Therefore, physicians should strongly advise and supervise patients with hypertension to quit smoking and encourage them to seek medication-assisted cessation (use of nicotine replacement, bupropion extended-release tablets, and varenicline), and should also follow up and monitor successful quitters to avoid relapse.
4. Limit alcohol consumption
Long-term heavy alcohol consumption can lead to increased blood pressure, and limiting alcohol consumption can significantly reduce the risk of developing hypertension. Long-term heavy alcohol consumption is more common among men in China, and several ethnic minority women, such as the She, also have the habit of drinking alcohol. All study participants should control the amount of alcohol consumed. Daily alcohol intake should not exceed 25 grams for men; 15 grams for women. It is not advocated that hypertensive patients should drink alcohol, and if they do, it should be in small amounts: less than 50ml, 100ml and 300ml of white wine, wine (or rice wine) and beer respectively.
5. Physical exercise
General physical activity can increase energy consumption, which is very beneficial to health. And regular physical exercise can have important therapeutic effects, which can lower blood pressure and improve sugar metabolism. Therefore, it is recommended that about 30 minutes of appropriate physical activity should be performed every day; and there should be more than one aerobic physical exercise per week, such as walking, jogging, cycling, swimming, aerobics, dancing and non-competitive rowing. A typical physical activity program consists of three phases: ①
5 to 10 minutes of light warm-up activities; ② 20 to 30 minutes of endurance activities or aerobic exercise; ③ a relaxation phase of about 5 minutes, gradually reducing exertion so that the response of the cardiovascular system and the body’s thermogenic function gradually stabilize. The form of exercise and the amount of exercise should be based on personal interest and physical condition.
6, reduce mental stress, maintain psychological balance
Psychological or mental stress causes psychological stress (reaction), that is, the body’s response to the stimulation of psychological and physical factors in the environment. Long-term, excessive psychological reactions, especially negative psychological reactions can significantly increase cardiovascular risk. The main causes of increased mental stress include excessive work and life stress and pathological psychology, including depression, anxiety, Type A personality (a personality characterized by hostility, aggressiveness and jealousy and a sense of time urgency), social isolation and lack of social support. Various measures should be taken to help patients prevent and relieve mental stress as well as correct and treat pathological psychology, and patients are advised to seek professional psychological counseling or treatment if necessary.