Additional Nutritional Support
While the three nutrients discussed can form the backbone of a
natural approach to lowering blood pressure (and may work in
conjunction with blood pressure–lowering medication), there are many
other nutrients that may also help lower blood pressure.
Minerals. Magnesium works in conjunction with
calcium, potassium, vitamin D, and other nutrients to control the
contraction and relaxation of muscles. It is very important to maintain
the correct balance for proper blood pressure maintenance. A Canadian
study concluded that daily intake of calcium, potassium, and magnesium
is essential in the management of high blood pressure (Touyz RM et al
2004). The study recommended calcium, potassium, and magnesium
supplementation for people who don’t currently have high blood pressure
but are at risk of developing it.
Based on a large body of evidence, the Joint National Committee on
Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
also recommends increasing your intake of potassium, calcium, and
magnesium to control blood pressure (National Institutes of Health
2006). Calcium supplementation should always be complemented with
magnesium because calcium stimulates muscle contraction, and magnesium
is needed for relaxation. Supplemental potassium should only be taken
on the advice of a physician because proper potassium balance is based
on individual blood test values. For more information, see the Safety
Caveats section of this chapter.
Magnesium seems especially beneficial for heart patients. Low levels
of magnesium are associated with an improper balance of sodium,
potassium, and calcium. Magnesium deficiency is frequently documented
in alcoholics, in patients who have high blood pressure or congestive
heart failure, and in people who have had a heart attack (Kurabayashi M
2005). Multiple studies recommend that people who have high blood
pressure (or who are at risk of developing it) maintain an adequate
intake of magnesium (Touyz RM et al 2004). In recent years, researchers
in Japan have been focusing on the benefits of magnesium because
magnesium intake has diminished in Japan as the traditional Japanese
diet of seafood and vegetables is being replaced by a diet high in fat
and animal products (Kumeda Y et al 2005).
Researchers have found that:
- Magnesium is necessary for the activity of chemicals that lower
cholesterol in the body, which contributes to its ability to fight
atherosclerosis and endothelial dysfunction (Inoue I 2005).
- Women taking magnesium supplements have a significantly lower risk of developing metabolic syndrome (Song Y et al 2005).
- A diet low in magnesium is associated with a potassium deficiency,
which alters the balance of sodium and potassium in favor of sodium.
Also, a low magnesium level is associated with high intracellular
calcium levels, which contributes to vasoconstriction and high blood
pressure (Rosanoff A 2005). The author of this study recommended
long-term, adequate intake of magnesium to ensure a healthy balance of
potassium to sodium and of magnesium to calcium.
For people who are taking diuretics or have kidney problems,
retaining an adequate amount of magnesium in the body is more
difficult. Most Americans get far less magnesium from their diets than
they need, so supplementation is a good option. There is some evidence
that magnesium improves insulin sensitivity, which decreases the risk
of developing high blood pressure (Guerrero-Romero F et al 2004).
Another study showed that taking magnesium along with beta blockers
significantly reduced blood pressure compared to taking beta blockers
alone (Wirell MP et al 1994).
Vitamin E. Vitamin E is an antioxidant that
detoxifies (reduces) strong oxidants in the body. It stabilizes cell
membranes and regulates oxidation reactions, as well as protects
polyunsaturated fatty acids and vitamin A. Meta-analyses have suggested
that vitamin E may be particularly beneficial for patients who have
high blood pressure or cardiovascular problems (Taber M 2006). Small
studies have shown that vitamin E, even when taken at fairly low doses,
increases nitric oxide synthase activity, which leads to vessel
dilation and lowered blood pressure. A larger study reported a
significant reduction in systolic blood pressure when subjects took 600
mg/day of vitamin E (Galley HF et al 1997). A study of 895 participants
reported that vitamin E supplementation might have an antihypertensive
effect even among those who get an adequate supply from their diets
(Mayer-Davis EJ et al 2002).
