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

Table 9

Summary of recommendations about stress management in guidelines.

Guideline	Stress management	Class of recommendation and level of evidence
2017 ACC [10]	NA	NA
2018 ESC [11]	NA	NA
2019 NICE [12]	Committee deleted the recommendation for relaxation therapies	NA
2020 CAN [13]	(1) In hypertensive patients in whom stress might be contributing to high BP, stress management should be considered as an intervention	Grade D
	(2) Individualized cognitive-behavioural interventions are more likely to be effective when relaxation techniques are used	Grade B
2020 ISH [14]	Chronic stress has been associated with high blood pressure later in life. Although more research is needed to determine the effects of chronic stress on blood pressure, randomized clinical trials examining the effects of transcendental meditation/mindfulness on blood pressure suggest that this practice lowers blood pressure. Stress should be reduced and mindfulness or meditation introduced into the daily routine	NA