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Systemic arterial hypertension (SAH) remains a leading global cause of premature death, significantly increasing the risk of cardiovascular, cerebrovascular, and renal diseases. While non-modifiable factors, such as age and genetics, contribute to its development, lifestyle changes are crucial for prevention and management. Dietary modifications, such as reducing sodium intake, increasing potassium, and adopting a diet rich in fruits and vegetables, combined with regular physical activity, weight management, smoking cessation, and reduced alcohol intake are effective strategies for lowering blood pressure. Recent research has increasingly focused on bioactive compounds with antioxidant and anti-inflammatory properties for the management of SAH. Substances such as polyphenols, curcumin, and other plant-derived compounds, as well as live microorganisms such as probiotics, are being actively studied for their potential to improve endothelial function, modulate nitric oxide production, and reduce oxidative stress. This narrative review summarizes the current evidence on dietary interventions and bioactive compounds as complementary approaches to traditional treatments, examining their mechanisms of action.