Changes in lifestyle after hypertension diagnosis in Canada.

Lifestyle modification should be an important part of therapy when hypertension is first diagnosed, with or without starting antihypertensive medication. The objective of the present study was to determine the extent to which recently diagnosed hypertensive Canadians modify their lifestyles and to examine how lifestyle modification relates to antihypertensive medication use. The longitudinal National Population Health Survey in Canada was conducted between 1994 and 2002, including five interview cycles at two-year intervals. During this time, 1281 persons reported hypertension in one cycle but not in the previous cycle, and were considered to be new hypertensive patients. Information collected included body mass index, smoking, alcohol consumption, physical inactivity and medication use. The main lifestyle modification associated with newly diagnosed hypertensive patients was smoking cessation, with a 18.6% relative risk reduction (RRR). A smaller change was seen in decreasing physical inactivity (RRR 6.2%). Persons not taking antihypertensive medication were not more likely to make lifestyle improvements. Paradoxically, new hypertensive patients showed increased numbers in the obese category (RRR -9.6%). Weight gain was especially marked among antihypertensive medication users and largest in female beta-blocker users (RRR -36.6%). If confirmed, this needs to be considered when prescribing to overweight people. In general, a greater effort is required to manage hypertension by lifestyle risk modification with or without antihypertensive medication.