By modifying their lifestyle, some people can bring their blood pressure back to normal without medication, or with less medication than they might otherwise need. At the same time, they also greatly reduce their risk of heart attack, stroke and other potentially debilitating or fatal conditions.

Reduce your alcohol intake

Excessive alcohol consumption is a known cause of high blood pressure. According to government guidelines, men and women should drink no more on average than two standard drinks a day. Note that a standard drink is one that contains 10 grams of pure alcohol, and is generally less than a glass of wine or the smallest bottle of beer. Click here for more information on what constitutes a standard drink.

Even if a regular drinker switches from a full-strength to a low-alcohol variety they can reduce their blood pressure by about 5 mmHg. At its most extreme, binge drinking can cause a rapid though brief rise in blood pressure that can be severe enough to bring on a stroke. Alcohol can also interfere with drug treatment for high blood pressure and is a common reason for treatment failing.

Lose weight

Being overweight is an important reversible cause of high blood pressure, particularly for young people. Weight loss through healthy eating and regular exercise can reduce blood pressure in overweight young adults as much as medication, as long as they keep the weight off.

It’s not just what you weigh, but also where you carry the weight. People with excess body fat around the middle are more likely to develop high blood pressure and coronary heart disease than those with weight around their arms, legs, breasts and buttocks.

If you’re overweight, aim to reduce the number of calories you consume each day.

Eat well

To reduce blood pressure and the risk of stroke and coronary heart disease, cut down on your alcohol and salt intake and eat more fruit, vegetables and low-fat dairy. Somre more eating tips:

-Healthy fats and oils

Fats are the most concentrated energy available and contain more energy per gram than any other food. Saturated fat, which is solid at room tempera- ture and comes predominantly from animal fat, elevates LDL (bad) cholesterol and increases the risk of heart disease to a small degree, but not the risk of stroke. Replacing it with liquid polyunsaturated fat does lower the heart-disease risk by a modest degree. Replacing it with carbohydrate does not appear to be beneficial.

Fish consumption seems to be associated with lower rates of heart disease, but taking fish oil sup- plements does not seem to have the same effect.

Approximately half of all Australian adults have a higher than recommended blood choles- terol level. Our bodies produce all the cholesterol we need. To control LDL (bad) cholesterol, limit your saturated fat intake and increase your polyunsaturated fat intake. This is more effective than cutting down on foods that contain cholesterol.

If you can’t get your cholesterol levels down by changing your diet and lifestyle, or you have naturally high cholesterol, you may need to take medication. People with multiple risk factors, such as high blood pressure and high blood cholesterol, or a history of heart disease, may be prescribed statins, which have been shown to reduce choles- terol and prevent heart attacks.

-Sodium and salt

Sodium is one of the minerals the body needs to function properly. But while we need some sodium, most of us eat far more than we need. Salt (sodium chloride) is the major source of sodium in our diet. Salt is in virtually all processed foods, including bread.

Give up smoking

While smoking does not itself cause high blood pressure, it does enormously increase associated risks, including heart attack, stroke and other serious serious conditions, such as gangrene of the legs. If you have high blood pressure, you smoke and you’re under fifty, you’re three times more likely to have a heart attack than a non-smoker the same age with high blood pressure. Over 50, you’re twice as likely. In fact, people who have heart attacks under forty are almost always smokers.

Once you stop smoking, the extra risk of heart attack is quickly reduced, along with your risk of other serious health conditions. Some people are reluctant to give up smoking for fear of putting on weight, but the risks of smoking far outweigh those associated with a small increase in weight.

The key to stopping smoking is to keep trying – many people who eventually give up smoking failed the first time they tried.

Exercise more

There’s no doubt that regular exercise is helpful for people with high blood pressure. In fact, regu- lar exercise has about the same long-term effect as blood-pressure-lowering medication – reducing blood pressure on average by 4 over 2.5 mmHg. As well as improving blood pressure, exercise also reduces the risk of other major diseases, includ- ing diabetes, stroke and coronary heart disease. It also helps with weight control and increases energy output.

This doesn’t mean you have to push yourself to extremes where you’re sweaty and completely out of breath. Any increase in physical activity is beneficial, including dancing, walking the dog or gardening. Moderate, regular exercise is just as good for your health as very strenuous exercise.

Manage your diabetes

The best way to avoid complications from diabetes such as high blood pressure is to work hard to prevent or manage diabetes. You can regulate your blood sugar levels by modifying your lifestyle and eating habits in much the same way as outlined in this chapter, combined with regular medical check- ups.

More than two-thirds of people with type 2 diabetes require medication to lower their blood pressure and reduce their risk of heart attack or stroke. They usually need to take several different blood-pressure-lowering drugs and also change their lifestyle.

This is an edited extract from The Baker IDI Blood Pressure Diet and Lifestyle Plan, available now through Penguin Books.