Hypertension is a problem. It raises the risk of heart disease; it’s one of the most consistent risk factors for that condition, as well as others like kidney disease. But before you start freaking out about your high blood pressure, make sure you actually have it. A single elevated reading does not a hypertension diagnosis make. Readings are snapshots in time. They can be a part of a trend, or they can be an isolated case. Don’t assume based on one bad reading.
I can remember  going to the doctor about ten years ago for a routine checkup, showing 140/100, and almost getting a prescription based on that. It was absurd, so absurd that I took matters into my own hands and got a fancy blood pressure device to measure my own over the next couple weeks. The result?
There was almost no pattern. Maybe it was a lot lower after dinner, due to relaxation, but other than that there weren’t any trends. Sometimes it was high, mostly it was low-normal. It all depends on stress
Okay, say that’s not you. Say you have a legitimate problem with protracted and consistently high blood pressure. What can you do in addition to (or besides, if your doctor says it’s safe to wait) opt for the prescription?
1) Eat More Potassium
A common cause of salt-related blood pressure increases is inadequate potassium intake. Very few of us eat as much potassium as we evolved eating.
The pre-agricultural environment was potassium-rich and sodium-poor. That’s why we have a physiological taste for salt, and why salted food tastes so good: we had to seek it out. That’s why we don’t have a physiological taste for potassium: it was everywhere. Loren Cordain estimates some hunter-gatherer groups got upwards of 10-12 grams of potassium a day , whereas the average American gets about 2.5 grams.
Studies show  that both sodium-sensitive and potassium-deficient subjects with high blood pressure see the biggest improvements with increased potassium intake.
I love sodium, and it’s actually beneficial for endothelial health when consumed with enough potassium, but you have to eat potassium  too.
2) Improve Your Insulin Sensitivity
Ever since earlier studies established that hypertensive patients tend to exhibit abnormally high insulin responses to standard glucose loads, researchers have wondered about a connection between insulin and blood pressure. It turns out there is a powerful connection .
- In non-diabetic people with normal blood pressure, insulin levels and shifts in blood pressure are related—higher insulin, higher blood pressure; lower, lower.
- In both diabetic and non-diabetic subjects, lower insulin sensitivity predicts elevated blood pressure.
- Insulin increases sodium retention in the blood, which increases blood volume and pressure. The less insulin sensitive you are, the more insulin you’ll release in response to a given stimulus, and the more sodium you’ll shuttle into the blood.
- Both insulin resistance and the compensatory hyperinsulinemia (elevated insulin levels) that results have distinct pro-hypertensive effects.
Luckily, there are dozens  upon dozens  of ways to improve your insulin sensitivity . Choose a few, or all of them (a better proposal, actually), to not only improve your blood pressure but also your health and life in general.
3) Earn Your Carbs With Physical Activity
The ones you earn through physical activity, that is. Let’s look at two scenarios.
First: You eat way more carbs than you actually earn through training. You haven’t trained, so you’re more insulin-resistant than the You from the alternative universe who did train. This means any carbs you eat will cause a greater spike in insulin, which has been shown to increase blood pressure.
Second: You only eat the carbs you’ve earned through training. Since you’re training, your insulin sensitivity is high, and you don’t actually secrete all that much insulin in response to the carbs. Training also upregulates non-insulin dependent glycogen repletion, meaning you can shove glycogen into muscles post-workout without even using insulin.
Once or twice, this isn’t an issue. But if you’re consistently eating more carbs than you need, the resultant elevation in insulin will raise blood pressure. At the very least, it won’t help.
Not only that, but regular training improves endothelial function and reduces the risk of high blood pressure on its own.
4) Eat Fermented Dairy
Milk fermented with the L. helveticus bacteria has been shown to lower blood pressure in people with hypertension in a number of studies .
In one , they drank the fermented milk for 21 weeks.
In another , they drank the milk for 10 weeks.
Look for products that include Lactobacillus helveticus, such as kefir, aged cheese (Swiss, emmental, pecorino romano, cheddar, parmigiano reggiano),
5) Get Your Zinc (Red Meat and Oysters)
Zinc is an essential nutrient for regulating the nitric oxide synthase system in the body. Without adequate zinc, your ability to produce nitric oxide—which increases blood vessel dilation and thus regulates blood pressure—is hampered.
6) Get Sunlight
There are consistent relationships between adequate vitamin D levels and normal blood pressure, though it’s unclear whether this is causal. Studies haven’t found  a consistent blood pressure effect of actually supplementing with vitamin D. What might be going on is that vitamin D is acting as a marker for sun exposure, because we know that sunlight increases the production of nitric oxide, a compound that improves the function of your blood vessels.
Sure enough, human studies show  that sun exposure causes the conversion of nitrogen oxide in the skin to nitric oxide, lowering blood pressure and improving endothelial function.
7) Address Your Stress
Stress might be the biggest trigger for hypertension, especially since most of us live lives laden with hidden, inevitable stressors—commutes, jobs we don’t like, bills, and the like. It’s everywhere, we can’t really escape it entirely, so we have to figure out how to deal with it.
I know how I do it (paddling , Ultimate , walks , quality time with family, smart supplementation ). There are other ways, like adaptogens , or this , or this . You can rethink stress entirely . You can meditate , or try alternatives that achieve similar things . What are you going to do?
If your blood pressure is resistant to dietary, exercise, or lifestyle changes, make sure you manage it with your doctor.
8) Take ACE Inhibitors or AR Blockers If Warranted
The body uses a hormone called angiotensin to raise blood pressure in a couple ways. First, by directly constricting blood vessels and increasing flow pressure. Second, by promoting the release of aldosterone, a hormone that shuttles sodium to the blood to increase blood volume. ACE inhibitors inhibit angiotensin secretion and AR blockers block angiotensin receptor sites. While I know we’re usually suspicious of drugs that block or inhibit the secretion or action of hormones, ACE inhibitors and AR blockers appear to be quite safe and effective. And there’s even evidence that normotensive subjects who take them live longer than normotensive subjects who don’t .
They do tend to lower zinc status , though, so keep up with your zinc intake.
That’s it for today, folks. The good news is that high blood pressure is manageable with diet and lifestyle changes, and even if that doesn’t work, the available medications seem better than most.
How do you manage your blood pressure? What’s worked? What hasn’t?
Sebastian A, Cordain L, Frassetto L, Banerjee T, Morris RC. Postulating the major environmental condition resulting in the expression of essential hypertension and its associated cardiovascular diseases: Dietary imprudence in daily selection of foods in respect of their potassium and sodium content resulting in oxidative stress-induced dysfunction of the vascular endothelium, vascular smooth muscle, and perivascular tissues . Med Hypotheses. 2018;119:110-119.
Filippini T, Violi F, D’amico R, Vinceti M. The effect of potassium supplementation on blood pressure in hypertensive subjects: A systematic review and meta-analysis . Int J Cardiol. 2017;230:127-135.
Takano T. Anti-hypertensive activity of fermented dairy products containing biogenic peptides . Antonie Van Leeuwenhoek. 2002;82(1-4):333-40.
Seppo L, Jauhiainen T, Poussa T, Korpela R. A fermented milk high in bioactive peptides has a blood pressure-lowering effect in hypertensive subjects . Am J Clin Nutr. 2003;77(2):326-30.
Jauhiainen T, Vapaatalo H, Poussa T, Kyrönpalo S, Rasmussen M, Korpela R. Lactobacillus helveticus fermented milk lowers blood pressure in hypertensive subjects in 24-h ambulatory blood pressure measurement . Am J Hypertens. 2005;18(12 Pt 1):1600-5.