High blood pressure is a major risk factor for heart disease, stroke, and peripheral vascular and kidney disease. In the United States, 30 percent of the entire population over the age of 18 has hypertension as defined by a top or systolic pressure above 140 or a bottom or diastolic pressure above 90.

The prevalence rises with advancing age. The disease affects 50 percent of the population over 65 and 66 percent of those over 75. As many as 40 percent of individuals have significant hypertension that is not being treated, and for those over the age of 75, only 25 percent with systolic pressures of 180 are receiving treatment.

The benefits of treatment are proved, and medications used for over a half a century are highly effective in returning blood pressure to normal and reducing the risk of life threatening and debilitating illnesses by 50 percent or more.

Because hypertension is a silent killer, adults must measure their blood pressure a few times every year. A visit to the doctor is not needed as every drugstore has a machine that can accurately measure blood pressure and identify a problem at its very earliest stages.

Just as important is a public-health strategy to prevent hypertension that can be achieved by lifestyle changes that include exercise, weight control, diet and stress management.

First and foremost is controlling stress — perhaps the most critical risk factor in developing hypertension. Although a natural part of life and the way we respond to challenges, stress causes acute and chronic hormonal changes that lead to high blood pressure.

Acute stress stimulates the release of noradrenalin and adrenalin that increases the heart rate and causes constriction of arteries that raise blood pressure.

Chronic stress raises blood pressure by increasing hormones that cause sodium retention, alteration in appetite and weight gain.

More and more evidence shows that, as a nation, we are not dealing with stress well. According to a recent survey of the American Psychological Association, 78 percent of Americans admit to using poor coping skills when it comes to stress.

Learning to unwind and seek true and inner peace saves lives. Dealing with stress requires education, time and commitment. There are many relaxation techniques available, including medication, prayer, yoga, tai chi, breathing exercises and an approach called guided imagery. Books, tapes and even smart phone applications can teach relaxation techniques that suit everyone's personality and schedule.

Eating a prudent diet that limits salt intake reduces the risk of hypertension. The average American consumes 10.5 grams of salt daily, twice as much as the recommended amount.

Simply being a savvy shopper can reduce salt intake while simultaneously providing a more healthful diet. Try and buy fresh or frozen foods over canned, and always read the salt content of any food bought. Wherever possible, buy food with the lowest salt content and avoid adding too much salt, particularly if suffering from hypertension.

The best diet for our health and blood pressure is the Dietary Approaches to Stop Hypertension diet. Developed by the National Institutes of Health and the American Heart Association, this diet includes fruit and vegetables, lower fat foods, more whole grain products and foods rich in magnesium, potassium and calcium.

Of course, no healthy lifestyle is complete without exercise, and it is not surprising that increasing exercise and being physically fit lowers blood pressure.

Using these approaches will reduce the prevalence of hypertension within the community, but according to many health experts, they should also be the initial effort to treating mild to moderate elevation of blood pressure. Lifestyle changes should always be recommended for anyone whose blood pressure is consistently above 120 over 80. Referred to as "prehypertension," these minimal elevations are risk factors for major diseases. And even for those with blood pressures as high as 145, lifestyle changes can be attempted before resorting to lifelong medication use.

Preventive care makes so much sense. And for every common illness the approach is the same. Although hard to achieve, lifestyle changes are the best, safest and most predictable approach to living a long, healthy life.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at:

www.drdavidhealth.com