It's not your imagination—Americans’ numbers are rising. Control yours so you don’t stress about it (because that would be counterproductive).

By Christine Richmond
Updated April 25, 2018
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Back in November, a funny thing may have happened to you: One day you were fine, and then—bam!—whether you knew it or not, you had high blood pressure. No, it wasn’t because you realized there were only six weeks left until Christmas; it was because the American College of Cardiology and the American Heart Association changed the medical definition of “high blood pressure.” The condition now starts at 130/80 mm Hg rather than 140/90, and close to half of all U.S. adults have it (before the new definition, a third did).

Why the change? We’ve learned that people with a blood pressure of 130/80 “are already at about double the risk of heart attack or stroke,” says Paul K. Whelton, MD, the lead author of new guidelines for health care providers that were written to accompany the updated blood pressure numbers.

As the report points out, high blood pressure, also known as hypertension, is second only to cigarette smoking as the leading preventable cause of death in the U.S. You might think of hypertension as something older men deal with, but it affects women and men just about equally. Black women are at especially high risk, and they tend to get it at an earlier age. Family history is another big factor: If you have even one close relative with high blood pressure, you’re twice as likely to have it too.

So now might be a good time to schedule a checkup to find out your numbers and discuss with your doctor what they mean. If you learn you’re one of the more than 100 million Americans with high blood pressure, you won’t necessarily end up on meds. Lifestyle factors—like what you eat, how often you work out, and how you manage stress—make a big difference, whether you have hypertension or are just trying to reduce your risk. Ahead, eight things to try today—and how to actually work them into your life.

Amrita Marino

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The guidelines call for 90 to 150 minutes of exercise per week. Any moderate-intensity activity will do—like swimming, strength training, or dancing, says Whelton. The simplest (and cheapest) move may be walking, as long as you’re going fast enough that you can’t easily maintain a conversation, says Angela L. Brown, MD, associate professor of medicine and director of the Hypertension Clinic at Washington University School of Medicine in St. Louis.

If you never exercise and don’t know how to begin, Tammara Davis of California, Maryland, has some tips. Davis was a self-described couch potato for decades, and her attempts at exercise were off-putting. “It felt like my lungs were on fire. I hated it,” she says. But then her blood pressure crept up, and she decided to make a change. That was about 10 years ago; the 44-year-old now runs half marathons. To get there, she started slowly, doing a couch-to-5K program using the C25K app. Next, she took a hard look at the things that were keeping her from exercising. “My hair, for example. I’m a black woman. I’d get my hair done and wouldn’t want to work out for a week after,” she says. “I started wearing my hair natural, and that was key.” She also likes having a goal to work toward, so signing up for races has been motivating. Not only are races fun (she’s looking forward to the Reggae Half Marathon in December, held in Jamaica), they also cost money, so she’s more likely to follow through. Finally, Davis found a community of local women to work out with through a running club called Black Girls Run. “They’re my sisterhood. Without them, I’d feel pretty isolated as a runner,” she says. “We travel. We celebrate birthdays. We’re all cheerleaders for each other, and we’ve seen each other through so much.”

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About 25 million Americans have this condition, which makes you briefly stop breathing multiple times during the night, and it’s a major contributor to high blood pressure and heart disease, says Brown. Severe snoring, extreme fatigue during the day, irritability, and difficulty concentrating or remembering are all symptoms of sleep apnea. But the only way to know for sure if you have it is to go in for a sleep study, in which your breathing is monitored overnight.

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A number of drugstore standbys, such as decongestants, ibuprofen, and aspirin, can raise blood pressure. So can prescription meds, like certain antidepressants and birth control pills, as well as steroids such as prednisone. Tell your doctor everything you’re taking, including supplements. If needed, she can suggest blood pressure–friendly swaps, like acetaminophen for pain and a progestin-only form of contraception.

