Silberman and colleagues reported the results of an analysis of patients (n=2974) participating in an intensive cardiac rehabilitation program. The authors reported significant improvements in body mass index (BMI), triglycerides, low density lipoprotein cholesterol, total cholesterol, hemoglobin A1c, systolic blood pressure, diastolic blood pressure, depression, hostility, exercise, and functional capacity at 12 weeks and 1 year. (32)
Risks of smoking, caffeine and alcohol use by patients with high blood pressure:
Smoking and hypertension:
Patients should be counseled to quit smoking to reduce the risk of cardiovascular disease. If they don’t smoke, they should be counseled not to start. Quit tobacco by using a combination of several methods to assist in cessation. For instance, combine nicotine replacement with at least one additional method such as an exercise program, medication, hypnosis, or formal counseling such as support groups. The recommendation to counsel patients to stop smoking, stop using tobacco products, and provide methods of cessation is reinforced by the USPSTF (34). Many resources are available to assist in smoking cessation such as the online sites http://smokefree.gov/ , http://www.cdc.gov/tobacco/campaign/tips/quit-smoking/, and the phone number for free help 1-800-QUIT-NOW.