About one in three Americans have high blood pressure, and only about half of those people have their condition under control. High blood pressure, also called hypertension, can be caused by lifestyle factors or by genetics—or, usually, a combination of both. It can be dangerous if left untreated, raising your risk for cardiovascular disease, such as heart attack, and stroke.
For people who aren’t able to bring their levels down naturally, medication may be necessary. But if your high blood pressure is a result of unhealthy habits, making some simple changes may help reduce—or even eliminate—your need for prescription drugs. With your doctor’s okay, give these tricks a try and see if they work for you.
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Maintain a healthy weight
“Weight is one of the most important determiners of blood pressure,” says John Bisognano, MD, director of the Hypertension Clinic at the University of Rochester Medical Center in Rochester, New York. “Once someone’s BMI is over 25 to 28, taking off a few pounds will make a big difference in treating high blood pressure.” (A body mass index of 25 to 29.9 is considered overweight, while 30 and higher is obese.)
The correlation works both ways, too: A small 2014 study found that people who gained even just 5% of their body weight saw slight boosts in their blood pressure. People who packed on extra fat around their bellies saw the greatest increases.
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Break a sweat
Most healthy people should get at least 150 minutes of moderate-intensity exercise a week. If you need to lower your blood pressure, though, the American Heart Association has some additional advice: Within that 150 minutes, aim to get 40 minutes of higher-intensity (moderate to vigorous) activity three or four times a week. “It really can be anything that makes you break a sweat, but the important thing is that it’s something you can do most days, without fail,” says, Dr. Bisognano, who is also the president elect of the American Society for Hypertension. “If you want to go to the gym for an hour a day and run or take classes, fantastic. But if a brisk walk around the neighborhood fits your lifestyle better, than that’s great too.”
If you’re starting from scratch and even this level of fitness seems intimidating, take heart. Even just a few minutes a day of easy exercise helped to lower blood pressure in a 2015 study of overweight adults with diabetes.
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Cut back on salt
Most Americans—including 86% of those with high blood pressure—eat more salt than is advised by the government’s Dietary Guidelines for Americans. If you’re one of them, reducing your intake to less than the recommended limit of 2,300 milligrams (about a teaspoon) a day may make a big difference in your blood pressure (and even better if you can stay below the American Heart Association's 1,500-mg daily limit). Even just reducing your sodium intake by 10 or 20% can help, says Dr. Bisognano. “We ask people to decrease their consumption from sky-high to reasonable levels,” he adds. “Learn not to salt your eggs; finish your lunch without a pickle—you want to make little changes you can tolerate for the long term.”
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Follow the DASH Diet
For an even bigger impact on blood pressure levels, try the DASH Diet, also known as Dietary Approaches to Stopping Hypertension. You’ll lower your salt intake on this plan, but you’ll also eat more fruits, vegetables, whole grains, and low-fat diary products. “The DASH Diet can lower the top number—systolic pressure—anywhere from 8 to 14 points,” says cardiologist Nieca Goldberg, MD, medical director of the Women’s Heart Program at NYU Langone Medical Center in New York City. “The diet is high in foods that have calcium, magnesium, and antioxidants, all of which contribute to lowering blood pressure.” It's also rich in potassium, which can help blunt the impact of any sodium you consume.
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Power up your probiotics
In a 2014 review of previous studies, people who consumed probiotics—healthy bacteria found in yogurt and other fermented foods—saw their systolic blood pressure reduced an average of 3.6 points, and their diastolic reduced 2.4 points, compared to those who didn’t. Those with blood pressure higher than 130/85 experienced the greatest reductions, along with those who took probiotic supplements or ate probiotic foods for longer than two months. (Any blood pressure over 120/80 mm Hg is considered elevated.) Experts say any effect probiotics have on blood pressure is likely modest, but that they may play a role in an overall heart-healthy lifestyle.
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Eat out less often
Americans eat too much salt in large part because restaurants add so much of it to their cooking, according to a 2016 report from the Centers for Disease Control and Prevention. This can be confusing even to customers who try to make smart choices, since high-sodium foods don’t always taste salty. In order to see a big impact on American salt consumption, restaurants will have to commit to using less, the CDC’s report stated. Until then, says Dr. Goldberg, try to cook more of your own food so you’re aware of how much salt goes into it. When you do eat out, she suggests, skip salty toppings like cheese, and order dressings and sauces on the side.
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Monitor your numbers at home
The act of taking your own blood pressure won’t lower it, but getting to know your numbers can help you better understand what’s healthy and what’s not for you. “The first time patients have a high blood pressure reading in the doctor’s office, we don’t usually start treating right way,” says Dr. Goldberg. That’s because individual readings can vary, especially in potentially high-stress situations like a doctor’s visit.
Dr. Goldberg teaches these patients to monitor their blood pressure at home in the mornings and evenings. This gives her a more complete picture before prescribing any medications. But there’s a hidden benefit, as well: Research suggests that keeping track of their own blood pressure may be incentive for patients to make healthy choices like losing weight and eating healthier.
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After a cigarette break, blood pressure rises for a short time. Interestingly—and even though it’s bad for your heart in other ways—it doesn’t seem to raise levels very much in the long-term. But besides those temporary spikes, there’s another reason to kick the habit: Smoking dulls taste buds, says Dr. Bisognano, so smokers tend to salt their food more and have a harder time decreasing sodium intake.
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Cut your calorie intake
One simple way to reduce your salt intake may just be to reduce your overall food intake. “If you eat 25% more food, you’re likely getting 25% more salt,” says Dr. Bisognano. “Plus, eating more food than you need will probably make you gain weight, which also raises blood pressure.”
