Robust statistically significant effects were found for improved diet , aerobic exercise , alcohol and sodium restriction , and fish oil supplements : mean reductions in systolic blood pressure of 5.0 mmHg [ 95 % confidence interval ( CI ) : 3.1 - 7.0 ] , 4.6 mmHg ( 95 % CI : 2.0 - 7.1 ) , 3.8 mmHg ( 95 % CI : 1.4 - 6.1 ) , 3.6 mmHg ( 95 % CI : 2.5 - 4.6 ) and 2.3 mmHg ( 95 % CI : 0.2 - 4.3 ) , respectively , with corresponding reductions in diastolic blood pressure .
Relaxation significantly reduced blood pressure only when compared with non-intervention controls .
We found no robust evidence of any important effect on blood pressure of potassium , magnesium or calcium supplements .
Available evidence does not support relaxation therapies , calcium , magnesium or potassium supplements to reduce blood pressure
PURPOSE To quantify effectiveness of lifestyle interventions for hypertension .
Dieting to reduce body weight for controlling hypertension in adults.
OBJECTIVES : Evaluate whether weight-loss diets are more effective than regular diets or other antihypertensive therapies in controlling blood pressure and preventing morbidity and mortality  in hypertensive adults . SEARCH STRATEGY : MEDLINE and The Cochrane Library were search ed through November 1997 . Trials known to experts in the field were included through June 1998 . SELECTION CRITERIA : For inclusion in the review , trials were required to meet each of the following criteria : 1 ) r and omized controlled trials with one group assigned to a weight-loss diet and the other group assigned to either normal diet or antihypertensive therapy ; 2 ) ambulatory adults with a mean blood pressure of at least 140 mm Hg systolic and /or 90 mm Hg diastolic ; 3 ) active intervention consisting of a  calorie-restricted diet intended to produce weight loss ( excluded studies simultaneously implementing multiple lifestyle interventions where the effects of weight loss could not be disaggregated ) ; and 4 ) outcome measures included weight loss and blood pressure . DATA COLLECTION AND ANALYSIS : Studies were dual abstract ed by two independent review ers using a st and ardized form design ed specifically for this review . The primary mode of analysis was qualitative ; graphs of effect sizes for individual studies were also used . MAIN RESULTS : Eighteen trials were found . Only one small study of inadequate power reported morbidity and mortality outcomes . None addressed quality of life or general well being issues . In general , participants assigned to weight-reduction groups lost weight compared to control groups . Six trials involving 361 participants assessed a weight-reducing diet versus a normal diet . The data suggested weight loss in the range of 4 % to 8 % of body weight was associated with a decrease in blood pressure in the range of 3 mm Hg systolic and diastolic . Three trials involving 363 participants assessed a weight-reducing diet versus treatment with antihypertensive medications . These suggested that a stepped-care approach with antihypertensive medications produced greater decreases in blood pressure ( in the range of 6/5 mm Hg systolic/diastolic ) than did a weight-loss diet . Trials that allowed adjustment of participants ' antihypertensive regimens suggested that patients required less intensive antihypertensive drug therapy if they followed a weight-reducing diet . Data was insufficient to determine the relative efficacy of weight-reduction versus changes in sodium or potassium intake or exercise . REVIEW ER 'S CONCLUSIONS : Weight-reducing diets in overweight hypertensive persons can affect modest weight loss in the range of 3 - 9 % of body weight and are probably associated with modest blood pressure decreases of roughly 3 mm Hg systolic and diastolic . Weight-reducing diets may decrease dosage requirements of persons taking antihypertensive medications
Robust statistically significant effects were found for improved diet , aerobic exercise , alcohol and sodium restriction , and fish oil supplements : mean reductions in systolic blood pressure of 5.0 mmHg [ 95 % confidence interval ( CI ) : 3.1 - 7.0 ] , 4.6 mmHg ( 95 % CI : 2.0 - 7.1 ) , 3.8 mmHg ( 95 % CI : 1.4 - 6.1 ) , 3.6 mmHg ( 95 % CI : 2.5 - 4.6 ) and 2.3 mmHg ( 95 % CI : 0.2 - 4.3 ) , respectively , with corresponding reductions in diastolic blood pressure .
Relaxation significantly reduced blood pressure only when compared with non-intervention controls .
We found no robust evidence of any important effect on blood pressure of potassium , magnesium or calcium supplements .
Available evidence does not support relaxation therapies , calcium , magnesium or potassium supplements to reduce blood pressure
PURPOSE To quantify effectiveness of lifestyle interventions for hypertension .