The MKSAP Challenge
Answer: A
Educational objective: Understand the effect of lifestyle interventions for hypertension.
A recent meta-analysis has reconfirmed that aerobic exercise (30 minutes of exercise vigorous enough to cause a sweat) significantly reduces blood pressure. Each of the other interventions lowers blood pressure modestly, but not as much as aerobic exercise, which lowers blood pressure in both hypertensive and normotensive patients.
Weight loss lowers blood pressure by about one point systolic and diastolic for every kg lost. Other lifestyle interventions of importance include sodium restriction (the average American consumes 10 g of salt per day; 4 g per day is a no-added-salt diet), and adequate dietary potassium and calcium intake. Limiting alcohol to one drink per day is also recommended, as is smoking cessation.
References:
1. Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136:493-503.
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