• Philip B Mellen, Shana L Palla, David C Goff, and Denise E Bonds.
• Section of General Internal Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
• J Gen Intern Med. 2004 Sep 1; 19 (9): 917924917-24.

ObjectiveTo evaluate the prevalence of nutrition and exercise counseling for patients with hypertension.DesignCross-sectional survey data from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) for 1999 and 2000.SettingOffice-based physician practices and hospital outpatient departments.Patients/ParticipantsPatients age 18 or older with a diagnosis of hypertension.Measurements And Main ResultsIn 1999 and 2000, over 137 million patient encounters had a diagnosis of hypertension. Nutrition and exercise counseling were provided at 35% and 26% of visits, respectively. Patients older than 74 received the least nutrition (28%) and exercise (18%) counseling. Asians and Hispanics were more likely to undergo any lifestyle counseling, while non-Hispanic whites received the least exercise and nutrition counseling. Patients with 2 cardiovascular comorbidities were counseled for diet (53%) and exercise (32%) more than those with 1 (44% and 31%) or none (30% and 23%; PConclusionsWhile there were significant differences in counseling rates with respect to age, race, comorbidity, and survey cohort, counseling for therapeutic lifestyle changes for patients with hypertension was uniformly suboptimal. Physicians need to recognize the importance of nonpharmacologic treatment in hypertension.

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