Plans for Your Body · Heart & circulation
The blood pressure plan
High blood pressure is a plumbing problem with a metabolic cause.
The goal: Measure it properly at home first. Then lower insulin, cut processed-food salt, eat more potassium, lose waist, add wall sits to your training, and fix your sleep. Retest weekly at home and with your doctor at 3–6 months. If you take blood pressure medication, your doctor adjusts it as your numbers fall.
One reading at the doctor’s office, slightly nervous, after rushing through traffic, and you’re labelled. Or not labelled, and missed. This plan gets you a real number at home, works on what pushes it up, and lets the readings tell you if it’s working.
- MeasureA week of home readings, done properly · waist · fasting insulin
- ChangeLower insulin · less processed salt · more potassium · wall sits · sleep
- RetestWeekly at home, with your doctor at 3–6 months
Most people treat the pressure. This treats what’s pushing it.
Not medical advice
Discuss everything here with a medical doctor before acting on it — supplements included. Your doctor has your bloodwork and history. We have neither.
02 Why it matters
The silent one.
The default
No symptoms, so it gets ignored until it isn’t. High blood pressure is a leading driver of strokes, heart attacks, heart failure and kidney disease, and it does its damage quietly, for years.
The better bet
Lifestyle changes move it more than most people expect: the DASH diet alone lowered systolic pressure by about 11 mmHg in people with hypertension, and isometric exercise by about 8. That’s roughly what one medication does. Results vary, and not everyone gets there on lifestyle alone.
Knowing what raises it changes what you do. Here’s the mechanism.
03 How it works
High insulin tells your kidneys to hold salt.
Insulin does more than move sugar. It tells your kidneys to hold on to sodium, and with sodium comes water. More fluid in the same pipes means more pressure. Chronically high insulin also tightens blood vessels and revs up the stress response. That’s the link Fung and Jamnadas put first. Salt, potassium, alcohol and weight are the levers with the longest trial record, much of it from Paul Whelton’s trials.
- Systolic / diastolic
- The top number is pressure when your heart beats; the bottom, between beats. 130/80 or higher is hypertension by the 2025 US guideline; Canada diagnoses at 135/85 on home readings.
- Insulin and the kidneys
- Insulin signals the kidneys to reabsorb sodium, so a body that runs on high insulin all day holds more salt and water than it needs. That’s one reason cutting refined carbs can drop pressure before the scale moves much.
- Sodium and potassium
- Sodium holds water; potassium helps your kidneys let it go. Most sodium comes from processed and restaurant food, not the salt shaker. Most people eat too little potassium. In Whelton’s Trials of Hypertension Prevention, people coached to eat less sodium had about 25% fewer cardiovascular events 10–15 years later.
- Waist
- Visceral fat raises insulin and pressure. Roughly 1 mmHg comes off for every kilogram lost.
- Sleep apnea
- Loud snoring, gasping, daytime exhaustion. A common, treatable cause of blood pressure that won’t come down.
- White-coat effect
- Readings at the doctor’s office often run high. Home readings, done right, are the better guide.
04 The steps
Measure it right. Lower what pushes it. Retest.
With your doctor · If you take blood pressure medication
Your numbers will fall. Your doses may need to as well.
- Tell your doctor firstbefore you start
Cutting carbs and fasting lower blood pressure, sometimes quickly. On full-dose medication that can mean dizziness or fainting.
- Know the signstoo low
Lightheaded when you stand, blurred vision, unusual fatigue. Sit down, check your pressure, and call your doctor.
- Never stop on your ownyour doctor adjusts
Some blood pressure drugs rebound if stopped suddenly. Every change goes through your doctor.
Measure · Week 0
Get a real number, not a nervous one.
- Home monitorvalidated upper-arm cuff
Wrist cuffs and phone apps are unreliable. Buy a validated upper-arm monitor in the right cuff size.
- How to measuremorning and evening, 7 days
Seated, back supported, feet flat, arm at heart height, bare arm, 5 minutes of quiet first. No caffeine, exercise or smoking for 30 minutes. Two readings a minute apart. Ignore day one; average the rest.
- Fasting insulin and glucosemorning, after an overnight fast
Together they give HOMA-IR, a simple insulin-resistance score. Fasting insulin often isn’t covered in Canada. It’s cheap to pay for. High insulin with high blood pressure points straight at this plan’s main lever.
