17
Blood Pressure Reduction
➤ 3.7: In individuals with blood pressure above 130/80 mmHg and a ten-year
cardiovascular risk <10%, ES suggests lifestyle management to lower
blood pressure to <130/80 mmHg and to reduce the risk for ASCVD.
(2|⊕⊕⊕
)
Technical Remarks:
▶ Since the 10-year risk is ≤10%, lifestyle intervention is appropriate and preferable
to use of medications.
▶ Interventions include weight loss, healthy diet, sodium restriction, enhanced
potassium intake, increased physical activity, and moderation of alcohol use.
➤ 3.8: In individuals without a history of ASCVD with metabolic risk
who have a 10-year cardiovascular risk of >10% and blood pressure
of >130/80 mmHg, ES suggests the use of blood pressure-lowering
medication in addition to lifestyle modifications for primary prevention
of ASCVD only if lifestyle modification alone has failed. (2|⊕⊕⊕
)
Reducing Progression to Type 2 Diabetes
➤ 3.9: In individuals with prediabetes, ES recommends prescribing lifestyle
modification before drug therapy to reduce plasma glucose levels.
(1|⊕⊕⊕⊕)
➤ 3.10: In individuals with prediabetes who have limitations to physical
activity or are not responding to lifestyle modifications, ES recommends
metformin as a first pharmacologic approach to reduce plasma glucose
levels. (1|⊕⊕⊕
)
