Beyond Pharmacotherapy: Lifestyle Counseling Guidance Needed for Hypertension
Authors: E. Amy Janke, Caroline Richardson, Kristin L. Schneider
Journal: Annals of Internal Medicine (2019)

Ideas and Opinions5 February 2019Beyond Pharmacotherapy: Lifestyle Counseling Guidance Needed for HypertensionE. Amy Janke, PhD, Caroline Richardson, MD, and Kristin L. Schneider, PhD, on behalf of the Society of Behavioral Medicine Executive Committee*E. Amy Janke, PhDUniversity of the Sciences, Philadelphia, Pennsylvania (E.A.J.), Caroline Richardson, MDUniversity of Michigan Medical School, Ann Arbor, Michigan (C.R.), and Kristin L. Schneider, PhDRosalind Franklin University of Medicine and Science, North Chicago, Illinois (K.L.S.), on behalf of the Society of Behavioral Medicine Executive Committee*Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2361 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In their 2017 hypertension guidelines, the American College of Cardiology and American Heart Association (ACC/AHA) expanded their focus on lifestyle recommendations to prevent and manage hypertension (1). The literature review that informed the guidelines makes a compelling case that hypertension rates remain high and that the use of antihypertensive medications to control high blood pressure in U.S. adults is suboptimal. The ACC/AHA recommends that every U.S. adult be encouraged to engage in healthy lifestyle habits to prevent hypertension and that those with hypertension adopt a healthier lifestyle, either alone or alongside medical treatment, to reduce their blood pressure. Largely missing ...References1. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:2199-269. [PMID: 29146533] doi:10.1016/j.jacc.2017.11.005 CrossrefMedlineGoogle Scholar2. Marcus BH, Williams DM, Dubbert PM, Sallis JF, King AC, Yancey AK; American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). 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Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129:S102-38. [PMID: 24222017] doi:10.1161/01.cir.0000437739.71477.ee CrossrefMedlineGoogle Scholar9. Johnson HM, Olson AG, LaMantia JN, Kind AJ, Pandhi N, Mendonça EA, et al. Documented lifestyle education among young adults with incident hypertension. J Gen Intern Med. 2015;30:556-64. [PMID: 25373831] doi:10.1007/s11606-014-3059-7 CrossrefMedlineGoogle Scholar10. Gorin SS. Provider and office-based approaches to prevention in primary care. In: Gorin SS, eds. Prevention Practice in Primary Care. New York: Oxford Univ Pr; 2014:106-230. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of the Sciences, Philadelphia, Pennsylvania (E.A.J.)University of Michigan Medical School, Ann Arbor, Michigan (C.R.)Rosalind Franklin University of Medicine and Science, North Chicago, Illinois (K.L.S.)Acknowledgment: The authors thank Sherri Sheinfeld Gorin, PhD, for providing writing assistance and editing.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2361.Corresponding Author: E. Amy Janke, PhD, Department of Behavioral and Social Sciences, University of the Sciences, 600 South 43rd Street, Philadelphia, PA 19104; e-mail, e.[email protected]edu.Current Author Addresses: Dr. Janke: Department of Behavioral and Social Sciences, University of the Sciences, 600 South 43rd Street, Philadelphia, PA 19104.Dr. Richardson: Department of Family Medicine, University of Michigan Medical School, 1018 Fuller Street, Ann Arbor, MI 48104.Dr. Schneider: College of Health Professions, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064.Author Contributions: Conception and design: E.A. Janke, C. Richardson, K.L. Schneider.Drafting of the article: E.A. Janke, K.L. Schneider.Critical revision for important intellectual content: E.A. Janke, C. Richardson, K.L. Schneider.Final approval of the article: E.A. Janke, C. Richardson, K.L. Schneider.Administrative, technical, or logistic support: E.A. Janke, K.L. Schneider.This article was published at Annals.org on 8 January 2019.* For members of the Society of Behavioral Medicine Executive Committee, see the Appendix. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHome‐based transcutaneous electrical acupoint stimulation for high‐normal blood pressure: A randomized controlled trialTranscutaneous electrical acupoint stimulation for high-normal blood pressure: study protocol for a randomized controlled pilot trialTraining health professionals to provide physical activity counsellingCatalysts for Change: Accelerating the Lifestyle Medicine Movement Through Professionals in Training 5 February 2019Volume 170, Issue 3Page: 195-196KeywordsAlcoholsBehaviorBlood pressureDietExerciseHypertensionMedicareObesityScientistsSmoking cessation ePublished: 8 January 2019 Issue Published: 5 February 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. 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