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Sodium restriction
and substitution of sodium by potassium salt may be useful. Reduced intake
of saturated fat and cholesterol and increased intake of fibers and
omega3fattyacid are beneficial. Supplementation of calcium may reduce the
systolic pressure by 1.8 mm Hg and diastolic pressure by 0.7 mm Hg.
Lifestyle modification, not only helps blood pressure control, but also is
useful in glycaemic and lipid control. Type 2 diabetics are relatively
resistant to antihypertensive drugs in view of the associated obesity and
hyperinsulinaemia, and many will require at least three drugs for tight
blood pressure control. Isolated systolic hypertension in the elderly is
dangerous & should be treated. Aggressive lowering of blood pressure is
required in patients with risk factors. |