Natural therapies to lower blood pressure


I previously wrote about ways to preventive high blood pressure. Now let’s consider treatment using herbal and nutrient supplements to lower blood pressure.


Before you start taking prescription medicine for high blood pressure

It makes sense to carefully review the many ways to lower blood pressure I discussed previously. After all you can do, if you reliably and consistently have elevated blood pressure, consider treatment with natural medicine. There are many herbs and nutrient supplements shown to lower blood pressure. Remember that they may not work as rapidly as prescription medicines.


Nutrient supplements and herbal treatments for hypertension

I have learned from the American Academy of Anti-aging Medicine fellowship training that by using only nutrition, nutrient supplements, and stress-reduction, you can expect to achieve normalize your blood pressure 80% of the way. Here are the nutrient supplements that are useful to lower blood pressure:

  • Fish oil (fish or omega 3 PUFAs) at 3-4 grams daily DHA with EPA daily reduces blood pressure on average by 8 mmHg systolic and 5 mmHg diastolic (8/5 mmHg); it also lowers heart rate 6 beats/minute and lowers endothelial inflammation.[1] [2] [3] [4] [5] [6]

  • CoEnzymeQ10 has been shown in a meta-analyses[7] of 12 studies (n=362) to lower blood pressure by 17/10 mmHg at modest doses of 60 mg twice daily and in another study[8] this modest dose reduced blood pressure by 26 mm Hg systolic on average of the 55% who responded to treatment.

  • Green coffee extract contains chlorogenic acids, shown in a number of studies to significantly lower blood pressure.[9] [10] [11] [12] [13] An average dose of 140mg daily lowered blood pressure 5.6 mmHg systolic and 3.9 mmHg diastolic.

  • Polyphenols: Resveratrol,[14] quercetin, flavonoids, red wine (6 oz twice weekly), dealcolholyzed red wine,[15] purple grape juice[16] (independent of alcohol content), red grape polyphenolic extract,[17] dark chocolate,[18] [19] and other plant-derived polyphenols[20] have been shown to safely reduce endothelial inflammation,[21] increase nitric oxide (a vasodilator), and thereby lower both blood pressure and cardiovascular disease. For example, concentrated pomegranate juice (contains polyphenols) 50ml daily lowered systolic blood pressure 5% in a 2-week study[22] largely due to its ACE-inhibition (like the prescription ACE-inhibitors such as Lisinopril®) and by 12% in a year-long study[23] in which it also significantly reduced atherosclerosis (IMT reduction by up to 30%).

  • Soy isoflavones[24] [25] because they contain diadzein and genistein, they are known to lower blood pressure.

  • Lycopene extract lowered blood pressure by 9 / 7 mmHg in a small study[26] (30 study participants) for 8 weeks; when added to ACE-inhibitor, Calcium channel blocker or a diuretic medication, lycopene lowered blood pressure by 10/5 mmHg.[27]

  • L-arginine (6 grams daily) significantly increases nitric oxide secretion which is a powerful vasodilator with endothelial anti-inflammatory effects,[28] [29] [30] especially in salt-sensitive persons.[31] A meta-analysis of 11 randomized double-blinded placebo-controlled trials (387 study participants) using 4 to 24 grams daily lowered pressure 5.39 mm Hg systolic and 2.66 mm Hg diastolic on average.[32]

  • L-carnitine (1 gram twice daily) lowers blood pressure and lowers insulin resistance,[33] [34] and has maximal effect at 3 grams twice daily for the hypertensive diabetic person.

  • Taurine has pronounced beneficial heart health effects including its blood pressure lowering effect[35] [36] --best at 3 grams twice daily.

  • R (alpha) lipoic acid lowers blood pressure and improves endothelial dysfunction through beneficial effects on nitric oxide (the vasodilator) and other mechanisms at the optimal dose of 100-200 mg daily.[37]

  • Hawthorne berry has ACE-inhibition effects (like the prescription ACE inhibitors such as Lisinopril®) and mildly reduces systemic vascular resistance.[38] [39] [40]

  • Green tea extract contains epigallocatechin gallate (EGCG) which has been shown to be anti-hypertensive.[41]

  • Other teas: Dandelion leaf tea is a mild diuretic and therefore can lower blood pressure; fresh ginger tea lowers blood pressure.[42] Hibiscus tea helped lower blood pressure according to a few studies.[43] [44]

  • Ginkgo biloba has ACE inhibition effects and improves endothelial dysfunction[45] and has been found to lower blood pressure and slow heart rate, although not all studies agree.

  • Garlic and onion extracts have been found to lower blood pressure and slow heart rate[46] although not all studies agree.