- Waisttape measure
At the belly button. More than half your height points to visceral fat.
- Kidney function and potassiumblood test
Your doctor checks these anyway. They matter before you use a potassium salt substitute.
Change the inputs · Weeks 1–12
Lower insulin, lose the processed salt, train smarter.
- Sugar and refined carbscut hard
Sugar, sweet drinks, juice, white flour and most packaged snacks. The fastest lever on insulin, blood sugar and triglycerides. Lower insulin means your kidneys let go of sodium and water. Many people see their pressure drop within weeks.
- Processed-food saltcut the packets, not the shaker first
Most sodium comes from bread, deli meat, sauces, soups, snacks and takeout. Cooking real food removes most of it without counting milligrams. The sodium cuts in Whelton’s trials were modest and still counted.
- Potassiumfrom food
Leafy greens, avocado, beans, squash, potatoes, yogurt, fish. Potassium is half of why the DASH diet works.
- Eating windowdaily, e.g. noon to 8 pm
Eat inside a fixed window and not outside it. Fewer insulin spikes per day, fewer chances to overeat.
- 36-hour fastonce a week
Dinner one day, then only water, black coffee or tea until breakfast two days later. A standard protocol in Dr. Fung’s clinic: long enough for insulin to fall and the body to draw on stored fat. A pinch of salt helps with headaches. Fasting lowers insulin and sheds water and sodium. Blood pressure often falls during fasting periods, which is why medication needs watching.
- Wall sits4 × 2 min, 3×/week
Isometric exercise lowered systolic pressure by about 8 mmHg in the largest analysis of exercise trials, more than any other type. Back against the wall, knees bent, hold. Breathe; don’t hold your breath.
- Trainingstrength 2–3×/week, cardio 150+ min/week
Lift, and walk briskly or cycle most days. Muscle is where most of a meal’s glucose ends up, so more muscle means more room for it. Cardio makes that muscle more sensitive to insulin. Cardio and strength both lower pressure; combined training ranked second only to isometrics.
- Sleep7+ hours
One short night measurably worsens insulin sensitivity, blood sugar and appetite the next day. The cheapest part of the protocol, and the most skipped. If you snore loudly or wake exhausted, ask your doctor about a sleep apnea test.
- Alcoholnone while fixing the numbers
It goes straight to the liver, raises triglycerides and adds to liver fat. Less is better; none is best while you’re fixing the numbers. Alcohol raises blood pressure directly. Cutting back is one of the fastest wins.
- Saunaoptional, if you have access
Rhonda Patrick reviews the case for regular sauna: heat stress works the blood vessels a bit like exercise does. In a Finnish cohort, men who used one 4–7 times a week were about half as likely to develop high blood pressure as once-a-week users. Observational: sauna users may differ in other ways. Not if your pressure is uncontrolled or you have heart disease without your doctor’s OK; skip alcohol and drink water.
Before you fast
Don’t do extended fasts if you’re on insulin or other diabetes medication, pregnant, breastfeeding, underweight, or have a history of eating disorders, unless your doctor approves.
Supplements · optional, with your doctor’s OK
Two with evidence behind them, one maybe.
- Potassium-enriched saltUse it in place of regular salt
It swaps some sodium for potassium. In a five-year trial of about 21,000 older adults with high blood pressure or a past stroke, it cut strokes by 14% and deaths by 12%; pooled trials found systolic pressure about 4–5 mmHg lower. Don’t use it if you have kidney disease or take a drug that raises potassium (such as spironolactone): potassium can build up to dangerous levels. Pooled trials found systolic pressure about 4–5 mmHg lower. Some blood pressure pills raise potassium too, so ask your doctor first.
Find it on Amazon: Potassium-enriched salt - Magnesium~300–400 mg a day of elemental magnesium, with food
Lowered blood pressure by about 2 mmHg in pooled trials, and modestly improved blood sugar in people with or at risk of diabetes. Small, but cheap and safe for most. Loose stools are the usual side effect. Avoid with kidney disease, and take it a few hours apart from thyroid pills, osteoporosis pills and some antibiotics. Lowered blood pressure about 2 mmHg in pooled trials: small but real. Glycinate or citrate are easier on the stomach.
