1. Increase activity and exercise more

A meta-analysis of 65 studies suggests that aerobic and resistance exercise can significantly lower blood pressure, especially for men. In a 2013 study, sedentary older adults who participated in aerobic exercise training lowered their blood pressure by an average of 3.9 percent systolic and 4.5 percent diastolic (5). These results are as good as some blood pressure medications. As you regularly increase your heart and breathing rates, over time your heart gets stronger and pumps with less effort. This puts less pressure on your arteries and lowers your blood pressure. How much activity should you strive for? A 2019 report by the American College of Cardiology and the American Heart Association advises moderate- to vigorous-intensity physical activity for 40-minute sessions, three to four times per week. If finding 40 minutes at a time is a challenge, there may still be benefits when the time is divided into three or four 10- to 15-minute segments throughout the day. The American College of Sports Medicine makes similar recommendations.

• using the stairs
• walking instead of driving
• doing household chores
• gardening
• going for a bike ride
• playing a team sport

Just do it regularly and work up to at least half an hour per day of moderate activity. One example of moderate activity that can have big results is tai chi. A 2017 review on the effects of tai chi and high blood pressure shows an overall average of a 15.6 mm Hg drop in systolic blood pressure and a 10.7 mm Hg drop in diastolic blood pressure compared with no exercise at all. A 2014 review on exercise and lowering blood pressure found that there are many combinations of exercise that can lower blood pressure. These exercises include:

• aerobic exercise
• resistance training
• high-intensity interval training
• short bouts of exercise throughout the day
• walking 10,000 steps a day

Ongoing studies continue to suggest that there are still benefits to even light physical activity, especially for older adults.

If you’re overweight, losing 5 to 10 pounds can reduce your blood pressure. Plus, you’ll lower your risk of other potential medical problems. A review of several studies reports that weight loss diets reduced blood pressure by an average of 3.2 mm Hg diastolic and 4.5 mm Hg systolic.

3. Cut back on sugar and refined carbohydrates

Many studies show that restricting sugar and refined carbohydrates can help you lose weight and lower your blood pressure. Sugar, especially fructose, may increase your blood pressure more than salt, according to one 2014 review. In trials lasting at least 8 weeks, sugar increased blood pressure by 5.6 mm Hg diastolic and 6.9 mm Hg systolic (13). A 2020 study that compared various popular diets found that for people who with more weight or obesity, low carb and low fat diets lowered their diastolic blood pressure by an average of about 5 mm Hg and their systolic blood pressure 3 mm Hg after 6 months. Another benefit of a low carb, low sugar diet is that you feel fuller longer, because you’re consuming more protein and fat.

Increasing your potassium intake and cutting back on salt can also lower your blood pressure (15). Potassium is a double winner: It lessens the effects of salt in your system and eases tension in your blood vessels. However, diets rich in potassium may be harmful to people with kidney disease, so talk with your doctor before increasing your potassium intake. It’s easy to eat more potassium. So many foods are naturally high in potassium. Here are a few:

• low fat dairy foods, such as milk and yogurt
• fish
• fruits, such as bananas, apricots, avocados, and oranges
• vegetables, such as sweet potatoes, potatoes, tomatoes, greens, and spinach

Note that people respond to salt differently. Some people are salt-sensitive, meaning that a higher salt intake increases their blood pressure. Others are salt-insensitive. They can have a high salt intake and excrete it in their urine without raising their blood pressure (16). The National Institutes of Health recommends reducing salt intake using the DASH (Dietary Approaches to Stop Hypertension) diet. The DASH diet emphasizes:

• low sodium foods
• fruits and vegetables
• low fat dairy
• whole grains
• fish
• poultry
• beans
• fewer sweets and red meats

5. Eat less processed food

Most of the extra salt in your diet comes from processed foods and foods from restaurants, not your salt shaker at home. Popular high salt items include:

• deli meats
• canned soup
• pizza
• chips
• other processed snacks

Foods labeled “low fat” are usually high in salt and sugar to compensate for the loss of fat. Fat is what gives food taste and makes you feel full. Cutting down on — or even better, cutting out — processed food will help you eat less salt, less sugar, and fewer refined carbohydrates. All of this can result in lower blood pressure. Make it a practice to check nutrition labels. According to the Food and Drug Administration (FDA), a sodium listing of 5 percent or less on a food label is considered low, while 20 percent or more is considered high.

