What other interventions are recommended for treatment of comorbid hypertension and obesity?

Lifestyle changes—ie, dietary interventions and increased physical activity—are cornerstones of therapy. The Dietary Approaches to Stop Hypertension (DASH) diet is known to show great utility in the management of hypertension. Appropriate diets for the management of obesity-related hypertension will be rich in potassium, calcium, magnesium, and fiber and low in salt and saturated fat.

These diets should promote consumption of vegetables, fruits, low-fat dairy products, whole grains, nuts, poultry, and fish and should discourage salt, red meats, sweets, and sugary drinks.


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It is important to encourage patients to avoid a sedentary lifestyle and increase physical activity. Aerobic exercise can reduce weight and lower BP. Physical activity also helps maintain weight loss and improves cardiovascular risk factors. Smoking cessation is critical, as smoking acutely increases BP and is also associated with arterial stiffness. Lifestyle programs targeting smoking cessation are important. Behavioral modification techniques, including social and professional support, goal-setting, self-monitoring, and relapse prevention strategies, are essential to ensuring both short- and long-term success. 

Take Our Poll!

Health professionals across the United States have been closely watching the unfolding political battle in New York City. 

On one side, Mayor Michael Bloomberg has been waging a war on obesity. He has attempted to ban the sale of large open containers of sugary drinks, such as the 24-ounce sodas patrons buy at movie theaters. On the other, civil libertarians (and ornery locals) have fought back. 

As a clinician, on which side are you? MPR would like to know. Vote in our poll!

Do you think the government should get involved to help curb obesity?

References

American Heart Association. Statistical Fact Sheet: Overweight and Obesity. 2012 update. Available at: http://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319588.pdf. Accessed: March 4, 2013.

Landsberg L, Aronne LJ, Bellin LJ, et al. Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment. J Clin Hypertension. 2013;15(1):14-33.

Landsberg L, Aronne LJ, Bellin LJ, et al. Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment. Obesity (Silver Spring). December 20, 2012. [Epub ahead of print]

Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of Obesity in the United States,2009–2010. NCHS Data Brief No. 82 January 2012. Available at: http://www.cdc.gov/nchs/data/databriefs/db82.pdf. Accessed: March 4, 2013.