If you're among the one in three Americans with high blood pressure (hypertension), odds are you know it raises your risk for a heart attack, stroke, or kidney failure. What you may not know is that many people can cut their blood pressure to a safe level with no pills.

"Increase your physical activity. Reduce your sodium intake. Have more fruits and vegetables. Limit your drinking. Choose which is easiest, and do it first. They'll all add up," says Eva Obarzanek, Ph.D., a research nutritionist with the National Heart, Lung, and Blood Institute. A 2006 study she helped write showed lifestyle changes can help people control blood pressure without medication.

Striking difference

The study involved 810 men and women with high blood pressure. Some were given individual and group counseling and asked to meet weight-loss, exercise, and dietary goals. Others just got general guidance. About 60 percent of those in the first group controlled their blood pressure in 18 months, compared with 37 percent in the second group.

Those who cut their blood pressure the most, Dr. Obarzanek notes, followed a heart-healthy eating plan called DASH, for Dietary Approaches to Stop Hypertension. It calls for nine to 12 servings of fruit and vegetables a day, two to three servings of low-fat dairy products, and a fat intake of no more than 25 percent of daily calories.

"We know that the DASH diet works within two weeks," she says. "As soon as you start losing weight, your blood pressure goes down."

Not everyone with high blood pressure can control it through exercise and diet. "If you have markedly elevated blood pressure [for example, above 180/110 vs. the ideal of 120/80 or less], your treatment should be medications," warns James M. Hagberg, Ph.D., a fellow of the American College of Sports Medicine.

Pressure points

  • Get moving. Start with 15 minutes of walking or yard work. Ask your doctor what exercise is right for you. Build up to at least 30 minutes of moderate exercise most days.

  • Quit smoking.

  • Eat healthy. Add one serving of fruits or vegetables to each meal. Switch to low-fat milk and skip soda.

  • Limit alcohol. Men should stop after two drinks a day, women after one.

  • Consume less salt. Try for no more than a teaspoon (2,300 mg) per day. Choose low-sodium snacks, canned soups, and packaged meals.

  • Be wary of over-the-counter medications. Some decongestants and pain relievers can raise blood pressure. Read labels or ask a pharmacist.

Medical Reviewer: [Dwyer, Johanna, D.Sc., R.D., Fleck, Steve, Ph.D., Gonnella, Joseph, M.D., McDonough, Brian, M.D., T. David O'Halloran, MD, Whorton, Donald, M.D.] Last Annual Review Date: 2010-01-20T00:00:00-07:00 Copyright: © Health Ink & Vitality Communications

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High blood pressure, or hypertension, is known as the "silent killer" because: