The only way to know if you have high blood pressure is to measure it, which is typically done each time you visit your physician. While medication is often prescribed to manage high blood pressure, your lifestyle, especially what you eat and drink, can also play a big role in lowering it.

“Diet and lifestyle can have a profound impact on blood pressure, and it's worth as much as one or two pills,” says R. Kannan Mutharasan, MD, a cardiologist at Northwestern Medicine. “It's just as potent. What I often will do if people have elevated blood pressure — so long as it's not really, really high — is say, ‘Why don't we try three months of lifestyle changes before taking medication and see where we land?’ I think diet and lifestyle are that powerful, and it is a teachable moment for patients to understand that.”

Key Nutrients and Foods for Managing Blood Pressure

Potassium: This mineral helps regulate the sodium level in your body by helping your kidneys eliminate excess sodium. Potassium also relaxes your blood vessel walls for better blood flow. Excellent sources include:

• Fruits: Bananas (a classic choice for a quick potassium boost), avocados, cantaloupe, oranges and dried apricots.
• Vegetables: Sweet potatoes, spinach, potatoes (with skin), tomatoes and Brussels sprouts
• Dairy: Yogurt (especially Greek yogurt) milk and cottage cheese

If you have kidney disease, Dr. Mutharasan cautions, “You should always check with your doctor whether it would be safe for you to try a high potassium diet, because patients with kidney disease tend to have higher potassium levels.”

Magnesium: Like potassium, magnesium also helps relax your blood vessels. Find it in:

• Leafy greens: Spinach, kale and Swiss chard
• Nuts and seeds: Almonds, pumpkin seeds, chia seeds and sunflower seeds
• Whole grains: Brown rice, rolled oats and quinoa
• Legumes: Black beans and kidney beans
• Protein: Chicken, salmon, tuna and tofu

Calcium: This mineral plays a role in blood vessel function because it helps them tighten and relax when they need to. Good sources include:

• Dairy: Milk, Greek yogurt and cheese (choose fat-free or low-fat dairy products)
• Leafy greens: Kale, collard greens and spinach.
• Calcium-fortified foods: Some plant-based milk alternatives and cereals

Fiber: Found in plant-based foods, fiber feeds healthy gut bacteria. This produces short-chain fatty acids, which can lower blood pressure. Roshini G. Merneedi, RD, a dietitian at Northwestern Medicine, says that you should aim for 25 to 35 grams per day. For perspective, there are 4 grams of fiber in a half cup of blackberries or raspberries, or in one cup of oatmeal. High-fiber foods include:

• Whole grains: Oats, brown rice, whole wheat bread
• Fruits and vegetables: Especially those with edible skins and seeds
• Legumes: Beans and lentils

Omega-3 fatty acids: A type of healthy fat that slows the rate of plaque buildup in your blood vessels.

• Fatty fish: Salmon, tuna, mackerel and sardines
• Nuts and seeds: Flaxseeds, walnuts, hemp seeds and chia seeds
• Legumes: Soybeans

Nitrates: Nitrates (molecules made up of nitrogen and oxygen) convert to nitric oxide in the body, which relaxes your blood vessels. Good sources include:

• Leafy greens: Spinach and arugula
• Berries: Blueberries, strawberries, raspberries and cranberries
• Beets: Beetroot and beetroot juice

If you are taking an anticoagulation (blood thinning) medication, Merneedi cautions that you should check with your care team before adding foods into your diet that are high in vitamin K, such as leafy greens, avocados and blueberries. Vitamin K can counteract the effects of blood thinners.

Crafting a Heart-Healthy Diet

To maximize the benefits of these foods, consider the following tips:

