Dr. Hibberd's answer:
 

Hypertension stresses and kills the cell lining of your fragile arteries. These vessels feed your tissues with oxygen, nutrients, and glucose, as well as serving as a hormone conduit to your tissues. The most recognizable adverse effects associated with uncontrolled hypertension are seen as aneurisms, premature heart attacks, kidney failure, and strokes.
 

Some of us are salt sensitive, and reduction of dietary sodium — to 2,000 milligrams a day or less — helps reduce blood pressure. Weight and stress management help some. But hypertension needs attention early, and until other factors can be modified, drug therapy is usually advised.
 

You can always taper the drug therapy to fine tune your blood pressure as other risk factors are managed and modified. A salt-reduced diet often takes weeks to produce results, and weight reduction may take months or years.
 

Sometimes there are other causes such as hyperthyroidism, or renal artery stenosis (blocked or narrowed renal artery) that can be remedied by other medication or surgical management. But in the meantime drug management with lifestyle changes remain at the mainstay of treatment for most people regardless of cause.