Having high blood pressure means that you must make some changes in your life. You’ll need to do some or all of the following:

• Lose weight if you’re overweight
• Be physically active
• Choose foods low in salt and sodium
• Limit your alcohol intake
• Take your high blood pressure pills.

You don’t have to try to make all of the changes necessary right off the bat. The key is to focus on one or two at a time. Once they become part of your normal routine, you can go on to the next change. Sometimes one change leads naturally to another. For example, increasing physical activity will help you lose weight.

The first four steps can also help prevent many people from developing high blood pressure. So you can follow them with your family to keep everyone healthy.

Let’s go through each change:

Lose weight if you are overweight.

Losing extra pounds is a very important step that you can take to reduce your high blood pressure. Losing just a small amount of weight can help lower your blood pressure. For some people—those with less severe high blood pressure—losing weight may be all that’s needed to control their hypertension. For others, losing weight may reduce the medication they need to take for their high blood pressure. Two things count about weight: how much and where.

How much—As your body weight increases over your desirable weight, your blood pressure goes up.

Where—Extra pounds are bad enough, but it also matters where those pounds are stored. If they are around your belly, you are "apple-shaped." If they are around your hips and thighs, you are "pear-shaped." Where you store weight is for the most part inherited from your parent, just like the color of your eyes or hair, although men tend to be "apple-shaped," and women "pear-shaped." If you are apple-shaped, you are at greater risk for heart disease. But whether you are an "apple" or a "pear," you should take steps to lose extra pounds.

And by losing excess weight, you will not only help to reduce your blood pressure but also feel better, be more able to exercise, and reduce your chance of having a heart attack.

To help you lose weight: Eat fewer calories than you burn. Don’t try to see how fast you can lose weight. It’s best to do it slowly. "Fad" diets do not work over the long haul because they cannot be followed for life. When people go back to their old way of eating, they usually regain the weight, leading to cycles of weight loss and gain.

Try to lose about ½ to 1 pound a week. This isn’t as hard as it sounds. One pound equals 3,500 calories—or 7 times 500. So if you cut 500 calories a day by eating less and being more active, you should lose about 1 pound in a week. For example in one day if you replace a chocolate candy bar at lunch with a small apple, have a piece of baked chicken instead of fried chicken at dinner, and then take a 15-minute brisk walk after lunch and dinner instead of lingering at the table, you can cut your calories by 500. Making these kind of changes everyday will help you to lose about a pound a week.

Keep reading to learn what foods to choose to help you lose weight. Pages 43-49 offer some menu and recipe ideas. You’ll find that you can still enjoy favorite meals—a few simple changes can turn most meals into recipes for health.

Here are two tips on how to eat to lose weight.

1. Choose foods low in calories and fat. Low calorie foods are great for losing weight. But you may not know that healthy low fat foods can also be low in calories. Fat, no matter what kind it is, saturated or unsaturated (see above), is a concentrated source of calories. So if you replace fatty foods with less fatty foods, but keep the same portion sizes, you’ll eat fewer calories. For example, save calories by eating baked fish instead of fried fish or low fat yogurt instead of ice cream. Fatty foods to cut down on include: butter and margarine, fatty meats, whole-milk dairy foods (such as cheese), fried foods, and many sweets and snacks. Try some of the enjoyable low fat alternatives for fatty foods listed on page 10.

   Foods low in fat also include those high in starch and fiber. These foods also are good sources of vitamins and minerals. Some foods high in starch and/or fiber are listed above. Try to replace foods higher in fat with these kinds of items.

2. Limit your serving size. To reduce your daily calorie intake, you’ll need to watch how much you eat, not just what. This means cutting down on portion sizes.

   Try to take only mid-sized helpings of foods high in starch and fiber, and only small helpings of fatty foods, such as cheese and high fat meats. And don’t go back for seconds.

   One good way to change what and how much you eat is with a food diary. For 2-3 days, record what you eat, when you eat it, and why. Try to include one weekend day. Be sure to include snacks. This will tell you what food habits you have—and what bad habits may be causing you to be overweight.

   Once you understand your habits, you can set goals to change them. For example, you may find you often snack on fatty, high calorie foods while watching television. Change this habit by having fresh fruit, unsalted popcorn, or unsalted pretzels handy as you watch TV. Or, you may find that you skip breakfast and then eat a very large lunch. Perhaps you picked up the habit because you don’t have enough time in the mornings to eat breakfast at home. Instead of eating too much at lunch, take a low fat muffin, bagel, or cereal with you and eat breakfast at work.

   The other part of using more calories than you eat is being physically active. Regular activity helps you lose weight—and keep it off—and improves the health of your heart and lungs.

   Be physically active.

   Regular activity does more than help you lose weight: It makes you feel and look better, helps lower high blood pressure, and can reduce your risk of having a heart attack.

   You don’t have to run marathons to benefit from physical activity. Any activity, if done at least 30 minutes a day over the course of most days, can help. Look on page 15 for ideas to get you moving.

   Certain forms of activity are best for conditioning your heart and lungs. Called "aerobic," they cause the body to use oxygen more efficiently. Examples include brisk walking, swimming, bicycling, and running. The activity should be done for at least 30 minutes, three or four times a week.

   Whatever the activity, if you don’t have 30 minutes, try two, 15-minute periods or even three, 10-minute sessions. But do something!

   Many people are able to start an activity without seeing a doctor first. However, before beginning an activity, check with a doctor if you are taking high blood pressure medicine, have heart disease, have had a heart attack or a stroke, or have any other serious health problem.

   Otherwise, get out and get active. Start slowly, if necessary, and work up to a comfortable pace and schedule. You may want to start doing an activity only twice a week. Then build to three or four times a week. The key is to begin and stay with it.

   And have your family join in—regular physical activity is one of the best steps to prevent high blood pressure. Try the sample walking program to get you and your family started.