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Hypertension

HTN: Introduction (2015)

Guideline Overview 

Guideline Title 

Hypertension (2015) Evidence-Based Nutrition Practice Guideline

Guideline Narrative Overview 

Guideline Title

The focus of this guideline is on the treatment of hypertension (HTN) in adults. Adults are classified as having prehypertension or HTN as follows:

Categories for Blood Pressure Levels in Adults Measured in Millimeters of Mercury (mmHg)

Category     Systolic Blood Pressure (SBP)       Diastolic Blood Pressure (DBP)
Normal     <120     And <80
Prehypertension                120–139    Or 80–89
High Blood Pressure        
Stage 1     140–159         Or 90–99
Stage 2     ≥160  Or   ≥100

Reference: U.S. Department of Health & Human Services. National Institutes of Health. What Is High Blood Pressure? Accessed online August 11, 2015: http://www.nhlbi.nih.gov/health/health-topics/topics/hbp

Guideline Development and Contributors

This guideline outlines the most current information on HTN. The recommendations developed in this guideline were based upon a systematic review of the literature in multiple practice areas and the American College of Cardiology / American Heart Association Task Force 2013 Guidelines. 

A summary of the evidence analysis is below. Topics include: 

  • HTN: Medical Nutrition Therapy     
  • HTN: Vitamin D     
  • HTN: Potassium
  • HTN: Calcium
  • HTN: Magnesium    
  • HTN: Sodium
  • HTN: DASH Dietary Pattern 
  • HTN: Alcohol  
  • HTN: Physical Activity

The number of supporting documents for these topics is below:

  • Recommendations: 15   
  • Conclusion Statements:  13
  • Evidence Summaries: 13
  • Article worksheets: 69

Additional conclusion statements and evidence summaries supporting the recommendations are located in the American College of Cardiology / American Heart Association Task Force 2013 Guidelines.

To view the guideline development and review process, click here.
 
Contributors

Expand the Project Team to see the list of expert workgroup members, analysts and contributors for this project. 

Revision

Academy guidelines are revisited every five years. An expert workgroup will be convened by the Evidence-based Practice Committee to determine the need for new and revised recommendations based on the available science. The process includes:   

  • Literature searches to identify new research published since the previous searches were completed. Updated inclusion/exclusion criteria and search terms may be warranted.
  • Review to determine if the update will include modification to all, some or no recommendations compared to the earlier version(s) of the guideline, or development of new recommendations.
  • Creation of a table comparing the new guideline and the older version of the guideline. The document will indicate which recommendations remained unchanged; updated; new; or not reviewed.

Using the Academy's EAL Methodology, an unbiased and transparent systematic review will be completed and the updated guidelines published on the EAL.

Medical Nutrition Therapy and Hypertension 

The registered dietitian nutritionist (RDN) plays an integral role in the interdisciplinary healthcare team by designing the optimal nutrition prescription that complements drug therapy, physical activity, and behavioral therapy. Based on the client’s treatment plan and comorbid conditions, other nutrition practice guidelines, such as Adult Weight Management, Disorders in Lipid Metabolism and Type 2 Diabetes, may be needed in order to provide optimal treatment.

Populations to Whom This Guideline May Apply 

Population groups, medical conditions or coexisting diagnoses, where the HTN recommendations may be indicated, include:

  • Cardiovascular disease (CVD) 
  • Type 2 Diabetes Mellitus
  • Overweight / Obesity
  • Older persons
  • Individuals with unhealthy lifestyle (high sodium intake, excessive alcohol intake; low physical activity)
  • African Americans