  • B vitamins: take vitamin B complex and at least 200 mg of vitamin B1 (thiamin) daily.[47] Why? Because niacin (vitamin B3 or nicotinic acid) 500 to 1,000 mg is a vasodilator and taken in an extended release form will lower blood pressure and raise good cholesterol levels (HDL-C).[48] [49] Also, pyridoxine (vitamin B-6) stabilizes nitric oxide[50] (a potent vasodilator) as do the other micronutrients vitamin C, vitamin D3, and vitamin E (gamma & delta tocopherols and tocotrienols). Pyridoxine also has calcium channel-blocking effects[51] (like the prescription Calcium channel blockers Amlodipine® and Nifedipine®).

  • Vitamin D3: make sure your blood levels are 50 ng/ml or higher (on blood test), which usually requires supplementation with 2,000-5,000 IU daily if you are low.

  • Magnesium: low serum magnesium is linked to hypertension;[52] magnesium intake (diet/supplementation) is associated with less hypertension.[53]

  • Potassium: a high potassium diet of 5,000 mg daily[54] [55] is recommended (unless you have kidney failure) for optimal heart health and blood pressure. Learn how to get this amount in your diet by reading more here: http://www.winchesterhospital.org/health-library/article?id=14011

To feeling well in your long term health,


Michael Cutler, M.D.


__________________________

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[2] Alexander JW. Immunonutrition: the role of omega-3 fatty acids. Nutrition. 1998 Jul-Aug;14(7-8):627-33.

[3] Sagara M, Njelekela M, Teramoto T, Taguchi T, Mori M, Armitage L, Birt N, Birt C, Yamori Y. Effects of docosahexaenoic Acid supplementation on blood pressure, heart rate, and serum lipids in Scottish men with hypertension and hypercholesterolemia. Int J Hypertens. 2011 Mar 8;2011:809198.

[4] Toft I, Bønaa KH, Ingebretsen OC, Nordøy A, Jenssen T. Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. A randomized, controlled trial. Ann Intern Med. 1995 Dec 15;123(12):911-8.

[5] Ueshima H, Stamler J, Elliott P, Chan Q, Brown IJ, Carnethon MR, Daviglus ML, He K, Moag-Stahlberg A, Rodriguez BL, Steffen LM, Van Horn L, Yarnell J, Zhou B; INTERMAP Research Group. Food omega-3 fatty acid intake of individuals (total, linolenic acid, long-chain) and their blood pressure: INTERMAP study. Hypertension. 2007 Aug;50(2):313-9.

[6] Park Y, Oh SH, Rhee MY. Association between 24-hour ambulatory blood pressure and erythrocyte n-3 polyunsaturated fatty acids in Korean subjects with hypertension. Nutr Res. 2010 Dec;30(12):807-14

[7] Rosenfeldt FL, Haas SJ, Krum H, Hadj A, Ng K, Leong JY, Watts GF. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum Hypertens. 2007 Apr;21(4):297-306.

[8] Burke BE, Neuenschwander R, Olson RD. Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in isolated systolic hypertension. South Med J 2001;94(11):1112-1117.

[9] Watanabe T, Arai Y, Mitsui Y, Kusaura T, Okawa W, Kajihara Y, Saito I.The blood pressure-lowering effect and safety of chlorogenic acid from green coffee bean extract in essential hypertension. Clin Exp Hypertens. 2006 Jul;28(5):439-49.

[10] Ochiai R, Jokura H, Suzuki A, Tokimitsu I, Ohishi M, Komai N, Rakugi H, Ogihara T. Green coffee bean extract improves human vasoreactivity. Hypertens Res. 2004 Oct;27(10):731-7.

[11] Yamaguchi T, Chikama A, Mori K, Watanabe T, Shioya Y, Katsuragi Y, Tokimitsu I. Hydroxyhydroquinone-free coffee: a double-blind, randomized controlled dose-response study of blood pressure. Nutr Metab Cardiovasc Dis. 2008 Jul;18(6):408-14.

[12] Ochiai R, Chikama A, Kataoka K, Tokimitsu I, Maekawa Y, Ohishi M, Rakugi H, Mikami H. Effects of hydroxyhydroquinone-reduced coffee on vasoreactivity and blood pressure. Hypertens Res. 2009 Nov;32(11):969-74.

[13] Kozuma K, Tsuchiya S, Kohori J, Hase T, Tokimitsu I. Antihypertensive effect of green coffee bean extract on mildly hypertensive subjects. Hypertens Res. 2005 Sep;28(9):711-8.

[14] Biala A, Tauriainen E, Siltanen A, Shi J, Merasto S, Louhelainen M, Martonen E, Finckenberg P, Muller DN, Mervaala E. Resveratrol induces mitochondrial biogenesis and ameliorates Ang II-induced cardiac remodeling in transgenic rats harboring human renin and angiotensinogen genes. Blood Press. 2010 Jun;19(3):196-205.

