A healthy lifestyle is an integral part of any treatment plan to control high blood pressure. Even if you need medications to treat high blood pressure (hypertension), and many people do, your lifestyle still plays a central role in your treatment strategy. If you successfully control your blood pressure with a healthy lifestyle, you may avoid, delay or reduce the need for medication.

By making only one healthy change to your lifestyle, you're likely to be more successful controlling your blood pressure than is someone who doesn't make any changes. A lower blood pressure can help you live a longer and fuller life, and prevent heart attack, stroke, kidney disease, blindness and dementia.

Lifestyle change — it may sound both simple and overwhelming at the same time. But, breaking it down to manageable pieces can help you start down the road to reducing your blood pressure and benefiting from the trickle down health effects of doing so.

Blood pressure often increases as weight increases. Losing just 10 pounds can help reduce your blood pressure by several points. In general, the greater the weight loss, the greater the reduction in blood pressure. Weight loss also increases the effectiveness of blood pressure medications (antihypertensives).

• Check your weight. Calculating your body mass index (BMI) and measuring your waist circumference are two ways to help tell if you're overweight or obese. In general, if your BMI is 25 to 29, you're overweight, and if it's 30 or higher, you're obese.
• Measure your waist circumference. Waist circumference is a useful tool to assess abdominal fat. In general, men are considered overweight if their waist measurement is greater than 40 inches. And women, in general, are overweight if their waist measurement is greater than 35 inches.
• Talk to your doctor. You and your doctor can determine your target weight and the best way to achieve it.
• Make changes. Eat healthier, exercise and change self-defeating behaviors, such as late-night snacking or big servings at meals. Medications or even surgery might be options for some people.
• Avoid questionable products. Don't be lured by promises of easy fixes with over-the-counter diet products or supplements that can actually harm you, such as those containing ephedra. Dietary supplements that contain ephedra have been banned in the United States since April 2004.

Physical activity is an important part of an overall strategy to control blood pressure. If you have prehypertension, exercise can help you avoid developing full-blown hypertension. If you already have hypertension, regular physical activity can bring your blood pressure down to safer levels.

Regular physical activity — at least 30 to 60 minutes most days of the week — can lower your blood pressure by several points. And it doesn't take long to see a difference. If you've been sedentary, increasing your activity can lower your blood pressure within just a few weeks. People with hypertension who are active and fit may live longer than those who don't exercise.

• Evaluate your current activity level. Are you getting at least 30 minutes of exercise most days of the week? If not, consider increasing your activity level.
• Develop an exercise program. Talk to your doctor about developing an exercise program tailored to your needs and medical conditions. Your doctor can help determine whether you need any exercise restrictions. Even moderate activity, such as walking, can help.
• Add strength training. Strength training can slow and reverse declines in strength, bone density and muscle mass that occur as you age. It's also helpful in controlling blood pressure. However, if you have high blood pressure, don't do strenuous, prolonged isometric exercises — straining of your muscles without moving. Isometrics can significantly increase your blood pressure during exercise and for a short time afterward.
• Don't be a weekend warrior. Trying to squeeze all your exercise in on the weekends to make up for weekday inactivity isn't a good strategy. If you have uncontrolled hypertension or heart problems, those sudden bursts of activity could actually do more harm than good.

Remember that old saying, "You are what you eat"? While that might be a bit of an exaggeration, what you eat certainly can affect your blood pressure.

A key research study called Dietary Approaches to Stop Hypertension (DASH) showed that you can reduce your blood pressure by following an eating plan that is rich in grains, fruits, vegetables and low-fat dairy products and skimps on fat, saturated fat and cholesterol. A DASH-style eating plan can reduce your blood pressure by up to 14 millimeters of mercury (mm Hg).

