While medications that lower blood pressure are a key tool, many nondrug strategies are also useful, but often neglected. Lifestyle changes are not easy, but should be central to how we approach high blood pressure. Changes in physical activity, diet, sleep and weight not only lower blood pressure with few side effects, but also favorably impact the risk of other important outcomes such as cancer and cognitive decline. Many drugs work more effectively when combined with lifestyle changes. The new guidelines hinge on people at higher risk for future bad events — like heart attacks and strokes — being treated more intensively. This requires being more aggressive about lifestyle changes, as well as being more willing to prescribe multiple medications for blood pressure. A good first step for many people is to begin a routine of walking each day with a gradual increase in the distance covered.