Isotonic exercise is more effective in lowering blood pressure. It is important to make certain that patients understand the difference between the two types of exercise. Many patients with high blood pressure have coexisting coronary artery disease, which must be controlled before unsupervised exercise can be started. In severe hypertension, medical therapy should be started before endurance training is initiated. The pressor effects of alcohol can lead to increases in blood pressure, even in people who are normotensive.
Many people are hypertensive solely because of excessive alcohol intake.
Clearly, patients with hypertension that is difficult to control need to discontinue excessive alcohol consumption. Recommendations on moderation of intake begin with detailed history taking of the amount of alcohol being consumed. All patients should be advised to stop smoking. Summary Any approach to antihypertensive therapy should include lifestyle modifications. In the beginning, emphasis should be on weight loss and exercise, along with moderation of alcohol use and cessation of smoking.