The smartest thing to cut out first? Processed foods. More than 75% percent of sodium in the average American diet comes from packaged products like canned soups, salad dressings, bread and cereal, and cold cuts and cured meats.
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Find a way to relax
Stress can cause blood pressure to rise, both short- and long-term. So finding something that helps you relax can be an important part of preventing or reducing hypertension. What that something is, exactly, is up to you—but research suggests that yoga, meditation, spending time with pets, laughing, and even having sex (!) may be good choices. “Just like with exercise, you have to choose something that you enjoy and that you can do consistently as part of your daily lifestyle,” says Dr. Bisognano.
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Add strength training to your gym routine
Aerobic exercise will have the biggest effect on your blood pressure, but you’ll get even bigger benefits if you combine your regular sweat sessions with a few weight-lifting or resistance-training workouts a week.
It was once thought that weightlifting could actually raise blood pressure to dangerous levels—and it can, in fact, cause short-term spikes. But now doctors know that having stronger muscles, in the long run, reduces stress and demand on the heart.
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Don't overdo your drinking
Moderate alcohol consumption—up to one drink a day for women and two for men—may have beneficial effects on blood pressure. “But any more than that seems to do just the opposite,” says Dr. Goldberg. “We know that heavy drinking raises blood pressure, in addition to increasing your risk for other chronic conditions.”
This shouldn’t just be a concern for older adults or people who already have high blood pressure, either. A 2016 study found that 20-somethings who regularly binge drink were more likely than their moderately drinking peers to have prehypertension—a condition that can progress to full-blown hypertension.
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Watch your coffee habit
“Moderate coffee intake doesn’t seem to make much of a difference in blood pressure levels,” says Dr. Bisognano, “but I do see more and more people drinking huge amounts of highly caffeinated beverages—and that very likely has a negative effect.” A few cups of coffee a day is fine for most people, he adds, but “if you measure coffee in pots, you could be in trouble.” Watch out for energy drinks, too, which have been shown to spike blood pressure and cause irregular heart rhythms.
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Low levels of vitamin D—which the body gets from fortified foods, supplements, or the skin’s exposure to sunlight—have been linked to high blood pressure. But most research has found that taking supplements doesn't seem to help. Dr. Bisognano says the jury’s still out on how the two are linked. “I have found that people with extremely low vitamin D levels can have high blood pressure that’s more difficult to treat,” he says, “but I can’t be sure whether that’s the driving issue.”
There are other reasons you may want to spend more time in the great outdoors, though. A 2014 study found that when the skin is exposed to sunlight, a chemical reaction causes blood vessels to widen and blood pressure to drop. And in a 2010 study, people who spent time in nature—walking in the forest as opposed to in an urban environment—saw greater reductions in their blood pressure, pulse rate, and stress hormones.
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Get better sleep
If you’re not getting enough shuteye—either because you’re burning the midnight oil or you’re dealing with a sleep disorder—you may be at greater risk for high blood pressure. That makes sense, says Dr. Goldberg: People who are sleep deprived are more likely to overeat, crave junk food, gain weight, and feel stressed.
In one 2009 study, every hour less of average sleep duration per night was associated with a 37% increase in the odds of developing hypertension over five years. In another report from 2015, people with sleep apnea—a dangerous condition that can cause hypertension in itself—saw reductions in their blood pressure when they were treated with continuous positive airway pressure (CPAP) machines or mandibular advancement devices (MADs).
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Acupuncture might help lower blood pressure, according to a small 2015 study, though the authors say more research is needed to know for sure. Participants had 30 minutes a week of electroacupuncture—in which the needles carry low-level electrical currents—for eight weeks, focusing on their inner wrists and their legs below their knees.
This group saw reductions of 6 to 8 points for systolic blood pressure and 4 points for diastolic blood pressure, compared to another group whose treatment focused on other body parts and who saw no change. Some participants saw further drops when they followed up with monthly treatments for six more months.
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Lend a helping hand
Being generous with your time, money, or your talents can do more than make you feel good; a 2006 study found that people who gave social support to those in their social networks had lower blood pressure than those who didn’t.
Other research shows that volunteering and helping others can lower stress levels and boost happiness, which may have long-term effects on your blood pressure, as well.
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Take a nap
Napping may do your heart some good. Adults with high blood pressure who took hour-long naps every day saw their systolic blood pressure drop an average of 5% over the course of the day in a 2015 study, compared to those who didn’t rest. Those who napped also had to take fewer blood pressure medications than those who didn’t, and seemed to have less damage to their arteries and their heart. The study was only able to show a correlation between napping and blood pressure reduction, but the authors say that the results do suggest a benefit to afternoon siestas.
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Consider other health issues
“Go over your medical history and any drugs and supplements you’re taking with your doctor,” says Dr. Goldberg. “Sometimes you can be on medicines that raise your blood pressure, or you can have an underlying condition—like a thyroid imbalance or a kidney obstruction—that needs to be treated.”
Drugs that can cause hypertension include acetaminophen, nonsteroidal anti-inflammatories (NSAIDs), antidepressants, corticosteroids, birth control pills and other hormones, migraine medications, nasal decongestants, and over-the-counter cough and cold medicines. Don’t stop taking a medicine without talking with your doctor first; you may be able to take a replacement or adjust your dosage.
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Get friends and family on board
Need help enforcing these lifestyle strategies? Tell friends, family, and coworkers that you’re working hard to keep your blood pressure or your weight down, and ask them for your support.
“When you let people know that these goals are important to your health, most of the time they’ll go along with it,” says Dr. Bisognano. “They won’t pressure you to eat a third piece of pizza or to accept a special pie they baked just for you.” You may even encourage to adopt healthy habits, too!
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