[15] Chiva-Blanch G, Urpi-Sarda M, Ros E, Arranz S, Valderas-Martínez P, Casas R, Sacanella E, Llorach R, Lamuela-Raventos RM, Andres-Lacueva C, Estruch R. Dealcoholized red wine decreases systolic and diastolic blood pressure and increases plasma nitric oxide: short communication. Circ Res. 2012 Sep 28;111(8):1065-8.

[16] Stein JH, Keevil JG, Wiebe DA, Aeschlimann S, Folts JD. Purple grape juice improves endothelial function and reduces the susceptibility of LDL cholesterol to oxidation in patients with coronary artery disease. Circulation. 1999 Sep 7;100(10):1050-5.

[17] Lekakis J, Rallidis LS, Andreadou I, Vamvakou G, Kazantzoglou G, Magiatis P, Skaltsounis AL, Kremastinos DT. Polyphenolic compounds from red grapes acutely improve endothelial function in patients with coronary heart disease. Eur J Cardiovasc Prev Rehabil. 2005 Dec;12(6):596-600.

[18] Grassi D, Lippi C, Necozione S, Desideri G, Ferri C. Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons. Am J Clin Nutr. 2005 Mar;81(3):611-4.

[19] Taubert D, Roesen R, Schömig E. Effect of cocoa and tea intake on blood pressure: a meta-analysis. Arch Intern Med. 2007 Apr 9;167(7):626-34.

[20] Kanti Bhooshan Pandey and Syed Ibrahim Rizvi. Plant polyphenols as dietary antioxidants in human health and disease. Oxid Med Cell Longev. 2009 Nov-Dec; 2(5): 270–278. Online at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835915/

[21] Layne J, Majkova Z, Smart EJ, Toborek M, Hennig B. Caveolae: a regulatory platform for nutritional modulation of inflammatory diseases. J Nutr Biochem. 2011 Sep;22(9):807-11.

[22] Aviram M, Dornfeld L. Pomegranate juice consumption inhibits serum angiotensin converting enzyme activity and reduces systolic blood pressure. Atherosclerosis. 2001 Sep;158(1):195-8.

[23] Aviram M, Rosenblat M, Gaitini D, Nitecki S, Hoffman A, Dornfeld L, Volkova N, Presser D, Attias J, Liker H, Hayek T. Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation. Clin Nutr. 2004 Jun;23(3):423-33.

[24] Helena J. Teede, Barry P. McGrath, Lakmini DeSilva, Marja Cehun, Andriana Fassoulakis, Paul J. Nestel. Isoflavones Reduce Arterial Stiffness; A Placebo-Controlled Study in Men and Postmenopausal Women. Arteriosclerosis, Thrombosis, and Vascular Biology. 2003; 23: 1066-1071. Published online at:

http://atvb.ahajournals.org/content/23/6/1066.short

[25] Miguel Rivas, Ricardo P. Garay, Jesús F. Escanero, et al. Soy Milk Lowers Blood Pressure in Men and Women with Mild to Moderate Essential Hypertension. J. Nutr. July 1, 2002 vol. 132 no. 7 1900-1902. Published online at: http://nutrition.highwire.org/content/132/7/1900.short

[26] Engelhard YN, Gazer B, Paran E. Natural antioxidants from tomato extract reduce blood pressure in patients with grade-1 hypertension: a double-blind, placebo-controlled pilot study. Am Heart J. 2006 Jan;151(1):100.

[27] Paran E, Novack V, Engelhard YN, Hazan-Halevy I. The effects of natural antioxidants from tomato extract in treated but uncontrolled hypertensive patients. Cardiovasc Drugs Ther. 2009 Apr;23(2):145-51.

[28] Higashi Y, Oshima T, Ozono R, Watanabe M, Matsuura H, Kajiyama G.Effects of L-arginine infusion on renal hemodynamics in patients with mild essential hypertension. Hypertension. 1995 Apr;25(4 Pt 2):898-902.

[29] Higashi Y, Oshima T, Watanabe M, Matsuura H, Kajiyama G. Renal response to L-arginine in salt-sensitive patients with essential hypertension. Hypertension. 1996 Mar;27(3 Pt 2):643-8.

[30] Siani A, Pagano E, Iacone R, Iacoviello L, Scopacasa F, Strazzullo P. Blood pressure and metabolic changes during dietary L-arginine supplementation in humans. Am J Hypertens. 2000 May;13(5 Pt 1):547-51.

[31] Campese VM, Amar M, Anjali C, Medhat T, Wurgaft A. Effect of L-arginine on systemic and renal haemodynamics in salt-sensitive patients with essential hypertension. J Hum Hypertens. 1997 Aug;11(8):527-32.

