People who want non-drug options for managing their high blood pressure are in for some good news: there are indeed some promising natural treatments to choose from. "Right now we're seeing a cultural shift where an increasing number of people want to avoid standard pharmaceuticals," said John Bisognano, professor of Medicine and director of Outpatient Cardiology at the University of Rochester Medical Center. "We're also seeing a growing number of patients who require a large number of drugs to control their blood pressure and are looking for something else to help manage it." Bisognano and Kevin Woolf, M.D., a cardiology fellow at the Medical Center, emphasize that all patients with hypertension should adhere to the low-salt DASH diet, which is high in fiber, low in fats and incorporates lots of fruits and vegetables, and follow an exercise and weight loss regimen. Beyond these lifestyle modifications, a dietary supplement to help lower blood pressure is the antioxidant coenzyme Q10, which is also involved in energy production. Woolf also found that potassium helps lower blood pressure, and there is evidence that increasing the amount of potassium we get through the foods we eat could carry some of the same mild benefits as taking supplements. Those looking for herbal remedies can turn to mistletoe extract as a potential option, although it should be used with caution because it can be toxic at high doses. Hawthorn is another remedy that may offer a slight drop in blood pressure. However, steer clear of St. John's wort, ephedra/ma huang, yohimbine and licorice - all of which can increase blood pressure. The researchers also found that acupuncture reduces blood pressure compared to placebo in patients also taking anti-hypertensive medications. Other techniques that may provide some benefit include Zen Buddhist meditation and Qi Gong. Two devices that patients can use in the comfort of their own homes are the RESPeRATE breathing device and the Zona Plus hand drip device. The RESPeRATE system uses a breath sensor and gives patients feedback through headphones to help them slow their breathing, which research suggests benefits blood pressure. Research indicates that 15 minutes of practice daily can result in a modest reduction in blood pressure. The Zona Plus is a device that patients grip in either hand and perform multiple sets of squeezing at different levels in response to electronic cues. Bisognano says there is no good explanation as to why this works, but studies found the device decreased hypertension in patients using it three days a week for at least eight weeks.