Non-pharmacological treatment of hypertension in women

This paper reviews literature data about non-pharmacological treatment of hypertension in women. A reduction in salt intake, an increase in physical activity and body weight reduction have been clearly demonstrated to be effective in reducing blood pressure values in women. Other lifestyle changes have been investigated in past years, but the results are still debated. A 4-8% body weight reduction causes an average 3 mmHg blood pressure decrease. However, many women tend to regain the weight (weight cycling), and in this case an increase of blood pressure can be observed. Older women are less responsive to low-calorie diets. Sodium restriction is effective in a dose-dependent way. The main problem is that good compliance is difficult to obtain. Salt substitutes may be helpful. Regular physical activity can reduce blood pressure by at least 5/3 mmHg, while walking for less than 2 h per week can reduce the risk of stroke by 50%. Data on coffee drinking are less conclusive even if there is evidence that the effect on blood pressure is greater at increasing levels of blood pressure. The reduction of alcohol intake, an increase in fibers and an increase in unsaturated fatty acids are well known tools to improve blood pressure control. Within unsaturated fatty acids, olive oil seems to be particularly helpful since it is able to produce significant blood pressure reductions, which are greater than those observed with sunflower oil. (C) 2002 Lippincott Williams Wilkins.