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The healthiest way to eat if you’re worried about blood pressure, according to the new guidelines, is to pile your plate with produce, whole grains, dairy, and lean meats. And though some experts have challenged the role of salt in causing hypertension, reducing sodium intake is still standard advice—as is getting more potassium. If you want a more formal eating plan, check out the DASH (dietary approaches to stop hypertension) diet, which is based on the above principles and which studies suggest can start lowering blood pressure in as little as two weeks. Maggie Ratanapratum, 45, from Huntington Beach, California, has successfully followed the DASH diet for almost a year and a half, lowering her blood pressure from 140/90 to 110/60 and losing more than 60 pounds. She tried other eating plans in the past, such as Atkins and the South Beach Diet, but “they didn’t work, because I was following a prescriptive diet of foods I didn’t really like: frozen meals, ricotta with cocoa powder and artificial sweetener, big pieces of meat,” she says. Plus, she adds, “I was having to cook two meals—one for the family and one for myself.” She found that the basic rules of the DASH diet gave her plenty of flexibility, and she focused on learning to meal plan and cook healthy food for her whole family. Being organized is essential, she says, because “it’s a lot of work to plan meals, shop, cook things so they don’t spoil, and come up with food that doesn’t get boring.” But because she put in the work, Ratanapratum says she now has “really strong habits” that have kept her on track through life’s inevitable ups and downs.

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You’ve probably heard that a glass of red wine per day is good for your heart. There’s research to back that up, but it’s also true that too much booze can raise your blood pressure. For that reason, Whelton recommends that if you don’t drink, don’t start, and if you do, have no more than one standard drink per day if you’re a woman and two if you’re a man. “A standard drink is less than most people would think,” he adds—it’s 12 ounces of beer, five ounces of wine, or 1½ ounces of spirits (such as gin, vodka, or whiskey).

Luckily, Whelton’s report notes that caffeine intake doesn’t cause high blood pressure. But it can cause a temporary spike: Having caffeine before a blood pressure test can cause a falsely high reading (as can having to pee, and even feeling stressed about being at the doctor’s office). Ask your doctor to check again at a different appointment before she draws any conclusions.

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Your weight isn’t the only indicator of your well-being, and lots of different body types can be healthy. That said, if you have high blood pressure and you’re also considered overweight, your doctor will probably tell you to lose some pounds. “You get the biggest bang for your buck with weight loss. In some people it can really make the difference between needing to take a drug and not,” says Brown. How can you tell if you’d benefit from losing weight? Although it’s a controversial and imperfect tool, most doctors still use the BMI as a guideline to determine whether patients are at a healthy weight. But as Brown notes, “Telling someone that her BMI is 35 while a normal BMI is between 18.5 and 24.9 doesn’t always resonate, because what does that mean?” Instead, she gives patients the goal of losing 7 to 10 percent of their body weight. The numbers make sense to people, and the target feels doable. “For someone at 200 pounds, that’s only 14 pounds,” she says.

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Unsurprisingly, stress can affect your blood pressure—work is a common culprit. “I have a couple of patients whose blood pressure is lower on the weekends, when they’re out of the office,” says Brown. Chronic stress can also trigger behaviors that are known to cause high blood pressure, such as drinking too much and overeating. Taking care of yourself and reducing stress is absolutely beneficial, says Brown.

One super-easy tactic is to squeeze a stress ball. This has been shown to help lower blood pressure by increasing blood vessel function.

Beyond that, there are plenty of proven stress-reducing activities out there, including massage, yoga, meditation, deep breathing, knitting, gardening, hanging out with pets, and listening to music.

Amrita Marino

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Need an excuse to put off doing your laundry and go out to dinner with friends instead? This is a good one. Having strong social ties has been linked to a longer life, better brain health, and, yes, lower blood pressure. All the more reason to prioritize time with the people you love. And if you’re the hugging type (and your loved ones are too), you might as well go in for a squeeze: One small but sweet study of 59 women found that frequent hugs were associated with lower blood pressure.