RALPH SMITH took a lunch break one day and went to a different kind of fair—a health fair. The company where he works set up booths to tell employees about the best ways to stay healthy. One booth offered blood pressure checks. Ralph, 55 years old, hadn’t had his blood pressure checked in 5 years and the results startled him. His blood pressure was 144/94 mm Hg—above normal. The nurse told him to go to his family doctor for a complete physical. The visit to the doctor confirmed that he had high blood pressure. It also brought him some good news as well as a few pounds of bad news. The good news was that Ralph had no: Family history of high blood pressure, heart disease, stroke, diabetes, or high blood cholesterol Prior finding of high blood pressure Medical condition needing drug therapy or a doctor’s care Abnormal blood or urine test The bad news was that Ralph was a hefty 40 pounds overweight. He wasn’t getting any physical activity, and he ate salty foods, as well as those high in fat and cholesterol. He also drank two to three beers a day. The doctor cautioned Ralph that he had Stage 1 high blood pressure, and it needed to be lowered. Ralph was surprised to hear that his "treatment" called for improving his diet and fitness. The doctor explained that, because he had no family history of high blood pressure or other risk factors for cardiovascular disease, his blood pressure would probably go down without the need for any drug. The doctor told him how to change what he ate by eating fewer calories, and reducing fat and sodium. The doctor also said to be sure and eat enough potassium-rich foods, such as bananas and oranges. Ralph also was surprised to hear that he could continue drinking beers—but no more than one to two a day and only if he lost weight. To ease Ralph into some physical activity, the doctor suggested he start off with simple moves: using stairs, gardening, parking his car a few blocks away from the office, walking for 5-10 minutes a few times a week. "You want to slowly work up how much you do," the doctor told him. "Don’t go out and jog tomorrow. Just walk for 10 minutes. Gradually increase your effort until you can walk briskly for 30 minutes, three or four times a week." Ralph followed the doctor’s advice. He knew what might happen if he didn’t: A coworker had just had a stroke. But also, Ralph wanted to feel better. He decided this was his chance to trim down. He ate smaller portions, added no salt, snacked less and, when he did, bought fruit juices from the office vending machine instead of doughnuts. Sometimes he still had a drink or two at the end of the day. He had to burn up the extra calories by increasing his activity level and started climbing stairs instead of taking the elevator and took walks at lunchtime. Two months later, Ralph returned to the doctor. The doctor was impressed: Ralph was 6 pounds lighter. His blood pressure was down to 140/90 mm Hg. "I have all this new energy," he told the doctor. He also said his family had taken up his lifestyle changes. The doctor told him to keep up the good work, giving him the go-ahead to increase his walks to 30 minutes a day, three or four times a week. Over the next 10 months, Ralph’s health and fitness continued to improve. In 2 months, he’d lost 4 more pounds and his blood pressure was almost normal. Each month, the company nurse checked his blood pressure and weight. He kept losing weight, watched what he ate, and took up walking as a hobby. In fact, Ralph started his company’s lunchtime walking club. Only a year after his diagnosis, Ralph’s blood pressure was normal (134/80 mm Hg), and he felt great. And he came up with the idea of having the health clinic sponsor a weight-loss program. The kickoff was held at the annual company health fair—during which Ralph was honored as "Employee of the Month."