6. Stop smoking

It can be difficult to do, but it’s worth it: Stopping smoking is good for your all-around health. Smoking causes an immediate but temporary increase in your blood pressure and an increase in your heart rate (20). In the long term, the chemicals in tobacco can increase your blood pressure by damaging your blood vessel walls, causing inflammation, and narrowing your arteries. The hardened arteries cause higher blood pressure. The chemicals in tobacco can affect your blood vessels even if you’re around secondhand smoke. A study showed that nonsmokers who were able to go to smoke-free restaurants, bars, and workplaces had lower blood pressure than nonsmokers in areas that had no smoke-free policies affecting public places.

7. Reduce excess stress

We live in stressful times. Workplace and family demands, national and international politics — they all contribute to stress. Finding ways to reduce your own stress is important for your health and your blood pressure. There are lots of ways to successfully relieve stress, so find what works for you. Practice deep breathing, take a walk, read a book, or watch a comedy. Listening to music daily has also been shown to reduce systolic blood pressure. A 20-year study showed that regular sauna use reduced death from heart-related events (23). And one small 2015 study has shown that acupuncture can lower both systolic and diastolic blood pressure (24).

8. Try meditation or yoga

Mindfulness and meditation, including transcendental meditation, have long been used — and studied — as methods to reduce stress. Yoga, which commonly involves breathing control, posture, and meditation techniques, can also be effective in reducing stress and blood pressure. A 2013 review on yoga and blood pressure found an average blood pressure decrease of 3.62 mm Hg diastolic and 4.17 mm Hg systolic when compared with those who didn’t exercise. Studies of yoga practices that included breath control, postures, and meditation were nearly twice as effective as yoga practices that didn’t include all three of these elements (25).

9. Eat some dark chocolate

Yes, chocolate lovers: Dark chocolate has been shown to lower blood pressure. But the dark chocolate should be 60 to 70 percent cacao. A review of studies on dark chocolate has found that eating one to two squares of dark chocolate per day may help lower the risk of heart disease by lowering blood pressure and inflammation. The benefits are thought to come from the flavonoids present in chocolate with more cocoa solids. The flavonoids help dilate, or widen, your blood vessels.

10. Try these medicinal herbs

Herbal medicines have long been used in many cultures to treat a variety of ailments. Some herbs have even been shown to possibly lower blood pressure. However, more research is needed to identify the doses and components in the herbs that are most useful. Always check with your doctor or pharmacist before taking herbal supplements. They may interfere with your prescription medications. Here’s a partial list of plants and herbs that are used by cultures throughout the world to lower blood pressure:

• black bean (Castanospermum australe)
• cat’s claw (Uncaria rhynchophylla)
• celery juice (Apium graveolens)
• Chinese hawthorn (Crataegus pinnatifida)
• ginger root
• giant dodder (Cuscuta reflexa)
• Indian plantago (blond psyllium)
• maritime pine bark (Pinus pinaster)
• river lily (Crinum glaucum)
• roselle (Hibiscus sabdariffa)
• sesame oil (Sesamum indicum)
• tomato extract (Lycopersicon esculentum)
• tea (Camellia sinensis), especially green tea and oolong tea
• umbrella tree bark (Musanga cecropioides)

11. Make sure to get good, restful sleep

Your blood pressure typically dips down when you’re sleeping. If you don’t sleep well, it can affect your blood pressure. People who experience sleep deprivation, especially those who are middle-aged, have an increased risk of high blood pressure. For some people, getting a good night’s sleep isn’t easy. These are some of the many ways to help you get restful sleep.

• Try setting a regular sleep schedule.
• Spend time relaxing before bedtime.
• Exercise during the day.
• Avoid daytime naps.
• Make your bedroom comfortable.

The 2010 national Sleep Heart Health Study found that regularly sleeping fewer than 7 hours a night and more than 9 hours a night was associated with an increased rate of high blood pressure. Regularly sleeping fewer than 5 hours a night was linked to a significant risk of high blood pressure long term.

