Best hypertension treatment: Doctor-patient partnership

New recommendations to lower blood pressure give a nod of approval to potassium supplements but not herbal products. But the key continues to be counseling.

By Susan J. Landers, AMNews staff. Nov. 4, 2002.

Washington -- The evidence continues to pile up: High blood pressure leads to heart attacks, strokes and heart and kidney failure. But how many patients try to lower their blood pressure by cutting down on salt, trimming meal portions or taking a vigorous walk most days of the week? Not nearly enough.

Architects of a new set of recommendations hope to reverse this trend by arming physicians to better counsel patients with evidence-based information about what definitely works, and what doesn't.

One in two adults older than 60 has hypertension today and about 90% of all adults older than middle age have a lifetime risk for elevated blood pressure unless they act to prevent it, said Edward Roccella, PhD, MPH, coordinator of the National High Blood Pressure Education Program, which generated the recommendations.

Dr. Roccella is on a mission to spread the word about the changes that must be made in patients' diets and lifestyles to counter the high risk of heart attacks and strokes that accompany hypertension.

"The good news is that there is now solid evidence that we can keep blood pressure from rising and we can prevent most of this hypertension," said Dr. Roccella.

First issued in 1993, NHBPEP recommendations were updated and published in the Oct. 16 JAMA.

The recommendations include such tried-and-true dietary changes as cutting down on salt and alcohol. But it also includes some new suggestions, such as maintaining a diet rich in fruits, vegetables and low-fat dairy products, as well as those low in saturated and total fats; and supplying an adequate supply of potassium. [...]