Patient: Hello, I am 33 years old, 210 pounds six foot one. My resting heart rate is between 53-68 beats a miniute. I am working on losing 15-20 more pounds over the next year or so. I power walk 7 days a week, jog on most days and lift weights several days a week.In addition my job involves more walking and physical labor. One month ago I had an EKG, chest X-ray, full blood work, and basic physical performed. Everything is normal except elevated bilirubin, but I am negative for hepatitis and I went from light drinking to no drinking. I quit drinking caffienated bevaerages except for decaf coffee which has a trace amount of caffiene.A couple of years ago had 2 head ct’s which is clean. Carotids are working fine and vision is still 2020. Between 2005-2007 my BO would occasionally spike due to stres and too much coffee while attending college full time to as high as 190 over 100, stroke and heart attack territory. Thereafter, it would no longer spike that high but would average 153 over 85 to 160 over 90 upon physical examination.I then gave up caffeine and reduced sugar intake,and increased fruit intake considerably. I have always been physically active. Over the past 2 years or so my BP now only spikes on occasion right after physical activity in the low 140’s, but when relaxed I have an equal mode of 132 and 128 over 80 bp. Averaged out over a month and more than 40 bp readings from a pharmacy monitor show an arithmetic mean of 134 over 83. The longer I diet the more bp readings I get in the 125 over 77 to 128 over 80 category, which is not quite normal, but is far below what is used to be. My question is this: what else besides medication can I be doing to get a lower systolic diastolic arithmetic mean reading and lower mode readings? Except for occasional early mornings (6 am) or after brisk walking my bp is now in the prehypertensive range consistently.