12. Eat garlic or take garlic extract supplements

Fresh garlic or garlic extract are both widely used to lower blood pressure. A meta-analysis found that for people with high blood pressure, garlic supplements reduced their systolic blood pressure by up to about 5 mm Hg and reduced their diastolic blood pressure as much as 2.5 mm Hg. According to a 2009 clinical study, a time-release garlic extract preparation may have a greater effect on blood pressure than regular garlic powder tablets.

13. Eat healthy high protein foods

A long-term study concluded in 2014 found that people who ate more protein had a lower risk of high blood pressure. For those who ate an average of 100 grams of protein per day, there was a 40 percent lower risk of having high blood pressure than those on a low protein diet. Those who also added regular fiber into their diet saw up to a 60 percent reduction of risk. However, a high protein diet may not be for everyone. Those with kidney disease may need to use caution. It’s best to talk with your doctor. It’s fairly easy to consume 100 grams of protein daily on most types of diets. High protein foods include:

• fish, such as salmon or canned tuna in water
• eggs
• poultry, such as chicken breast
• beef
• beans and legumes, such as kidney beans and lentils
• nuts or nut butter, such as peanut butter
• chickpeas
• cheese, such as cheddar

A 3.5-ounce serving of salmon can have as much as 22 grams of protein, while a 3.5-ounce serving of chicken breast might contain 30 grams of protein. With regard to vegetarian options, a half-cup serving of most types of beans contains 7 to 10 grams of protein. Two tablespoons of peanut butter would provide 8 grams.

14. Take these BP-lowering supplements

These supplements are readily available and have demonstrated promise for lowering blood pressure:

Omega-3 polyunsaturated fatty acid

Adding omega-3 polyunsaturated fatty acids or fish oil to your diet can have many benefits. A meta-analysis of fish oil and blood pressure found a mean blood pressure reduction in those with high blood pressure of 4.5 mm Hg systolic and 3.0 mm Hg diastolic

Whey protein

This protein complex derived from milk may have several health benefits in addition to possibly lowering blood pressure.

Magnesium

Magnesium deficiency is related to higher blood pressure. A meta-analysis found a small reduction in blood pressure with magnesium supplementation.

Citrulline

Oral L-citrulline is a precursor to L-arginine in the body, a building block of protein, which may lower blood pressure.

15. Drink less alcohol

Alcohol can raise your blood pressure, even if you’re healthy. It’s important to drink in moderation. According to a 2006 study, alcohol can raise your blood pressure by 1 mm Hg for each 10 grams of alcohol consumed (38). A standard drink contains 14 grams of alcohol. What constitutes a standard drink? One 12-ounce beer, 5 ounces of wine, or 1.5 ounces of distilled spirits. Moderate drinking is up to one drink a day for women and up to two drinks per day for men. A review found that although drinking more than 30 grams of alcohol may initially lower blood pressure, after 13 hours or more, systolic blood pressure increased by 3.7 mm HG and diastolic blood pressure increased by 2.4 mm Hg.

16. Consider cutting back on caffeine

Caffeine raises your blood pressure, but the effect is temporary. In a 2017 study, the systolic blood pressure of 18 participants was elevated for 2 hours after they drank 32 ounces of either a caffeinated drink or an energy drink. Blood pressure then dropped more quickly for the participants who drank a caffeinated drink. Some people may be more sensitive to caffeine than others. If you’re caffeine-sensitive, you may want to cut back on your coffee consumption, or try decaffeinated coffee. Research on caffeine, including its health benefits, is in the news a lot. The choice of whether to cut back depends on many individual factors. One older study indicated that caffeine’s effect on raising blood pressure is greater if your blood pressure is already high. This same study, however, called for more research on the subject.

17. Take prescription medication

If your blood pressure is very high or doesn’t decrease after making these lifestyle changes, your doctor may recommend prescription drugs. They work and will improve your long-term outcome, especially if you have other risk factors However, it can take some time to find the right combination of medications. Talk with your doctor about possible medications and what might work best for you.