Impact of therapeutic lifestyle changes in resistant hypertension

Prog Cardiovasc Dis. 2020 Jan-Feb;63(1):4-9. doi: 10.1016/j.pcad.2019.11.012. Epub 2019 Nov 20.


Hypertensive individuals are at an increased risk of developing heart disease and stroke. Adopting healthy lifestyles, such as being active on ≥4 days per week, weight-loss in the presence of obesity, consuming a diet rich in fruits and vegetables, and sodium below the recommended threshold, avoiding high alcohol consumption and refraining from smoking have been effective lifestyle therapies to prevent or control stage 1 hypertension (HTN). Among the 1 in 3 Americans who have HTN (systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 80 mmHg), 16% are diagnosed with resistant HTN (RHT). Although there are comparatively fewer studies examining the blood pressure lowering effects of therapeutic lifestyle interventions in patients with resistant HTN, the available literature appears promising. This paper reviews key studies that quantify the blood pressure lowering effects of certain therapeutic lifestyles in patients with RHT and highlights areas needing more attention.

Keywords: DASH diet; Lifestyle change; Physical activity; Resistant hypertension.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Blood Pressure* / drug effects
  • Diet, Healthy
  • Diet, Sodium-Restricted
  • Dietary Approaches To Stop Hypertension
  • Drug Resistance
  • Exercise
  • Healthy Lifestyle*
  • Humans
  • Hypertension / diagnosis
  • Hypertension / physiopathology
  • Hypertension / therapy*
  • Resistance Training
  • Risk Factors
  • Risk Reduction Behavior*
  • Treatment Outcome
  • Weight Loss


  • Antihypertensive Agents