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Management of mild hypertension. Mild hypertension
is defined as diastolic blood pressure (DBP) of 90 to 105
mm Hg and/or systolic blood pressure (SBP) of 140 to 180
mm Hg. Drug treatment should be instituted more promptly
in patients with evidence of substantial risk of cardiovascular
disease or in patients with blood pressure above the mild
hypertension range. Although the World Health Organization
and Joint National Committee disagree on the definition
of "mild" hypertension, both groups recommend
non-drug treatment for 3 months before initiating drug treatment
in this group. Many experts are sanguine about patient compliance
with nondrug treatment, however, and would disagree with
this recommendation. Although weight loss will correct hypertension
in many who are overweight, and reduction in salt or alcohol
intake will help if these are employed to excess, the ability
of physicians to persuade patients to change their behavior
unless they have a strong support group and show
evidence of being prepared to change their behavior
remains ambiguous.
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