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Chronic high blood pressure — higher than 130/80 — takes a toll on your arteries, heart, kidneys and brain. Lower it, and you reduce your risk of heart attack and stroke.

Cardiologists say it can absolutely be done without the help of medication. In fact, lifestyle changes are the first approach they often try in patients with hypertension. So what are the best ways to lower your blood pressure without pills? We asked two experts:

• Dr. Ron Blankstein, a preventive cardiologist at Brigham and Women's Hospital in Boston, associate professor at Harvard Medical School and a member of the American College of Cardiology’s Prevention of Cardiovascular Disease Section Leadership Council.

• Dr. Jennifer Haythe, an assistant professor of medicine and co-director of the Women’s Center for Cardiovascular Health at the Columbia University Medical Center.

Here are their six tips:

1. WEIGHT LOSS IS ESSENTIAL
It’s imperative to shed any extra pounds, both doctors said. The rising rate of obesity in the U.S. means doctors are seeing more young people with high blood pressure because it rises as body weight increases. Being overweight puts extra strain on your heart, the American Heart Association noted, but losing just five to 10 pounds may help.

“There are many advantages of weight loss, but certainly that’s one of the most important ones — lowering blood pressure,” Blankstein said.

2. IMPROVE YOUR DIET
There’s good evidence plant-based diets high in fruits, vegetables, whole grains and legumes will lead to lower blood pressure and weight loss, Blankstein noted. You’ll also naturally get more potassium, which is associated with lower blood pressure.

At the same time, banish processed foods.

“You have to stick to real foods, which are foods that haven’t been taken by a company and processed and put in a box or plastic bag,” Haythe said.

Bottom line: Your weight and eating style should be at the core of your strategy.

“The combination of weight loss and diet together is incredibly powerful for lowering blood pressure. I have patients who have had enormous success doing that,” Blankstein said.

3. LIMIT SALT
We need sodium to live, but too much salt leads the body to hold on to more fluids and that causes volume changes inside blood vessels. Over time, blood pressure rises.

“The problem is, salt is everywhere,” Haythe noted.

“It’s not just the salt that you add with the shaker,” Blankstein added. “Most of the sodium we get in our diet is found in various processed foods — things like canned soups, chips, cold cuts, pickles and even bread.”

He recommended consuming less than 2 grams (2,000 mg) of salt — or less than one teaspoon — a day for people who are trying to lower their blood pressure. That can be very effective, he said.

4. GET ACTIVE
Exercise improves circulation and cardiac output, and has a dilating effect on your blood vessels, Haythe said. It raises blood pressure in the moment, but in an appropriate way, both doctors noted. Long-term, exercise actually lowers your resting blood pressure.

“Our blood vessels learn to relax when we’re not exercising. So the benefits with exercise are not necessarily at the time of exercise, but in general afterwards,” Blankstein said.

He advised cardio over weight lifting and considered the general recommendation of 30 minutes of aerobic exercise, five times a week, to be “the absolute minimum.” An hour of exercise a day on most days of the week is better.

Squeezing in a workout, but then just sitting the rest of the day is still not enough activity: Regularly get up and move, Blankstein said. He recommended aiming for 10,000 steps a day.

5. LIMIT ALCOHOL
Drinking too much alcohol can raise blood pressure, so have no more than two drinks a day if you’re a man, and no more than one drink a day if you’re a woman, the American Heart Association advises.

Eliminating alcohol altogether might be useful for someone who already has high blood pressure, Blankstein said.

6. MANAGE STRESS
You can feel your heart working hard if you get angry at work or frustrated in traffic. If you feel that way all the time, the damage accumulates.

“It’s very important for people to try to find ways to reduce their chronic stress, whether they need to go to a therapist, be on medication for that or exercise, do yoga, meditation,” Haythe said.

Stress management can be very helpful, Blankstein agreed. Still, he would never tell patients that managing stress would single-handedly do the job of lowering blood pressure if they’re also overweight or have a poor diet.

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If you’re not able to lower your blood pressure with lifestyle changes, having to take a medication is not a failure, Blankstein said. Sometimes, the combination of both is the best approach.

If you have high blood pressure, both doctors recommended buying a monitor for home use.

Whether at home or the doctor's office, blood pressure should be measured the right way: You need to be in a quiet room. Don't smoke, drink caffeinated beverages or exercise within 30 minutes before taking the measurement. Also, empty your bladder and be still for at least five minutes before, the American Heart Association recommends.

Measure your blood pressure at different times of day and keep a log so you and your doctor can identify any patterns. If the result is high, also include what you were doing just before the measurement.

It’s common to have “white coat hypertension” — or higher blood pressure when you’re nervous at the doctor’s office. “You don’t want to make any decisions based on that high number,” Blankstein said. Ask the staff to measure your blood pressure again at the end of the visit when you've had a chance to relax.

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