New Delhi. Hypertension or high blood pressure is the present ongoing epidemic of the society. Blood pressure is a silent killer said Dr KK Aggarwal, President Heart Care Foundation of India. Antihypertensive treatment is associated with reductions in stroke incidence averaging 35–40%, myocardial infarction, by 20–25 %; and heart failure, by more than 50%. A 5 mm reduction in diastolic lower blood pressure can reduce heart disease by 21%.

Dr Aggarwal said that if we were to eliminate pre hypertension from the society (or in other words keep the community blood pressure lower than 120/80 mm Hg) we can potentially prevent about 47 percent of all heart attacks.

The Framingham Study found that a pre hypertensive person is more than three times more likely to have a heart attack and 1.7 times more likely to have heart disease than a person with normal blood pressure.

Lifestyle modifications reduce BP, enhance anti-hypertensive drug efficacy, and decrease cardiovascular risk. If there is no target organ damage diabetes or multi cardiac risk factors one can try lifestyle management for up to 6 months. Presence of target organ damage necessitates drug treatment to lower the BP.

A 1,600 mg sodium DASH eating plan has effects similar to single drug therapy. Combinations of two (or more) lifestyle modifications can achieve even better results.

One should maintain normal body weight. A reduction of 5–20 mmHg of BP can be achieved for every 10 kg weight loss.

One should consume a diet rich in fruits, vegetables, and low fat dairy products with a reduced content of saturated and total fat. It can reduce blood pressure by 8-14 m Hg. One should reduce dietary sodium intake to no more than 100 mmol per day (2.4 g sodium or 6 g sodium chloride). It can alone reduce blood pressure by 2-8 mm Hg. One should engage in regular aerobic physical activity such as brisk walking (at least 30 min per day, most days of the week). It can alone reduce blood pressure by 4-9 mm Hg.

For those who drink should limit consumption to no more than 2 drinks (1 oz or 30 mL ethanol; e.g., 24 oz beer, 10 oz wine, or 3 oz 80-proof whiskey) per day in most men and to no more than 1 drink per day in women and lighter weight persons. It can alone reduce blood pressure by 2-4 mm Hg. One should reduce dietary sodium intake to no more than 100 mmol per day (2.4 g sodium or 6 g sodium chloride). It can alone reduce blood pressure by 2-8 mm Hg.

One should engage in regular aerobic physical activity such as brisk walking (at least 30 min per day, most days of the week). It can alone reduce blood pressure by 4-9 mm Hg. For those who drink should limit consumption to no more than 2 drinks (1 oz or 30 mL ethanol; e.g., 24 oz beer, 10 oz wine, or 3 oz 80-proof whiskey) per day in most men and to no more than 1 drink per day in women and lighter weight persons. It can alone reduce blood pressure by 2-4 mm Hg.