The level of risk in the hypertensive patient is heavily influenced by the presence or absence of target organ damage and of other risk factors. It is thus important to assess the patient's global risk by considering all major risk factors. The presence of these risk factors makes careful antihypertensive treatment all the more necessary and urgent. The adoption of healthy lifestyles also bears a potential for primary prevention of hypertension. Moreover, it is helpful in the control of other cardiovascular risk factors often associated to high blood pressure.
Nonpharmacological measures are appropriate for all hypertensives.
Weight reduction of as little as 4.5 kg reduces blood pressure in a large proportion of overweight hypertensives. Withdrawal of alcohol intake may lower blood pressure in heavy drinkers and improve the response to antihypertensive drug therapy, when this is needed. Its effect may be greater in older persons and those with higher pressures. Several studies have suggested that sodium chloride restriction may bring about other favourable effects, such as reduced diuretic-induced potassium wastage, prevention of urolithiasis by reduction in urinary calcium excretion and regression of left ventricular hypertrophy. A high potassium intake should be recommended to everyone, regardless of blood pressure.