• Cook at home: Preparing meals at home allows you to control the ingredients and reduce sodium intake.
• Read food labels: Pay attention to sodium content and choose low-sodium options. Also avoid foods high in saturated fat, which can increase your cholesterol. Merneedi recommends paying close attention to food claims and understanding what they mean, including:
• Fat-free: Less than 0.5 grams (g) of saturated and trans-fat per serving 
• Low-fat: 3 g or less per serving
• Reduced-fat: At least 25% less saturated fat than the traditional version 
• Sodium- or salt-free: Less than 5 milligrams (mg) per serving 
• Very low sodium: 35 mg or less per serving  
• Low sodium: 140 mg or less per serving  
• Reduced sodium: 25% less sodium than the traditional version 
• Light sodium: 50% less sodium than the traditional version  
• Unsalted: No added sodium, but the food may naturally contain sodium  
• Limit processed foods: Processed foods are often high in sodium, unhealthy fats and added sugars.
• Sprinkle on herbs and spices: Instead of turning to salt and sugar to add flavor to your foods, try adding herbs and spices like cinnamon, turmeric, garlic, cumin, basil, cilantro, black pepper and ginger. “Try salt-free seasonings like Mrs. Dash,” says Merneedi. “They are available in most grocery stores and supermarkets.”
• Consider the DASH diet: If high blood pressure is affecting your health, you may hear about the Dietary Approaches to Stop Hypertension (DASH) diet. Designed to lower blood, this eating plan was developed by researchers with support from the National Heart, Lung and Blood Institute, part of the National Institutes of Health. This balanced eating plan, which Dr. Mutharasan recommends to his patients, emphasizes:
• Fruits, vegetables and whole grains: These provide essential vitamins, minerals and fiber.
• Lean protein: Fish, poultry and beans are preferred over red meat.
• Low-fat or fat-free dairy: These provide calcium and other nutrients without excess saturated fat.
• Limited saturated fat, cholesterol and sodium: These can contribute to high blood pressure.
• Limited sweets and products with added sugar: Sugar-sweetened beverages, pastries, candy and other sugary foods offer empty calories and contribute to weight gain, which can raise blood pressure.

Merneedi says she talks about the DASH diet with her patients regularly. “Low-sodium and increased plant-based eating does make a difference in blood pressure,” she says. “The Mediterranean diet is also an effective diet to consider.”

In addition to diet, two other things that help lower blood pressure are weight loss and exercise (at least 150 minutes of cardiovascular exercise a week), says Dr. Mutharasan. The key is keeping the weight off, which he acknowledges can be difficult to do.

“Any dietary intervention that leads to weight loss will lead to a drop in blood pressure, including a low-carb diet and intermittent fasting,” says Dr. Mutharasan. “We don't know everything that we need to know about how to sustainably lose weight. What works for one person may not work for another.” He recommends talking with a healthcare professional about the safest and best plan of eating and exercise for you to maintain a healthy weight.

Healthy Food on a Budget

If finding healthy and affordable food options near you is challenging, consider these convenient and nutritious alternatives:

• Canned, dried or frozen produce: These options are just as healthy as fresh fruits and vegetables and can last longer.
• Low-sodium, reduced-sodium or no-salt added canned vegetables.
• Frozen vegetables with no added seasonings or sauces.
• Canned fruit packed in water or its own juice with no added sugars.  
• Dried fruit with no added sugars.
• Powdered milk (dry milk), which is made from liquid milk with the moisture removed.

Can Supplements Help?

Dr. Mutharasan says it’s better to get calcium, magnesium, potassium and other minerals from the foods you eat. “Supplements are generally not as scrutinized by the Food and Drug Administration, so you don't know exactly what's in them,” he explains. If you don’t think you are getting enough from your diet, it’s important to talk with your care team before taking any supplements.

How Often Should You Check Your Blood Pressure?

If you do not have a diagnosis of high blood pressure, Dr. Mutharasan says it’s reasonable to allow the blood pressure test to be done at your healthcare screening visits. But, if you have high blood pressure, it is important to have a blood pressure cuff at home as part of your healthcare toolkit. Dr. Mutharasan adds that it’s a good idea to have a home kit if you have white coat syndrome (your blood pressure is higher in a clinical setting) or masked hypertension (your blood pressure is normal in a clinical setting but elevated at home).

“When testing at home, it's important to know how to measure your blood pressure properly,” explains Dr. Mutharasan. He provides the following tips:

• Test in the morning after using the bathroom. If your bladder's full, your blood pressure will be higher.
• Sit in a chair, resting with your arm supported on a desk or table.
• Place the cuff on your bicep instead of your forearm for a more accurate reading.
• Rest for two to three minutes before starting the test.
• Keep your feet flat on the floor.
• Keep your bicep level with your chest, which is where your heart is. If your arm is too low, your blood pressure reading will be artificially high.

“There are so many Americans living with high blood pressure and don't even realize it,” says Dr. Mutharasan. “And there are so many people who have the diagnosis but don't have it adequately treated. We've realized that diet and lifestyle changes are really powerful for helping lower high blood pressure. There are also many patients who need the benefit of medications. Getting get your blood pressure in check is so important for your heart health as well as stroke and kidney disease prevention.”

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