Comparative Analysis of Hypertension Guidelines: Unveiling Consensus and Discrepancies in Lifestyle Modifications for Blood Pressure Control

Table 5

Summary of recommendations about weight reduction in guidelines.

Guideline	Weight reduction	Class of recommendation and level of evidence
2017 ACC [10]	Weight loss is recommended to reduce BP in adults with elevated BP or hypertension who are overweight or obese	I A
2018 ESC [11]	Body weight control is indicated to avoid obesity (BMI >30 kg/m^2 or waist circumference >102 cm in men and >88 cm in women), as is aiming at healthy BMI (about 20–25 kg/m^2) and waist circumference values (<94 cm in men and <80 cm in women) to reduce BP and CV risk	I A
2019 NICE [12]	For guidance on the prevention of obesity and cardiovascular disease, see NICE’s guidelines on obesity prevention and cardiovascular disease prevention	NA
2020 CAN [13]	(1) Height, weight, and waist circumference should be measured and body mass index calculated for all adults (Grade D)	Grade B, C, D
	(2) Maintenance of healthy body weight (body mass index 18.5–24.9 and waist circumference <102 cm for men and <88 cm for women) is recommended for nonhypertensive individuals to prevent hypertension (Grade C) and for hypertensive patients to reduce BP (Grade B). All overweight hypertensive individuals should be advised to lose weight (Grade B)
	(3) Weight loss strategies should use a multidisciplinary approach that includes dietary education, increased physical activity, and behavioural intervention (Grade B)
2020 ISH [14]	Body weight control is indicated to avoid obesity. Particularly abdominal obesity should be managed. Ethnic-specific cut-offs for BMI and waist circumference should be used. Alternatively, a waist-to-height ratio <0.5 is recommended for all populations	NA