Recently I wrote about a patient I met many years ago. Like most people, he spent a fair amount of time thinking about medical expenses. That was understandable, as his elevated blood pressure required treatment with four medications.

I explained to him that if he could make a couple of lifestyle changes, there was a good chance that he would be able to reduce the number of blood pressure medications he took. Could he take a short walk when possible? Could he cut back on ultraprocessed food items, like Ritz crackers and cheese whiz, and substitute homemade popcorn and a slice of Jarlsberg or cheddar on wasa crackers? What about more fresh fruit and vegetables? Maybe, but he was worried about the cost.

A colleague of mine with an interest in aging research has always had a unique way of thinking about how function changes with age. Once he sat down and shared his idea with me. He compared two theoretical men, both of whom live to the ripe old age of 88. The first was an active individual who ate a nourishing diet, had several strategies for managing stress, and maintained a high level of function almost all the way to the end of his life. In my colleague’s vignette, this man spends his last years essentially as he spent his earlier ones, engaging in the various activities that have always brought him joy. This represents the goal to which my colleague aspires and, to be honest, so far that’s exactly how his life is playing out.

The second individual, in contrast, begins in his 60’s to experience a noticeable reduction in his functioning. Arthritis, diabetes, heart disease, and, later, a stroke all begin to take their toll, so that by his 70s it can no longer be said that he is in good health. His later years are spent very differently than his earlier ones. Even a local outing to see a baseball game is a struggle; distant travel to see old friends becomes out of the question.

These descriptions represent two very different theoretical approaches to aging. Of course many people become ill through serendipity alone, and certainly no single individual will ever control all the variables that affect their health. Nevertheless, there are proven ways to increase the likelihood of living a longer, healthier life.

I asked my patient to bring all his medications to his next appointment, and then I lined them up on the counter. I asked about their costs, and picked out one. “If you make a few changes like the ones we’ve been talking about,” I said, “there is a good chance your blood pressure will improve sufficiently to discontinue this medication. And that may increase your grocery budget.”

He checked his blood pressure at home weekly, and shared the results with me at our next appointment. I taught him that if he began to feel dizzy when he rose quickly from sitting, it might be a sign that his blood pressure was getting too low, in which case he should call the office right away. A few months later, I was able to discontinue that blood pressure medication.

I continued to remain hopeful that the lifestyle changes he made would continue to have a beneficial effect on many other aspects of his health and function. Blood pressure medications may improve your blood pressure, but lifestyle changes have the potential to improve a great many other aspects of your health as well.