What lifestyle modifications should I advise for patients diagnosed with hypertension?

Lifestyle modifications for patients diagnosed with hypertension include:

• Dietary changes: Encourage a healthy diet low in sodium by reducing salt intake or substituting sodium salt, but avoid potassium chloride salt substitutes in older people, those with diabetes, pregnant women, kidney disease, or on certain antihypertensives. Advise eating at least 5 portions of fruit and vegetables daily, increasing intake of unsalted nuts, seeds, legumes, and oily fish (2 portions per week). Recommend reducing saturated fat intake to 7% or less of total energy and replacing it with mono- and polyunsaturated fats such as olive or rapeseed oil. Limit sugar and refined sugars intake. Keep total fat intake to 30% or less of total energy. (2, 3, 5)
• Weight management: Offer weight loss advice if the patient is overweight or obese, and assess for sleep apnoea if obese. (1, 3)
• Physical activity: Advise at least 150 minutes per week of moderate intensity aerobic activity (e.g., brisk walking, cycling) or 75 minutes of vigorous activity, or a combination. Encourage muscle-strengthening activities and avoiding prolonged sedentary behaviour. Tailor advice to individual capacity and preferences. (2, 3, 5)
• Alcohol consumption: Encourage reduction if drinking excessively, aiming for no more than 14 units per week spread over 3 or more days, with at least two alcohol-free days weekly. Avoid binge drinking. (2, 3)
• Caffeine: Discourage excessive consumption of coffee and other caffeine-rich products. (2)
• Smoking cessation: Offer advice and support to stop smoking. (2)
• Support and education: Provide patient information leaflets and inform about local initiatives or group support for lifestyle changes. (1, 2)