[32] Dong JY, Qin LQ, Zhang Z, Zhao Y, Wang J, Arigoni F, Zhang W. Effect of oral L-arginine supplementation on blood pressure: a meta-analysis of randomized, double-blind, placebo-controlled trials. Am Heart J. 2011 Dec;162(6):959-65.

[33] Ruggenenti P, Cattaneo D, Loriga G, Ledda F, Motterlini N, Gherardi G, Orisio S, Remuzzi G. Ameliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: effects of acetyl-L-carnitine therapy. Hypertension. 2009 Sep;54(3):567-74.

[34] Rajasekar P, Palanisamy N, Anuradha CV. Increase in nitric oxide and reductions in blood pressure, protein kinase C beta II and oxidative stress by L-carnitine: a study in the fructose-fed hypertensive rat. Clin Exp Hypertens. 2007 Nov;29(8):517-30.

[35] Xu YJ, Arneja AS, Tappia PS, Dhalla NS. The potential health benefits of taurine in cardiovascular disease. Exp Clin Cardiol. 2008 Summer;13(2):57-65.

[36] Yamori Y, Taguchi T, Hamada A, Kunimasa K, Mori H, Mori M. Taurine in health and diseases: consistent evidence from experimental and epidemiological studies. J Biomed Sci. 2010 Aug 24;17 Suppl 1:S6.

[37] Vasdev S, Ford CA, Parai S, Longerich L, Gadag V.Dietary alpha-lipoic acid supplementation lowers blood pressure in spontaneously hypertensive rats. J Hypertens. 2000 May;18(5):567-73.

[38] Schussler M, Holzl J, Fricke U. Myocardial effects of flavonoids from Crataegus species. Arzneimittelforschung 1995 45(8):842-5.

[39] Bahorun, T. Antioxidant activities of Crataegus monogyna extracts. Planta Medica 1994 60:323-8

[40] Busse W. Standardized Crataegus extract clinical monograph. Q Rev Nat Med 1996 189-97.

[41] Yang YC, et al.The protective effect of habitual tea consumption on hypertension. Arch Intern Med. 2004 Jul 26;164(14):1534-40.

[42] Chen ZY, Peng C, Jiao R, Wong YM, Yang N, Huang Y. Anti-hypertensive nutraceuticals and functional foods.J Agric Food Chem. 2009 Jun 10;57(11):4485-99.

[43] McKay DL, Chen CY, Saltzman E, Blumberg JB. Hibiscus sabdariffa L. tea (tisane) lowers blood pressure in prehypertensive and mildly hypertensive adults. J Nutr. 2010 Feb;140(2):298-303.

[44] http://www.motherearthnews.com/natural-health/lower-blood-pressure-naturally-zmgz11zrog.aspx#axzz2e7uDm5iF

[45] Mansour SM, Bahgat AK, El-Khatib AS, Khayyal MT. Ginkgo biloba extract (EGb 761) normalizes hypertension in 2K, 1C hypertensive rats: role of antioxidant mechanisms, ACE inhibiting activity and improvement of endothelial dysfunction. Phytomedicine. 2011 Jun 15;18(8-9):641-7.

[46] Brankovic S, Radenkovic M, Kitic D, Veljkovic S, Ivetic V, Pavlovic D, Miladinovic B. Comparison of the hypotensive and bradycardic activity of ginkgo, garlic, and onion extracts. Clin Exp Hypertens. 2011;33(2):95-9.

[47] Victor Soukoulis, MD, PhD; Jamil B. Dihu, DO; et al. Micronutrient Deficiencies: An Unmet Need in Heart Failure. J Am Coll Cardiol. 2009;54(18):1660-1673. http://content.onlinejacc.org/article.aspx?articleid=1140151

[48] Bays HE, Rader DJ. Does nicotinic acid (niacin) lower blood pressure? Int J Clin Pract. 2009 January; 63(1): 151–159. Published online at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2705821/

[49] Bays HE, Maccubbin D, Meehan AG, Kuznetsova O, Mitchel YB, Paolini JF. Blood pressure-lowering effects of extended-release niacin alone and extended-release niacin/laropiprant combination: a post hoc analysis of a 24-week, placebo-controlled trial in dyslipidemic patients. Clin Ther. 2009 Jan;31(1):115-22.

[50] Dakshinamurti K, Dakshinamurti S. Blood pressure regulation and micronutrients. Nutr Res Rev. 2001 Jun;14(1):3-44

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[54] Personal notes taken from the American Academy of Anti-aging Medicine fellowship module II training, 2012.

[55] Poorolajal J, Zeraati F, Soltanian AR, Sheikh V, Hooshmand E, Maleki A. Oral potassium supplementation for management of essential hypertension: A meta-analysis of randomized controlled trials. PLoS One. 2017 Apr 18;12(4):e0174967. eCollection 2017. PubMed PMID: 28419159; PubMed Central PMCID: PMC5395164.

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