A review of the relative efficacy of dietary, nutritional supplements, lifestyle, and drug therapies in the management of hypertension

Despite advancements in hypertensive therapies, the prevalence of hypertension and associated morbidities are still immense. Physicians are in great need for updated information on novel and effective antihypertensive therapies. Therefore, the study objective was to provide comprehensive information on the efficacy of available antihypertensive therapies. Antihypertensive therapies were divided into four general approaches: diet, nutritional supplements, lifestyle modification, and conventional antihypertensive medications. A search of PubMed and Google Scholar resulted in an analysis of 30 antihypertensive therapies from meta-analyses and randomized-controlled trials (RCTs). The studies were analyzed using the American Heart Association/American College of Cardiology classification system. Calculated average blood pressure reductions were: (systolic/diastolic) 6/4 mmHg, 4/2 mmHg, 5/3 mmHg, and 9/5 mmHg for dietary, nutritional supplements, lifestyle, and medications, respectively. The results demonstrate that dietary, nutritional supplement and lifestyle strategies have a solid level of evidence to support their efficacy as antihypertensive strategies. These strategies can be as effective as medications and, in some cases, even more effective. Dissemination of this information to physicians/dietitians can help facilitate an important shift in hypertension management.