The role of healthy lifestyle categories and score trend in managing hypertension among hypertensive adults

Despite the widespread use of antihypertensive medications, many patients struggle to achieve hypertension control, underscoring the need for additional strategies like lifestyle modification. Limited evidence exists on the impact of healthy lifestyle groups on hypertension control among individuals taking or not taking medication. This study assessed the effect of healthy lifestyle categories and scores on blood pressure control, systolic blood pressure (SBP), and diastolic blood pressure (DBP) among hypertensive adults in Iran. Data from the 2021 nationwide STEPwise Approach to non-communicable disease Risk Factor Surveillance survey were analyzed. Lifestyle variables, including physical activity, body mass index, alcohol consumption, tobacco use, and dietary habits, were scored for 9388 hypertensive adults ≥ 18 years across rural and urban regions from 2016 to 2021. Multivariable analysis, adjusted for antihypertensive medication use, showed that moderate and good lifestyle groups were associated with 9% (OR 0.91 [95% CI 0.85-1.04]) and 15% (OR 0.85 [95% CI 0.72-1.01]) lower odds of uncontrolled hypertension, respectively. These groups also significantly lowered SBP by - 1.22 (- 2.16 to - 0.23) and - 1.39 (- 2.54 to - 0.26) mmHg and DBP by - 1.01 (- 1.62 to - 0.41) and - 1.47 (- 2.21 to - 0.73) mmHg. These findings emphasize the potential of lifestyle interventions as part of public health strategies for blood pressure control.