A new patient has a BMI of 32 and hypertension. What should be your initial recommendation?

In cases of obesity, indicated by a BMI of 32, as well as the presence of hypertension, a primary focus is often on dietary interventions that can lead to improved health outcomes. Reducing sodium intake is a key recommendation for managing hypertension, as excess sodium can lead to fluid retention and an increase in blood pressure.

By advising the patient to reduce sodium intake, you are encouraging dietary changes that can help lower blood pressure and reduce the risk of cardiovascular complications. This approach targets one of the main contributors to hypertension directly and aligns with established dietary guidelines, particularly the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes lower sodium and higher intake of fruits, vegetables, and whole grains.

While increasing physical activity is also important for overall health and can assist in weight loss, the immediate focus for managing hypertension would prioritize sodium reduction. Increasing fluid intake does not directly address hypertension and starting a low-carb diet might be beneficial for weight loss but does not specifically target blood pressure management. Thus, the most appropriate initial recommendation in this scenario is to reduce sodium intake.