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Clinical and Public Health Advisory From the National High Blood Pressure Education Program

Paul K. Whelton, MD, MSc; Jiang He, MD, PhD; Lawrence J. Appel, MD, MPH; Jeffrey A. Cutler, MD, MPH; Stephen Havas, MD, MPH, MS; Theodore A. Kotchen, MD; Edward J. Roccella, PhD, MPH; Ron Stout, MD, MPH; Carlos Vallbona, MD; Mary C. Winston, EdD, RD; Joanne Karimbakas, MS, RD; for the National High Blood Pressure Education Program Coordinating Committee

JAMA. 2002;288:1882-1888.

The National High Blood Pressure Education Program Coordinating Committee published its first statement on the primary prevention of hypertension in 1993. This article updates the 1993 report, using new and further evidence from the scientific literature. Current recommendations for primary prevention of hypertension involve a population-based approach and an intensive targeted strategy focused on individuals at high risk for hypertension. These 2 strategies are complementary and emphasize 6 approaches with proven efficacy for prevention of hypertension: engage in moderate physical activity; maintain normal body weight; limit alcohol consumption; reduce sodium intake; maintain adequate intake of potassium; and consume a diet rich in fruits, vegetables, and low-fat dairy products and reduced in saturated and total fat. Applying these approaches to the general population as a component of public health and clinical practice can help prevent blood pressure from increasing and can help decrease elevated blood pressure levels for those with high normal blood pressure or hypertension.

Author Affiliations: Department of Epidemiology and Medicine, Tulane University Health Sciences Center (Dr Whelton) and Department of Epidemiology, School of Public Health and Tropical Medicine (Dr He), Tulane University, New Orleans, La; Departments of Internal Medicine, Epidemiology, and International Health, Johns Hopkins Medical Institutions, Baltimore, Md (Dr Appel); Division of Epidemiology and Clinical Applications (Dr Cutler) and National High Blood Pressure Education Program, Office of Prevention, Education, and Control (Dr Roccella), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md; Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore (Dr Havas); Department of Medicine, Division of Endocrinology, Metabolism and Clinical Nutrition, Medical College of Wisconsin, Milwaukee (Dr Kotchen); Health Care Research Center, The Procter and Gamble Company, Mason, Ohio (Dr Stout); Department of Family and Community Medicine, Baylor College of Medicine, Houston, Tex (Dr Vallbona); American Heart Association, Dallas, Tex (Dr Winston); and American Institutes for Research Health Program, Silver Spring, Md (Ms Karimbakas).

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