Lifestyle modification is widely advocated as initial and adjuvant therapy for the treatment and prevention of hypertension. In addition to exercise, nutritional changes including sodium reduction, adoption of the Dietary Approaches to Stop Hypertension (DASH) diet, alcohol reduction, and weight loss have significant blood pressure lowering effects. The current challenge to clinicians has been developing and implementing practical and effective approaches for use in clinical practice. This review discusses the evidence supporting each current lifestyle recommendation, discusses evidence on specific programs or office based strategies, and provides practical advice. (c)1999 by Le Jacq Communications, Inc.