High blood pressure affects 46% of Americans yet remains a silent killer with no symptoms. This AMA explains how to accurately measure blood pressure at home, why aggressive control matters for heart, brain, and kidney health, and which lifestyle factors—weight loss, exercise, sleep, sodium management—can rival medications in lowering blood pressure by 8-15 mmHg. Each 20 mmHg increase in systolic blood pressure doubles risk of death from stroke, heart disease, or vascular disease in adults ages 40-70.