Nonpharmacological interventions for the prevention of hypertension in low- and middle-income countries: a systematic review and meta-analysis

Abstract

Hypertension is the single biggest cause of various cardiovascular complications and at the same time one of the most preventable phenomena. Low- and middle-income countries (LMICs) are facing increasing prevalence of hypertension which is imposing a huge burden on morbidity, premature mortality, and catastrophic health expenditure. This systematic review searched for the nonpharmacological interventions for prevention of hypertension among normotensive people in LMICs considering the period 1990–2016. This review has been conducted following standard methodology of Cochrane review involving two independent reviewers in screening, quality appraisal, and data extraction. Narrative synthesis of included articles was demonstrated using tables and meta-analysis was conducted to pool the estimates of studies which fulfilled the criteria. Total seven trials were included in the review with 6046 participants from eight LMICs. Two cluster randomized trials were pooled and there was a statistically significant effect (Systolic Blood Pressure: mean difference −2.35 [95% CI: −4.31 to −0.38], Diastolic Blood Pressure: mean difference −2.11 [95% CI: −3.20 to −1.02]) of home based health education in reducing blood pressure. Three individual studies reported reduction of blood pressure as a result of restricted dietary sodium intake. None of the studies was appraised as low risk of bias due to poor methodological quality. Non-pharmacological interventions can play important role in preventing the development of hypertension among normotensive people. Further trials with longer follow-up period and robust methods are recommended for getting stronger evidence on these interventions.

Impact of Intensive Lifestyle Treatment (Diet Plus Exercise) on Endothelial and Vascular Function, Arterial Stiffness and Blood Pressure in Stage 1 Hypertension: Results of the HINTreat Randomized Controlled Trial

“…Lifestyle modification plays a key role in the treatment of EH by decreasing the levels of BP [16][17][18], in some cases delaying the onset of pharmacological treatment among patients at stage I EH of low CVD risk [19] and importantly by improving the cardiometabolic profile of patients [20]. In EH, attaining a healthy diet remains the hallmark of non-pharmacological treatment [21].…”

Prevalence, Knowledge and Treatment of Systemic Arterial Hypertension in A Campaign Day

“…Reducing body weight, performing regular physical activities, reducing salt or sodium intake, increasing potassium supplementation and avoiding harmful alcohol use are recommended. Regarding healthy eating, the Dietary Approaches to Stop Hypertension (DASH) argues that it can result in increased intake of potassium, magnesium, calcium and fibers, and research shows that it can reduce blood pressure, improve the lipid profile, contribute to glycemic control and reduce cardiovascular risk [7], [8].…”

Immediate Effect of Ice Massage to Head and Spine vs Cooling Pranayamas on Heart Rate Variability in Hypertensives

“…Different lifestyle modifications to treat or prevent hypertension have been established in various studies. Maintaining healthy body weight, regular physical activity, reduced salt or sodium intake, potassium supplementation, and avoiding harmful alcohol consumption are all recommended approaches for controlling hypertension [5]. The blood pressure of only half of medically treated hypertensive patients is under control despite using anti-hypertensive medications, as shown by a study report [6].…”