Simple lifestyle changes can cut CV, death risk for millions with elevated BP
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Widespread adoption of simple lifestyle changes, including switching to a well-known eating plan, could reduce risk for CV events and death for millions of adults with stage 1 hypertension, researchers reported.
“Millions of working-age people are walking around with elevated BP, which is symptomless but is also a leading preventable cause of disability and death,” Kendra D. Sims, PhD, MPH, a postdoctoral fellow at the University of California, San Francisco (UCSF) School of Medicine who presented the findings at the American Heart Association Hypertension Scientific Sessions, told Healio. “Our study found that 27,000 CVD events and 2,800 deaths could be prevented during the next 10 years if people with elevated BP follow through with recommended lifestyle changes. We would then save $1.6 billion in associated health care costs. The largest benefit comes from eating more fruits and vegetables and less salt, as outlined in the Dietary Approaches to Stop Hypertension (DASH) diet.”
Modeling benefits of diet, activity
Sims and colleagues simulated CVD events, mortality and health care costs from 2018 to 2027 using the CVD Policy Model, targeting U.S. adults aged 35 to 64 years with an untreated systolic BP of 130 mm Hg to 139 mm Hg. Researchers defined lower-risk adults as those without type 2 diabetes, chronic kidney disease or CVD and having a predicted 10-year CVD risk of less than 10%. Researchers used data from published meta-analyses and trials as inputs for the effects of dietary modification, sustained weight loss, physical activity, smoking cessation and alcohol moderation on systolic BP.
Among the estimated 8.7 million U.S. adults aged 35 to 64 years (51% women) with lower-risk stage 1 hypertension, 61% had regular health care access.
The researchers found that controlling systolic BP to less than 130 mm Hg in the full target population could prevent 27,000 CVD events and 2,800 deaths, as well as save an associated $1.6 billion in health care costs.
Researchers noted that the largest benefit would come from the adoption of the DASH diet, which could prevent an estimated 16,000 CVD events among men and an estimated 11,000 CVD events among women.
Make healthy eating ‘default option’
“To reach vulnerable groups without health care access, the change must come from outside the clinic,” Sims told Healio. “This research reveals that we should look to feasible ways our food system could make healthy eating the default option. This might be as straightforward as lowering the amount of salt in prepacked food or subsidizing large-scale agriculture to grow fruits and vegetables instead of corn. Straightforward does not mean simple. Well-being is a full-time, lifelong responsibility. At the same time, financial and social constraints throw up hurdles between millions of marginalized people and healthy behaviors.”
Sims said providers and policymakers must investigate actionable, effective ways to connect people with solutions instead of “blaming them for being sick.”
“This may look like running behavioral trials where we provide people with food insecurity a list of local farmers markets that doubles [electronic benefits transfer] credits,” Sims said. “Another study could provide a communal kitchen and classes at a local church to ensure that a neighborhood has a working kitchen to store and prepare food. Above all, we as scientists need to collaborate with patients as people about nourishing choices that fit best into their culture and lifestyle.”
In a 2021 update to the 2017 hypertension guideline reported by Healio, the AHA recommended lifestyle changes for patients with slightly elevated BP, adding medication if necessary after 6 months.
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Sims KD, et al. Abstract 678. Presented at: American Heart Association Hypertension Scientific Sessions; Sept. 7-10, 2022; San Diego (hybrid meeting).
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