Lifestyle interventions in the management of hypertension: a survey based on the opinion of 105 practitioners

Abstract

Background: Lifestyle interventions in the management of hypertension were beneficial in published studies.

Objective: To evaluate (1) which lifestyle recommendations are given by physicians and to what extent the possibility of drug-induced hypertension is addressed; (2) to study the characteristics of the physicians who more often perform lifestyle interventions.

Methods: General practitioners in the area of Dordrecht were asked whether or not they included lifestyle advice in the management of their patients' hypertension.

Results: Of the 176 physicians invited, 105 consented to take part. Measures to reduce body weight, stopping smoking, and physical exercise advice were given by 94, 92, and 92% of the physicians, respectively. Advice on psychological relaxation and reducing liquorice (Dutch: drop) intake was only given by 23 and 32%. Rural physicians were more active: they more often recommended quitting smoking (p<0.02), reducing weight (p<0.02), and participating in sporting activities (p<0.02). And so were older physicians: they more often recommended starting low-calorie diets (p<0.05), stopping liquorice consumption (p<0.04) and emphasised drug compliance (p<0.02). Increased blood pressure as a side effect of concomitant medications, other than nonsteroidal anti-inflammatory drugs and oral contraceptives, was virtually never addressed.

Conclusions: (1) Advice to reduce body weight, stop smoking, and increase physical exercise are the only lifestyle recommendations routinely given, (2) rural physicians and older physicians were more active in giving non-drug treatments, (3) increased blood pressure as a side effect of medications was virtually never addressed. (Neth Heart J 2009;17:9-12.).

Keywords: antihypertensive drugs; hypertension; lifestyle factors; non-drug treatment.