Find it on Amazon: Magnesium - Beetroot juice (dietary nitrate)One nitrate-rich shot a day
The body turns dietary nitrate into nitric oxide, which relaxes blood vessels. In pooled trials systolic pressure fell about 4 mmHg, but the trials were small and short. Choose a product that states its nitrate content. Pink urine is harmless; beetroot is high in oxalate, so ask first if you get kidney stones. Evidence is modest: short, small trials found systolic about 4 mmHg lower, and long-term data are thin.
Find it on Amazon: Beetroot juice (dietary nitrate)
Retest · Weekly, and at 3–6 months
Let the readings decide.
- Weekly averagesame time, same arm
Three days of morning and evening readings each week. Track the average, not single readings.
- 3–6 monthswith your doctor
Bring your home log. The 2025 US guideline gives lifestyle changes 3–6 months before recommending medication in stage 1.
- If the numbers won’t moveyour doctor
Take the before-and-after numbers to your doctor. Whether you need medication is their call. Needing it isn’t failure. If you’re above 140/90 or have diabetes or kidney disease, don’t wait out the 3–6 months: see your doctor now.
05 The rules
Short list. No exceptions.
Choose
- Real food you cook, so you control the salt
- Potassium-rich vegetables, beans and yogurt
- Wall sits three times a week, plus walking or lifting
- A validated upper-arm monitor and a written log
Avoid
- Processed meat, packaged snacks, sauces and takeout
- Sugar and refined carbs, which raise insulin and salt retention
- Alcohol, especially more than a drink a day
- Judging your pressure on one office reading
Non-negotiables
- Measure at home, properly, before you decide anything.
- If you take blood pressure medication, your doctor adjusts it as you improve.
- Don’t smoke. Each cigarette pushes your pressure up for a while. Quitting cuts the heart risk smoking adds, fast at first, though it stays above a never-smoker’s for years.
- Readings of 180/120 or higher, or chest pain, shortness of breath or weakness: emergency care, now.
06 Checkpoints
What to track, and what good looks like.
Your doctor sets your target. These are the standard thresholds.
| What | Target | How and when |
|---|---|---|
| Home average | <135/85 (Canada) · <130/80 (US guideline) | Morning and evening for 7 days, discard day one, average the rest. |
| Office reading | <130/80, ideally near 120/80 | At each visit. Bring your home log. |
| Waist-to-height | <0.5 | Monthly. |
| HOMA-IR | Under ~1.0 ideal; over ~2.5 suggests insulin resistance | Fasting glucose (mmol/L) × fasting insulin (µU/mL) ÷ 22.5. |
| Weight | Down, if you carry excess | Weekly. About 1 mmHg per kilogram lost. |
A single high reading isn’t a diagnosis; a week of home readings is evidence.
07 Where experts disagree
Where the experts don’t agree.
Everyone agrees lifestyle lowers blood pressure. The fights are over salt, and what comes first.
How hard should you cut salt?
Strict: Whelton, AHA, WHO
Less is better, all the way down: under 2,000 mg of sodium a day, ideally 1,500. In the TOHP trials, cutting sodium lowered pressure, and long-term follow-up found fewer cardiovascular events.
Moderate: Mente, Yusuf (PURE study)
Very low intakes were linked with more cardiovascular events, not fewer. The risk sits mainly with high salt intake.
Our read Critics showed PURE’s J-curve may be a measurement artefact. Practically: cut processed-food salt hard, eat more potassium, and don’t fear the shaker on food you cooked yourself.
Is it the salt, or the insulin?
Insulin first: Fung, Jamnadas
High insulin makes the kidneys hold sodium and water. Fix insulin and pressure often follows, sometimes before much weight is lost.
Salt and diet pattern first: guideline committees
Sodium reduction and the DASH diet have the strongest trial evidence. Lower sodium, more potassium, less alcohol.
Our read They overlap more than they argue. Cutting refined carbs and processed food lowers insulin and sodium at the same time.
How low should you go?
Lower is better: SPRINT trialists (Whelton among the leaders), 2025 US guideline
Aim under 130/80, as close to 120 as possible. Lower targets cut heart attacks and strokes.
Careful in older adults: many clinicians
Pushing hard with medication causes dizziness and falls. Targets should fit the person.
Our read Lifestyle lowers pressure without the side effects, so push it as far as it goes. Medication targets are your doctor’s call.
08 Limits
What this plan won’t fix.
