Regular at-home BP monitoring is preferred over sporadic in-office measurements. Manage hypertension with lifestyle modifications, starting with the DASH diet, which lowers BP by 10–20 mm Hg through reduced sodium and heart-healthy foods. Structured exercise (90–150 min weekly) can further reduce BP by 5 mm Hg, while limiting alcohol intake offers an additional 4 mm Hg reduction. For persistent hypertension, first-line medications include ACE inhibitors, calcium channel blockers, or thiazide diuretics, as prescribed by a healthcare provider.
January 14, 2025

High Blood Pressure: Best Drug-Free Solutions from the AHA

Evidence-Based Over-The-Counter Guide

William Shen

William Shen

Co-founder & CPO

See all guides. Have more questions?

This guide is based on American Heart Association and American College of Cardiologists guidelines.

Hypertension is defined by a systolic blood pressure ≥ 140 mm Hg and/or a diastolic blood pressure ≥ 90 mm Hg based on Joint National Commission (JNC) 8 guidelines. The condition increases the risk of cardiovascular disease, stroke, and kidney damage. Management includes lifestyle modifications and, if necessary, medications.

Importantly, daily at-home monitoring is preferred over sporadic in-office measurements as the gold standard for a patient’s baseline blood pressure.

First-line recommendations:

  • DASH Diet (Dietary Approaches to Stop Hypertension): A heart-healthy diet emphasizing fruits, vegetables, whole grains, lean proteins, and low-fat dairy while reducing sodium intake (<2300 mg/day) and limiting saturated fats and added sugars. The DASH diet is proven to lower blood pressure significantly by 10-20 mm Hg. Recommended DASH diet guide.

  • Home Blood Pressure Monitoring (HBPM): Regular at-home BP measurements help track treatment effectiveness and provide more reliable data than isolated in-office readings. Use a validated automatic BP cuff; measure twice daily (morning and evening) for optimal monitoring. Recommended FDA-registered device.

  • Structured exercise: Increased physical activity with a structured exercise program is recommended for adults with elevated BP or hypertension. 90–150 min per week of exercise (aerobic or resistance) can reduce BP by 5 mm Hg.

  • Reduce alcohol: Adult men and women with elevated BP or hypertension who currently consume alcohol should be advised to drink no more than 2 and 1 standard drinks per day, respectively. This can lower BP by around 4 mm Hg.

Prescription medications:

  • ACE inhibitors (e.g., lisinopril): Typically first-line for hypertension. Dose: 10-40 mg once daily.

  • Calcium channel blockers (e.g., amlodipine): Effective for many patients. Dose: 5-10 mg once daily.

  • Thiazide diuretics (e.g., hydrochlorothiazide): Often used as a first-line or add-on therapy. Dose: 12.5-25 mg once daily.

Citations:

Whelton, P. K., et al. (2017). 2017 ACC/AHA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension, 71(6), e13-e115.=

What OTC evidence is reviewed?

  • For each condition, we performed a literature review to find a recent widely cited expert group guideline published in the leading specialty-specific peer-reviewed journal or top general medical journal.

  • Based on the recommendations in the publication, we identify recommended active ingredients and devices that are available over-the-counter per FDA regulations.

What evidence is prioritized?

Levels of evidence considered:

  • Tier 1 (Safe and Definitely Effective): Professional field consensus or multiple randomized controlled clinical trials showing the same conclusion. Wherever possible, we use Tier 1 evidence for "first-line" recommendations.

  • Tier 2 (Safe and Probably Effective): Individual clinical trials which may be discordant or large-scale observational experience. Tier 2 evidence may inform "first-line", "second-line", or "supplement" recommendations.

  • Tier 3 (Safe and Maybe Effective): Mechanistic plausibility without high-quality clinical evidence of efficacy but high-quality evidence of safety. Tier 3 evidence may inform "second-line" or "supplement" recommendations.

How does MDandMe select recommended products?

  • Based on the top clinical recommendation, we evaluate products containing the recommended active agent with FDA-approved dosage based on price, average customer reviews, how often it is purchased, and how quickly it will ship to home. 

  • We provide public documentation of the active ingredients in our recommendations, using all 32 FDA monographs, Prescription-to-Nonprescription (Rx-to-OTC) Switches, as well as New Drug Application (NDA) approvals.

How does MDandMe select recommended devices?

  • Based on the top clinical recommendation, we evaluate devices that are FDA-cleared or comply with other medical guidelines (if not a FDA-regulated category) by reputability, price, and average customer reviews.

  • We provide public documentation of supporting evidence for each device.  

Where do I view other OTC guides?

Browse topic list here:

You can view all of our published OTC guides here.

Related Posts
How We Make OTC Guides
How We Make OTC Guides