The DASH diet, which is high in fruits, vegetables, potassium, calcium, magnesium, and fiber and low in saturated and total fat, has been demonstrated to be effective in lowering BP. Among those diagnosed with hypertension, the DASH diet produces, on average, overall reductions in SBP and is particularly effective among black patients.71 Conversely, among blacks, a US Southern-style diet characterized by high intake of fried foods, organ meats, processed meats, added fats, high-fat dairy foods, sugar-sweetened beverages, and bread contributes to the disproportionate burden of hypertension.72 and vegetarian dietary patterns77 have been demonstrated to lower BP. There is a strong and dose-dependent association between excessive alcohol consumption (>3 standard drinks per day) and BP. There is strong evidence that adequate physical activity lowers BP. The average reductions in SBP with aerobic exercise are approximately 2 4 mmHg and 5 8 mmHg in adult patients who are normotensive and hypertensive, respectively. In patients with ACC/AHA elevated BP, weight loss has been demonstrated to lower BP, with a dose response relationship of about 1 mmHg per kilogram of weight loss. Among patients who do not achieve weight-loss goals, pharmacological therapy or surgical procedures may be considered, with careful consideration of complications. SDM78,79 between the provider and patient should be considered in selecting specific lifestyle interventions, with consideration of the patient s individual values, preferences, socioeconomic status, associated conditions, and comorbidities to enhance adherence to lifestyle modification. 