Background. Hypertension is a major global health concern, and lifestyle modifications have been recommended as first-line treatment for hypertension in many guidelines. However, different guidelines may recommend different types of lifestyle adjustment, and it is unclear which ones are most effective. In this review, we compared hypertension guidelines to identify any differences and/or consensus in content, efficacy, and timing of initiation of lifestyle modifications. Methods. We conducted a search of databases to identify hypertension guidelines available in English. We extracted and compared information about lifestyle modifications recommended by the guidelines. Results. Five hypertension guidelines from America, Europe, the UK, Canada, and the International Society of Hypertension are included. They all recommend diet adaptation, sodium reduction, alcohol restriction, physical exercise, and weight reduction. Other lifestyle interventions emphasized by some guidelines, such as potassium supplementation, smoking cessation, and stress management, are not recommended by all the five guidelines. Among lifestyle changes, the dietary approaches to stop hypertension (DASH) diet may be considered the most effective treatment for reducing blood pressure. These guidelines recommend that for patients with high-normal blood pressure or grade 1 hypertension without high risk factors, lifestyle medicine should be used first for 3–6 months, if blood pressure is still not controlled, then start medication. For those patients who need drug treatment, lifestyle changes can also enhance the effects of antihypertensive therapy. Conclusion. Lifestyle modifications are crucial in the treatment of hypertension and should be recommended to most hypertensive patients. Among these lifestyle interventions, diet adaptation containing low sodium and alcohol restriction may be the most effective in reducing blood pressure. Physical exercise and weight reduction are also recommended. In some cases, lifestyle modifications should be tried first. They may also enhance the effects of antihypertensive drugs in other patients.

中文翻译：

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高血压指南的比较分析：揭示生活方式改变以控制血压的共识和差异

背景。高血压是全球主要的健康问题，许多指南都建议将生活方式改变作为高血压的一线治疗方法。然而，不同的指南可能会推荐不同类型的生活方式调整，并且尚不清楚哪种最有效。在这篇综述中，我们比较了高血压指南，以确定在内容、功效和开始生活方式改变的时间方面的任何差异和/或共识。方法。我们对数据库进行了检索，以确定英文版高血压指南。我们提取并比较了指南建议的生活方式改变的信息。结果。其中包括来自美国、欧洲、英国、加拿大和国际高血压协会的五份高血压指南。他们都建议调整饮食、减少钠摄入、限制饮酒、体育锻炼和减轻体重。一些指南强调的其他生活方式干预措施，例如补充钾、戒烟和压力管理，并不是所有五个指南都推荐的。在生活方式的改变中，控制高血压的饮食方法（DASH）饮食可能被认为是降低血压最有效的治疗方法。该指南建议，对于正常高值血压或无高危因素的1级高血压患者，应先使用生活方式药物3~6个月，如果血压仍未控制，再开始用药。对于那些需要药物治疗的患者来说，生活方式的改变也可以增强降压治疗的效果。结论。生活方式的改变对于高血压的治疗至关重要，应该推荐给大多数高血压患者。在这些生活方式干预措施中，包含低钠和限制酒精的饮食适应可能是降低血压最有效的方法。还建议进行体育锻炼和减轻体重。在某些情况下，应首先尝试改变生活方式。它们还可能增强抗高血压药物对其他患者的作用。