Purpose: Hypertension is a major modifiable risk factor for cardiovascular morbidity and mortality. While pharmacological management is standard, dietary modification, specifically reducing sodium and increasing potassium/magnesium intake, is a critical, sustainable component of long-term control. This case report aims to document the short-term reduction and long-term management of severe hypertension in a patient using an alkaline salt substitute (low sodium, high potassium, high magnesium) as a non-pharmacological intervention. Case Description: A 62-year-old female with a 3-year history of hypertension presented with headache and dizziness. Her vital signs revealed severe hypertensive urgency (BP 230/110 mmHg) without evidence of acute end-organ damage (normal EKG, clear chest X-ray, no focal neurological deficits). Initial blood pressure reduction was achieved using sublingual nifedipine 10mg, which reduced the mean arterial pressure (MAP) by approximately 25% within 24 hours (180/90 mm Hg after 24 hours). The long-term management strategy was then transitioned to sustained dietary modification. Intervention/Outcome: Following initial stabilization, the patient was transitioned to a regimen incorporating a low-sodium, high-potassium, high-magnesium alkaline salt substitute. The goal of this non-pharmacological intervention was to achieve sustained blood pressure control and prevent recurrence of hypertensive urgency. Conclusion: This case report highlights that factors such as medication non-adherence (irregular or missed doses), even in a patient with previously controlled blood pressure, can precipitate a hypertensive urgency. While initial management necessitates prompt pharmacological stabilization (as evidenced by the need for sublingual nifedipine), the long-term sustainability of blood pressure control is significantly enhanced by non-pharmacological interventions. Specifically, the introduction of a low-sodium, high-potassium, high-magnesium alkaline salt substitute proved to be a feasible, effective, and sustainable dietary strategy for maintaining long-term blood pressure control and preventing recurrent acute hypertensive episodes.