• Evaluate your eating style. Keep a food diary, even for just a week, to assess your eating patterns and habits. Monitor what you eat, how much, when and why. This can shed surprising light on your true eating habits.
• Eat healthier foods. Follow the DASH diet for a healthy eating style. Make grains, vegetables and fruits the mainstays of your diet, with plenty of low-fat dairy products. Eat less red meat and fewer sweets and fats.
• Consider boosting potassium. While most Americans get too much sodium, they often get too little potassium. Potassium can blunt the adverse effects of sodium on blood pressure, reduce the risk of kidney stones and possibly reduce bone loss. The best source of potassium is food, such as fruits and vegetables, rather than supplements. Some packaged food products list potassium on the labels. Bear in mind that too much potassium can be toxic. And in people with certain conditions, including high blood pressure, diabetes, renal disease, severe heart failure and adrenal insufficiency, overly high potassium intake can lead to life-threatening complications. Talk to your doctor about the potassium level that's best for you.
• Be a smart consumer. Make a shopping list before heading to the supermarket. Read food labels when you shop. And don't be lured by tempting displays of candy or cookies. Stick to your healthy-eating plan when you're dining out, too.
• Cut yourself some slack. Although the DASH diet is a lifelong eating guide, it doesn't mean you have to cut out all of the foods you love. It's OK to treat yourself occasionally to foods you probably wouldn't find on a DASH diet menu, like a candy bar or mashed potatoes with gravy.

Consuming more sodium than you need may raise your blood pressure. The DASH study found that even a modest reduction in sodium intake can reduce blood pressure. And bigger cutbacks mean greater reductions in blood pressure.

• Calculate your sodium consumption. Keep a food diary to estimate how much sodium you consume each day. You may be surprised at how much you're taking in. Most healthy adults need only between 1,500 and 2,400 milligrams (mg) of sodium a day. But if you have hypertension, are older than 50, are black, or have such chronic conditions as kidney disease or diabetes, you may be more sensitive to sodium and its ability to raise blood pressure. In that case, aim for less than 1,500 mg of sodium a day.
• Don't add salt. Just 1 level teaspoon of salt has 2,300 mg of sodium. Use herbs or spices, rather than salt, to add more flavor to your foods.
• Ease into it. If you don't feel like you can drastically reduce your sodium consumption suddenly, cut back gradually. Your palate will adjust over time.
• Read food labels. Look at the sodium content before you buy. If possible, choose low-sodium alternatives. Even some foods you think are healthy, such as some vegetable juices, may contain surprisingly high amounts of sodium.
• Eat fewer processed foods. Potato chips, frozen dinners and cured meats, such as bacon and processed luncheon meats, are high in sodium.
• Eat more fresh foods. Fruits, vegetables and unprocessed grains contain little sodium.
• Check your water softener. Water softeners are sometimes a hidden source of sodium in your water at home — although cold water to the kitchen often isn't softened. If your water softener adds excessive sodium to the water you drink, you might want to consider switching to a different water-purification system or buying demineralized water for drinking and cooking.

Alcohol can be both good and bad for your health. In small amounts, it can help prevent heart attacks and coronary artery disease. But that protective effect is lost if you drink excessive amounts of alcohol — generally more than one drink a day for women and more than two a day for men. The reason for the difference between men and women in the amount of alcohol recommended is not because of differences in body size, rather it is that women metabolize alcohol differently than men do. At those higher levels, alcohol can raise blood pressure by several points. In addition, it can reduce the effectiveness of your high blood pressure medications, compounding the risks of excessive alcohol consumption.

• Assess your drinking patterns. Along with your food diary, keep an alcohol diary to track your true drinking patterns. One drink equals one 12-ounce beer, one 5-ounce glass of wine or one 1.5-ounce shot of whiskey. If you're drinking more than the suggested amounts, cut back.
• Consider tapering off. If you're a heavy drinker, suddenly eliminating all alcohol can actually trigger severe hypertension for several days. So when you stop drinking, do it with the supervision of your doctor or taper off slowly, over one to two weeks.
• Don't binge. Binge drinking — having four or more drinks in a row — can cause large and sudden increases in blood pressure, in addition to other health problems. Don't abstain during the week and make up for it on the weekend.

On top of other health threats, the nicotine in tobacco products can raise your blood pressure by 10 mm Hg or more. Although that increase may be only temporary, lasting 30 to 60 minutes after using tobacco, having repeated elevations through the course of the day means your blood pressure may remain constantly high. In addition, chemicals in tobacco can damage your arteries and cause fluid retention, both of which can raise your blood pressure. And like alcohol, tobacco products can interfere with the effectiveness of your blood pressure medications.

