Nearly half of adults in the U.S. have high blood pressure, making it a pervasive issue. But high blood pressure, known as hypertension, is a serious problem that has implications for overall health.

“High blood pressure is truly the silent killer,” says Jennifer Haythe, MD, associate professor of medicine and co-director of Columbia Women’s Heart Center. “Most people do not feel their blood pressure being elevated, and so, without proper screening, hypertension can go undetected for many years.”

If you’re not familiar, your blood pressure is measured by your systolic blood pressure (the top number in a blood pressure reading), which tells how much pressure your blood exerts against your artery walls when your heart beats. In contrast, your diastolic blood pressure (the bottom number) reveals how much pressure your blood pushes against your artery walls as your heart rests, the American Heart Association (AHA) explains. Hypertension is defined as having systolic blood pressure greater than 130 mmHg or diastolic blood pressure greater than 80 mmHg.

While having random elevated blood pressure happens, consistently high pressure is a problem. “Over time, elevated blood pressure damages almost all of your organs, especially the brain, kidneys, heart, and all blood vessels,” Dr. Haythe says. “This can lead to stroke, heart attack, heart failure, kidney failure, and peripheral vascular disease.”

There are plenty of ways to treat high blood pressure, including medications, but doctors say that habit changes can play a significant role in bringing your numbers down, too. “Lifestyle factors like physical fitness, avoidance of alcohol, trying to lower your sodium intake, and weight loss are always recommended as a first step,” says Julius Gardin, MD, interim director of the division of cardiology at Rutgers New Jersey Medical School. “They’ve been shown to be quite helpful.”

Dr. Gardin says he’ll usually recommend patients with newly diagnosed hypertension try lifestyle modifications first, provided their blood pressure isn’t too high or linked to an underlying health condition like diabetes. However, sometimes medication is needed. “Even with a healthy active lifestyle, hypertension can persist as there are very strong genetic causes as well,” Dr. Haythe says. “This is why it is crucial to follow up with your physician and, if your blood pressure continues to be elevated after adjusting how you eat and live, medication will be essential.”

It can seem overwhelming to make significant lifestyle changes to lower your blood pressure, but many people have done it. These are just a few examples.

1. “I started off just walking on the treadmill and then did a little bit of running”

North Carolina resident Bebe was 19 when diagnosed with high blood pressure. But, while she was prescribed medication, she didn’t take it regularly until she ended up in the hospital. “I had been having a lot of headaches and dizziness, and I eventually went to the emergency room with what felt like the worst headache of my life,” she says. “The doctor told me I was a ‘walking stroke’ that was waiting to happen and warned that I would end up with permanent heart damage or kidney failure if I didn’t do anything about my blood pressure.”

Both of Ramzah’s parents have hypertension, and her father passed away from a stroke just months before her diagnosis.

After that warning from her doctor, Ramzah says she “changed everything.” That meant taking her medication, adjusting her diet, watching her sodium intake, and eating more fruits and vegetables. She also started exercising and joined a gym. “I started off just walking on the treadmill and then did a little bit of running,” she says. “I was so winded at first.” However, she has now run a marathon.

Her blood pressure once reached 189/126—something the AHA defines as a hypertensive crisis. “Now, I have much better readings,” she says.

2. “Most would be amazed at where their blood pressure goes after…low salt”

New Jersey resident Michael was diagnosed with high blood pressure three years ago. He says he decided to focus on lifestyle modifications because “I don’t like being on medication.”

So, he’s reduced his salt intake to follow the AHA’s recommendation of no more than 1,500 milligrams a day. “Most would be amazed at where their blood pressure goes after a week of low salt,” he says. He’s also been taking olive leaf extract, which research has linked to lowered blood pressure. Michael says his blood pressure is now usually around 117/73.

3. “I have been meditating”

Jessica Bane Robert, director of prestigious fellowships and scholarships at Clark University in Massachusetts, says that hypertension “runs in my family.” She noticed her blood pressure “started to creep up,” reaching around 154/93 at one point—a number that the AHA considers stage 2 hypertension.

“I experienced swelling in my feet and lower legs,” Robert says. To lower her blood pressure, Robert decided to lose weight—she dropped 10 pounds—and added 10 minutes of meditation to her morning routine to lower her stress levels. Research has linked regular meditation with lowered blood pressure, and Robert says she noticed results within a few months.

“When you calm the mind, you calm the body,” Robert says. “I have greater peace and calm through the day when meditating consistently. Now, when I have moments of stress and anxiety that take over, that is an exception and no longer the normal, every-day state.” Robert says her blood pressure is now typically at or around 124/78.

4. “I started gentle workouts three times per week”

Colorado resident Paula was diagnosed with high blood pressure in December 2017. “It was so high that my doctor said I was in danger of a heart attack,” she says.

Martin says she had recently gained weight around the time of her diagnosis, so she decided to change her eating habits and began exercising. “I changed to a vegetarian diet and started gentle workouts three times per week,” she says. Martin got an under-desk bike and would pedal for 10 minutes to start and lengthen his workouts over time.

“I noticed a considerable difference in my blood pressure after about four months and 50 pounds,” she says. Martin now walks, hikes, and does Pilates.

5. “Baked potatoes are my primary source of potassium, although I eat other high potassium foods, too”

Cookie in Indiana says she’s been dealing with “random high blood pressure” for a year and a half that started after she had an arrhythmia or irregular heartbeat. At one point, her blood pressure reached 210/110, which is considered a hypertensive crisis.

Cookie is under her doctor’s care, but she says she discovered that her blood pressure seems to go down after she has foods with potassium. According to the AHA, potassium lessens the effects of sodium in the body and eases tension in your blood vessels walls, lowering blood pressure. “Baked potatoes are my primary source of potassium, although I eat other high potassium foods, too,” Cookie says. “My high blood pressure seems to go down within an hour or two after eating a high potassium food.”

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