Hypertension, or high blood pressure, can sneak up on someone; even those who are seemingly healthy otherwise. In fact, new research shows that almost half of all Americans—a staggering 46%—are now categorized as having hypertension, while that number used to be closer to 38%. This means a huge portion of the population is at an increased risk for heart disease, stroke, kidney failure, and even blindness. Every medical organization agrees that we should start with diet and lifestyle changes to improve blood pressure and avoid these other health problems as well.

It’s easy to understand why balanced blood pressure is critical for optimal health and wellness; as blood pressure increases, your heart has to work harder, cumulatively damaging the walls of your arteries and creating inflammation. Ideally, you want your blood pressure to be less than or equal to 120/80 and luckily, there are lots of things you can do to naturally push your blood pressure in the right direction. Diet and lifestyle choices like exercise and stress management can work wonders in supporting optimal cardiovascular health.

1. DASH when you dine.

The DASH diet is based on real whole foods, is low in processed foods and sugar, and high in fiber and phytonutrients—beneficial compounds that come from plant foods. An easy approach to eating for optimal blood pressure is to get a variety of colors from lots of vegetables and some fruits (the whole rainbow!) in your diet everyday. Spinach, peppers, blueberries, strawberries, mushrooms, and onions are some of my favorite phytonutrient dense options.

2. Watch ratio of sodium to potassium. 

We have all heard that too much sodium can raise your blood pressure. But, this is only partly true. First of all, only some of us are salt-sensitive (though all of us need to avoid the salt in processed foods). That means that some people will experience a rise in blood pressure from eating too much salt, while others won’t. Secondly, the more important thing to focus on is the ratio of sodium to potassium in your diet, in order to provide your body with the ideal balance of minerals for healthy blood pressure. The Standard American Diet (or SAD diet) is high in sodium and low in potassium. This is the opposite of what we want. Focus on increasing your vegetable and fruit intake, and you will naturally increase your potassium intake. Focus on avoiding processed foods, and you will naturally lower your sodium intake.

3. Shed some extra weight.

For every 5 percent of excess weight lost, you can lower your blood pressure by three points. That means that if you are 40 pounds overweight, and you lose 2 of those pounds, you can expect to see your blood pressure decrease by three points. It’s amazing to see how much of a difference 2 pounds can make for some people. Eating the wholesome foods mentioned above is the perfect way to shoot for a healthy and manageable weight. If you have high blood pressure and you’re already at a healthy weight, you’ll want to instead look at other factors to see what you can tweak.

Some people may be of normal weight, but they are TOFI (Thin on the Outside Fat on the Inside). This means that their weight may be normal, but they may have signs of metabolic syndrome when we look deeper, like an imbalanced waist/hip ratio. An ideal W/H ratio is <0.8 for women and <0.9 for men.

To take your W/H ratio measurements:

• For your waist, wrap a measuring tape across your back, just above the highest point of hip bone or ½ way between here and the bottom of your 10th rib. Be sure the tape is horizontal to floor, just above the navel.
• Tape should be snug but not compressing skin, you should be able to breathe normally.
• For your hips, measure at the widest point, right below the bones of your pelvis and around your buttocks.
• Divide your waist measurement by your hip measurement.

If you are holding on to too much weight around your midsection, this increases your risk of having high blood pressure. Concentrate on exercise to improve your percentage of lean muscle mass. This person may not need to monitor the scale, but they probably have too much body fat. For the person with an elevated waist to hip ratio or too much weight around the belly, the W/H ratio may be better the monitor than the scale.

4. Get regular exercise.

Add in at least 40 minutes of moderate to vigorous activity three to four times per week and you can lower your blood pressure by up to five points. Keep in mind, while more intensive exercise might be practiced just a few times a week, it’s still important to incorporate some kind of movement into your routine each and every day. In addition, two of those days per week should include resistance exercise that will help build lean muscle mass. This will improve your metabolism, W/H ratio, and risk of high blood pressure. Working on this can produce a ton of other health benefits on top of lowering your blood pressure. Find something you enjoy doing and feel free to mix it up day to day.

5. Breathe deeply and get to know your diaphragm.

Harvard physician Herbert Benson was the first physician to popularize the mind-body connection and show that 15 minutes of deep breathing daily can lower a person’s blood pressure. He developed the RESPeRATE, a FDA-approved device to guide a person to engage their diaphragm through slow deep breaths. Breathwork can calm the body, improve our well-being, and lower blood pressure. Incorporate 15 minutes into your daily routine and you won’t be disappointed!

While the diagnosis of elevated blood pressure is alarming and should be taken seriously, there’s a lot you can do to naturally support your cardiovascular system and begin lowering those numbers. Start slowly with these five simple steps and you’re sure to notice many whole-body benefits.