Valedictory lecture Prof. dr. A. Kroon

“Under high pressure: a lifestyle-driven perspective on vascular health”

In cases of treatment-resistant hypertension, device-based therapies such as renal denervation and baroreflex activation can lower blood pressure when medication is ineffective or not tolerated, with average reductions of approximately 4–10 mmHg and greater effects in selected patients. New antihypertensive drugs also show promising results, with systolic reductions of up to approximately 16–17 mmHg. However, these effects are often limited compared to lifestyle interventions.

Lifestyle forms the basis of treatment. Weight loss of approximately 5% leads to a reduction of 6–8 mmHg, a DASH diet to 5–8 mmHg, and sodium restriction to less than 1500 mg per day to an additional 6–8 mmHg. Regular physical activity (≥150 minutes per week) lowers blood pressure by 4–8 mmHg.

It is precisely the combination of these interventions that is powerful: integrated programs show blood pressure reductions of up to approximately 20–25 mmHg systolic, comparable to or greater than intensive drug therapy. In addition, the effects reinforce each other and lead to substantial reductions in cardiovascular events and mortality, meaning that the overall health benefits are likely greater than with separate medication- or device-based treatments.

Click here for the live stream.