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Make every contact count by opportunistically asking about behavioural risk factors for high blood pressure

  • Making Every Contact Count (MECC) is an all-Wales approach to behaviour change, utilising day-to-day interactions, to support people to make positive changes that improve their physical and mental health and well-being. 
  • Consider encouraging practice staff to acquire MECC skills. For MECC e-learning (to level 1), see here  [ESR or other login/ registration required]. For MECC training contacts by health board, see here [intranet]. 
  • Brief intervention by staff in regular contact with people who could use some support to make informed choices is promoted by NICE guidance (PH49). 
  • Utilise opportunities to discuss and address smoking (BRF-001), unhealthy diet (BRF-002), physical inactivity (BRF-003) and alcohol misuse (BRF-004). 
  • Reducing behavioural risk factors lowers BP (BMJ 2016;355:i5719): Diet rich in fruits, vegetables, and low-fat dairy with reduced fat intake: 8-14 mmHg decrease in systolic BP; Regular aerobic activity at least 30 minutes a day: 4-9 mmHg; No more than 2400 mg (ideally 1600 mg) of sodium daily: 2-8 mmHg; Max 2 oz ethanol/ day (men) 1 oz ethanol/ day (women): 2-4 mmHg; Achieve/ maintain BMI of 18.5-24.9: 3 mmHg per 4-8% bodyweight reduction.
  • A 3 g reduction in daily salt intake (a reasonably conservative estimate of what could be achieved) would reduce systolic blood pressure by approximately 2 mmHg (NICE PH25; 2010).