Statistically significant reductions in blood pressure were found, in the short term for improved diet and exercise, relaxation therapies, and sodium and alcohol reduction.
Most areas featured considerable heterogeneity (i.e. study findings were inconsistent, some positive and some negative) over and above the variation expected by the normal play of chance. This heterogeneity tends to limit the strength of recommendation that can be made about any course of action.
Although without a formal meta-analysis, it likewise concluded that overweight hypertensive patients should be advised to reduce their weight.
Overall, patients receiving exercise-promoting interventions achieved a modest reduction in both systolic (3.1 mmHg, 95%CI: 0.7 to 5.5) and diastolic (1.8 mmHg, 95% CI: 0.2 to 3.5) blood pressure compared to those in control groups (see Figure 6).
The recent Canadian guideline reviewed studies between 1966 and 1997132. Although without a formal meta-analysis, it reported short term reductions in blood pressure of 5 to 10 mmHg and recommended 50–60 minutes of moderate intensity exercise three or four times per week.
The recent Canadian guideline reviewed studies between 1966 and 1997550. It concluded that multifaceted interventions to reduce stress were more likely to be effective than single component therapies and favoured the use of cognitive behavioural therapy, based on the findings of three meta-analyses192,293,366. For hypertensive patients in whom stress appears to be an important issue, they recommended that stress management including individualized cognitive behavioural therapy may be appropriate.
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