• Don't use any tobacco. That includes pipes, cigars, chewing tobacco and other forms of tobacco, not just cigarettes. The combination of high blood pressure and tobacco use increases your risk of having a heart attack or stroke. Once you stop smoking, your blood pressure may drop by a few points. Although that might not seem like much, you'll also reap the other health benefits of stopping, such as reducing your risk of lung cancer.
• Avoid secondhand smoke. Inhaling smoke from others also puts you at risk of health problems.

The role caffeine plays in blood pressure is still debatable. Drinking caffeinated beverages can temporarily cause a spike in your blood pressure. And some studies show that people who drink caffeine regularly have a higher average blood pressure, suggesting that caffeine might have a long-term impact. But other studies show you can develop a tolerance to caffeine so that it doesn't affect your blood pressure. A November 2005 study showed drinking coffee — even a lot of it — didn't seem to increase the risk of high blood pressure in women, but drinking colas containing caffeine did. However, it isn't clear whether there are other properties of the two beverages that might be affecting blood pressure.

• Check your caffeine consumption. Tally up how much caffeine you consume in an average day. Some doctors recommend limiting caffeine to 200 mg a day — about the amount in two cups of coffee.
• Test your sensitivity. To see if caffeine might be raising your blood pressure, check your pressure within 30 minutes of drinking a cup of coffee or another caffeinated beverage you regularly consume. If your blood pressure increases by five to 10 points, you may be sensitive to the blood-pressure-raising effects of caffeine.

As with caffeine, the influence of stress on blood pressure isn't settled. Stress or anxiety can temporarily increase blood pressure. That's why some people develop white-coat hypertension — a brief rise in blood pressure when they visit the doctor's office or are in stressful situations. But others may thrive on stress.

• Identify your stressors. You need to know what your stressors are before you can act on them. Take some time to think about what causes you to feel stressed, such as work, family, finances or illness.
• Reduce your stressors. Once you know what's causing you stress, see which stressors you can eliminate or reduce. For instance, if you typically say yes to each favor asked of you, start saying no to some requests. If you get stuck putting in overtime every day, talk to your supervisor about a more balanced workload.
• Learn better coping methods. If you can't eliminate all of your stressors, you can at least cope with them in a healthier way. Take breaks for deep-breathing exercises. Get a massage or take up yoga or meditation. If self-help doesn't work, seek out a professional for counseling. Try meditation or ask your doctor about purchasing a machine that helps teach slow deep breathing.

When you have high blood pressure, you'll likely need to monitor your blood pressure at home. Learning to self-monitor your blood pressure can be a motivating force in making and monitoring lifestyle changes to control blood pressure. In addition, a record of your blood pressure readings helps your doctor know if your medications are working or if they might need to be adjusted.

Regular visits to your doctor are also likely to become a part of your normal routine. These visits will help keep tabs on your blood pressure — and ensure that you don't neglect other health concerns.

• Have a primary care doctor. People who don't have a primary care doctor find it harder to control their blood pressure. If you can, visit the same health care facility or professional for all of your health care needs.
• Visit your doctor routinely. If your blood pressure is not well controlled, or if you have other medical problems, you might need to visit your doctor every month to review your treatment and make adjustments. If your blood pressure is well controlled, you might need to visit your doctor only every six to 12 months, depending on other conditions you might have. People who have frequent blood pressure checks at their doctor's office are more likely to control their blood pressure than are those who go a year or more between visits.

Supportive family and friends can help improve your health. They may encourage you to take care of yourself, drive you to the doctor's office or embark on an exercise program with you. Knowing that someone cares about you may inspire you to stick to healthy habits and take your blood pressure medication on schedule.

• Enlist support. Talk to your family and friends about the dangers of high blood pressure. If they understand the potential complications of uncontrolled high blood pressure, they're more likely to support your efforts to change unhealthy lifestyle habits.
• Join a support group. A support group brings together people who share similar interests or concerns. Joining a support group may put you in touch with people who can give you an emotional or morale boost, and who can offer practical tips to cope with your condition.

Despite the big benefits offered by making these healthy changes, only about half the people with high blood pressure try to modify their lifestyle as a way to treat their condition.

For most people, these are not drastic changes in daily life, but they offer significant rewards. When your blood pressure is under control, your risk of life-threatening complications, such as heart attack and stroke, decreases and you may live a longer and happier life.