Some causes are medical
Kidney artery narrowing, hormone disorders (like excess aldosterone) and some medications raise blood pressure regardless of diet. If yours won’t budge, ask your doctor to look for one.
Stiff arteries
Years of high pressure stiffen arteries. Lifestyle helps, but older arteries may still need medication.
Genes and age
Blood pressure tends to rise with age, and some families run high. You can shift your number, not your birth certificate.
The plan lowers the pressure. It can’t replace a diagnosis your doctor needs to make.
09 Resources
Worth your time.
The Obesity Code
Why insulin sits underneath weight gain, and much of what comes with it, blood pressure included.
Why this cardiologist recommends fasting
Jamnadas on insulin, visceral fat and the heart, in his own words.
Hypertension Canada 2020 Comprehensive Guidelines
What your Canadian doctor works from, including how to measure at home.
Long term effects of dietary sodium reduction on cardiovascular disease outcomes (TOHP follow-up)
The trial follow-up behind the case that cutting salt prevents events, not just lowers a number.
10 Questions
Questions, answered plainly.
How can I lower my blood pressure quickly?
Cut alcohol, processed food and refined carbs, and start wall sits. Many people see home readings fall within weeks. If you’re above 180/120 or have symptoms, that’s an emergency, not a lifestyle project.
What is a normal blood pressure?
Under 120/80 is normal. 130/80 or higher is hypertension by the 2025 US guideline; in Canada, a home average of 135/85 or higher.
Do wall sits really lower blood pressure?
Yes. In a 2023 analysis of 270 exercise trials, isometric training lowered systolic pressure by about 8 mmHg, the most of any exercise type, and the wall squat was the single most effective exercise.
Is salt really bad for blood pressure?
For most people with high blood pressure, yes, especially the hidden salt in processed food. Raising potassium at the same time matters as much as cutting sodium.
Can I come off blood pressure medication?
Some people can reduce or stop as their numbers fall, but only your doctor can make that call. Some drugs must be tapered, not stopped.
11 Sources
Where this comes from.
Experts drawn on
- Jason Fung, MD — Nephrologist, Toronto. Author of The Obesity Code.
- Pradip Jamnadas, MD — Cardiologist, Florida. Clinical assistant professor; known for his lectures on fasting, insulin and heart disease.
- Andrew Mente, PhD, and Salim Yusuf, MD — Epidemiologists, McMaster University. Lead investigators of the PURE study.
- Jamie Edwards, PhD — Exercise physiologist, Canterbury Christ Church University. Led the 2023 analysis of exercise and blood pressure.
- Paul Whelton, MD — Physician and epidemiologist, Tulane University. Led the 2017 ACC/AHA blood pressure guideline and major trials including TOHP and SPRINT.
- Rhonda Patrick, PhD — Biomedical scientist (PhD, biomedical science). Research and reviews on micronutrients, omega-3s, sauna and ageing; FoundMyFitness.
Sources
- Top 10 prevention takeaways from the 2025 high blood pressure guideline. Healio (summary of the 2025 AHA/ACC guideline), 2025.
- Hypertension Canada’s 2020 Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension. Canadian Journal of Cardiology, 2020.
- Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis. British Journal of Sports Medicine, 2023.
- Salt Substitute and Stroke Study (SSaSS). American College of Cardiology (summary of NEJM 2021), 2021.
- Effect of salt substitution on cardiovascular events and death. New England Journal of Medicine, 2021.
- Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis. Heart, 2022.
- Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. Journal of Nutrition, 2013.
- Effects of magnesium supplementation on blood pressure: a meta-analysis of randomized double-blind placebo-controlled trials. Hypertension, 2016.
- Insulin resistance and high blood pressure: mechanistic insight on the role of the kidney. Biomedicines, 2022.
- Sodium, potassium and cardiovascular events: PURE study analysis. PURE investigators (PubMed Central).
- Sauna bathing and incident hypertension: a prospective cohort study. American Journal of Hypertension, 2017.
- Sauna use as a lifestyle practice to extend healthspan. Experimental Gerontology, 2021.
- Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ, 2007.
- 2017 ACC/AHA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension, 2018.
- Why this cardiologist recommends fasting, with Dr Pradip Jamnadas. Feel Better, Live More podcast.
Not medical advice
Discuss everything here with a medical doctor before acting on it — supplements included. Your doctor has your bloodwork and history. We have neither.