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Managing Prehypertension Without Drugs

Keeping your blood pressure below 120/ 80 mm Hg is important to good health. High blood pressure is 140/90 mm Hg or greater, and blood pressure between 120/ 80 and 139/89 is considered "prehypertension," meaning that you are more likely to develop high blood pressure.

Both hypertension and prehypertension can increase your risk for stroke, coronary heart disease, and congestive heart failure, especially if they are uncontrolled, says the National Heart, Lung, and Blood Institute. People with prehypertension often show early signs of stiffening of the arteries, enlargement of the heart, or changes in the way their kidneys work.

Although maintaining a healthy weight is one of the most effective ways to lower your blood pressure without taking medication, you can take other steps to beat this leading cause of cardiovascular disease.

These lifestyle suggestions can help keep blood pressure in control.

Exercise your options

Work out regularly and build more physical activity into your day even if you're not overweight. For example, pace while talking on the phone, walk instead of driving, or play with your children instead of watching from the sidelines.

There's evidence that exercise alone slightly lowers blood pressure. It can also make weight loss easier, even if you don't reduce calories. People who exercise burn calories more efficiently than those who don't. A 200-pound man who exercises moderately, for example, generally needs to consume 400 more calories per day to maintain his weight than a same-sized man who's sedentary.

Moreover, working out can set the tone for other healthy habits. People who exercise tend to be mindful of their diets and avoid smoking. Good habits tend to cluster.

Test your salt sensitivity

Some people with borderline hypertension, especially African-Americans, are salt-sensitive. When they consume salt, they see a rise in their blood pressure. When they reduce their salt intake, their blood pressure falls.

If you're salt-sensitive, it may help to go on a reduced-sodium diet, such as the DASH diet (Dietary Approaches to Stop Hypertension), developed by the federal government's National High Blood Pressure Education Program. Rich in fruits and vegetables, this Mediterranean-style diet also includes low-fat dairy products. It has been found to prevent high blood pressure and lower it as effectively as many prescription drugs.

One caveat: The DASH diet can be difficult to maintain, especially if you often consume convenience foods or eat out regularly. Still, it's worth trying.

If you're not sure you're salt-sensitive, have your blood pressure checked, follow the DASH diet for several weeks, then have your blood pressure checked again. If you don't see a change then you probably don't have to worry as much about your salt intake. The USDA's 2010 dietary guidelines recommend limiting sodium intake to no more than 2,300 mg per day. However, those who are 51 or older and those of any age who are African-American or have hypertension, diabetes, or chronic kidney disease should consume no more than 1,500 mg a day from all sources. Please note that the American Heart Association (AHA) recommends that everyone—no matter age, ethnic background, or medical conditions—consume less than 1500 mg of sodium a day. 

Get more potassium

The recommended daily intake of potassium is 4,700 mg, according to the Institute of Medicine, but Americans average about 2,000 mg less than that. Adequate potassium is associated with reduced blood pressure.

To increase your intake and reduce your hypertension risk, try consuming at least two servings daily of any of the following potassium-rich foods: one cup of cantaloupe (494 mg), one medium banana (450 mg), eight ounces of orange juice (450 mg), 15 raw baby carrots (420 mg), eight ounces of skim milk (405 mg), or six ounces of nonfat yogurt (390 mg). Some salt-substitutes are a combination of salt and potassium; they can be a source of additional potassium and lower the sodium in your diet.

Raise your glass (in moderation)

If you drink, do so in moderation. That means no more than two drinks daily if you're a man and one if you're a woman. One drink equals 12 ounces of beer, four or five ounces of wine, or one 1.5-ounce shot of 80-proof liquor, all of which supply about 0.5 ounce of alcohol.

In studies, moderate amounts of alcohol have been shown to be heart-healthy.

Moderate alcohol users have higher HDL ("good") cholesterol and better cardiovascular prognoses than people who don't drink at all. But a person who chronically consumes three drinks a day will experience a rise in blood pressure.

People who have a family history of alcoholism or addiction shouldn't drink at all.

Don't smoke

Smoking only increases blood pressure when you're actually smoking. But if you smoke 20 to 30 times a day, the amount of time your blood pressure is elevated because of smoking quickly adds up to several hours. That's a meaningful change and can put you at increased risk for hypertension complications, such as heart disease and stroke.

For women who take birth-control pills, smoking is especially dangerous if their blood pressure is already slightly elevated. Taking birth-control pills at any age increases your blood pressure almost invariably by two or three points. But being on the pill, having blood pressure that's already slightly elevated, and being a cigarette smoker is a dangerous triad that can lead to stroke in women as young as 20.

To play it safe, get your blood pressure checked every time you go to the doctor. Check it at home on a regular basis and keep a log of the readings to share with your physician.