Hypertension

Use lifestyle treatment across BP categories and alongside medication. Agree on specific goals, review progress with BP trends, and intensify support when the plan is not feasible.

• Diet and sodium: Use the Dietary Approaches to Stop Hypertension (DASH) eating plan. Target sodium <2,300 mg/day, moving toward 1,500 mg/day; focus on packaged and restaurant foods. Adapt food choices to preferences, budget, and available preparation facilities.
• Potassium: Favor potassium-rich foods when appropriate. Before recommending supplements or potassium-based salt substitutes, assess CKD, potassium levels, and medications that increase hyperkalemia risk.
• Weight and activity: For overweight or obesity, aim for at least 5% weight loss. Prescribe ≥150 minutes/week of moderate or ≥75 minutes/week of vigorous aerobic activity, plus resistance exercise; adapt to functional capacity.
• Alcohol and sleep: Recommend reducing or eliminating alcohol. Assess OSA when suggested by symptoms or resistant HTN; address sleep disruption and stress as part of the care plan.
• Total vascular risk: Address tobacco use, dyslipidemia, and diabetes alongside BP. Lifestyle counseling should not delay medication when treatment thresholds are met.