High blood pressure (BP) or hypertension is a significant risk factor for mortality from cardiovascular disease.

When you are initially diagnosed with high blood pressure, your first step should be to try to change your diet and activity. Below are recommendations that have been shown to help.

Exercise is widely recommended as one of the critical preventive lifestyle changes to reduce the risk of hypertension and to manage high blood pressure. Typical amount and duration shown to be useful for lowering BP include aerobic physical activity 3–4 times per week lasting on average 40 minutes and involving at least moderate intensity physical activity. This has been shown to decrease systolic and diastolic BP, on average by 2–5 mm Hg and 1–4 mm Hg, respectively.

Research shows a strong dose-dependent relationship between consuming too much salt and raised levels of blood pressure. A modest reduction in salt intake for four or more weeks causes significant falls in blood pressure in both hypertensive and normotensive individuals. The 2015–2020 Dietary Guidelines for Americans recommend that Americans consume less than 2,300 milligrams (mg) of sodium each day as part of a healthy eating pattern.

Reference: Sodium: The Facts. https://www.cdc.gov/salt/pdfs/Sodium_Fact_Sheet.pdf

A meta-analysis of 141 papers studying the effect of magnesium supplementation with a mean dose of 410 mg appears to achieve a small but clinically significant reduction in blood pressure

Reference: European Journal of Clinical Nutrition volume 66, pages 411–418

Potassium supplementation is associated with a reduction of blood pressure in patients who are not on antihypertensive medication, and the effect is significant in hypertensive patients. Patients with elevated blood pressure may benefit from increased potassium intake along with controlled or reduced sodium intake.

Reference: Daily potassium intake and sodium-to-potassium ratio in the reduction of blood pressure: a meta-analysis of randomized controlled trials. J Hypertens. 2015 Aug;33(8): 1509-20

One study looked into nonpharmacological ways of reducing blood pressure. The objective was to determine if music guided, slow and deep breathing will lower the blood pressure among patients with hypertension in eight weeks. Both listening to music and deep breathing exercise were associated with a clinically significant reduction in blood pressure.

Reference: Med J Malaysia. 2018 Aug;73(4):233-238.

Another study compared the effects of yoga with non-aerobic exercise in individuals with prehypertension and stage 1 hypertension. The study found 24-hour diastolic, night time diastolic, and mean arterial pressure all significantly reduced in the yoga group (-3.93, -4.7, -4.23 mm Hg, respectively) but no significant changes in the non aerobic exercise group. This study has demonstrated that a yoga intervention can lower blood pressure in patients with mild hypertension.

Reference: J Clin Hypertens (Greenwich). 2014;16:54–62.

Meditation techniques are increasingly popular practices that may be useful in preventing or reducing elevated blood pressure. A review of several landmark studies found that meditation techniques appear to produce small yet meaningful reductions in blood pressure either as monotherapy or in conjunction with traditional pharmacotherapy. In summary, transcendental meditation and mindfulness-based stress reduction may produce clinically significant reductions in systolic and diastolic blood pressure.