Vitamin C. Vitamin C, also known as ascorbic acid,
is an antioxidant that protects other biochemicals from oxidation by
being oxidized itself. A small, well-controlled study of 39
participants showed that treatment with vitamin C significantly lowered
blood pressure after 30 days, while placebo had no effect (Duffy SJ et
al 1999). Although specific mechanisms have not been identified for
vitamin C, it may be that it can help promote vessel dilation. As an
antioxidant, it may also enhance the synthesis or prevent the
destruction of nitric oxide, which directly helps blood vessels dilate
and lower blood pressure (Khosh F et al 2001).
Omega-3 fatty acids. Omega-3 fatty acids are
essential fatty acids, which means the body needs these substances but
is unable to manufacture them. They must come from food, such as
cold-water fish or flaxseed. Studies that have looked at the incidence
of high blood pressure and omega-3 fatty acids in large populations
suggest that diets high in omega-3 fatty acids or dietary
supplementation with omega-3 fatty acids can reduce blood pressure
(Hirafuji M et al 2003). It appears that omega-3 fatty acids have a
direct widening effect on blood vessels (Din JN et al 2004).
Coenzyme Q10 (CoQ10). CoQ10 is found in the
mitochondria, which is the energy-producing center of cells. It is
involved in making the molecule known as adenosine triphosphate (ATP).
ATP is the cell’s major energy source. CoQ10 also serves as an
antioxidant. Some studies have suggested that CoQ10 may stimulate the
immune system and increase resistance to disease (Folkers K et al
1988), as well as lower blood pressure (Hodgson JM et al 2002). One
theory to explain the effectiveness of CoQ10 on blood pressure concerns
its role as an antioxidant. Studies of diabetics have found that
increased oxidative stress may underlie endothelial dysfunction by
decreasing production and increasing consumption of nitric oxide, as
well as generating free radicals. CoQ10 has been found to mitigate this
effect by reducing oxidative stress, thereby normalizing nitric oxide
production and consumption (Chew GT et al 2004; Watts GF et al 2002).
CoQ10 has been widely studied in patients who have congestive heart
failure and take hypertensive medications. One study of 109 patients
with essential hypertension who supplemented their diets with 225
mg/day of CoQ10 in addition to their hypertensive medication, found
that participants gradually were able to decrease the need for drug
therapy during the first 1 to 6 months. Fifty-one percent of the
participants were able to completely discontinue some of their
medications an average of 4.4 months after they began CoQ10
supplementation (Langsjoen P et al 1994).
Another study evaluating CoQ10 as a dietary supplement found that it
significantly lowered blood pressure by a mean of 17.8 mm Hg in
participants. It was also well tolerated and safe. The study broadly
concluded that CoQ10 has a beneficial therapeutic effect as an
alternative or complementary treatment of high blood pressure (Burke BE
et al 2001). Studies indicate it may take 4 to 12 weeks before the
blood pressure–lowering benefit is seen (Khosh F et al 2001).
L-arginine. L-arginine is a basic amino acid found
in many proteins and is essential to growth and health maintenance in
all vertebrates. There is abundant evidence that it also plays an
important role in maintaining endothelial function and blood vessel
dilation and in reducing blood pressure. L-arginine is a precursor to
nitric oxide, which is essential for the proper function of the
endothelium. L-arginine has been shown to boost levels of nitric oxide,
which reduces endothelial dysfunction (Boger RH et al 2005; Rasmussen C
et al 2005). This helps maintain vascular integrity (Boger RH et al
2005).
Animal studies that reported L-arginine lowers blood pressure
provided a launching pad for human studies of L-arginine. One human
study found that diets naturally rich in foods containing L-arginine
(and diets supplemented with L-arginine) lead to a decrease in blood
pressure (Siani A et al 2000).
Taurine. Taurine is a sulfur-containing amino acid
that is classified as conditionally essential, since the body can
produce it from other amino acids, such as cysteine, based on the
body’s needs. A study was performed on 10 young adults who were
borderline hypertensive and took 6 g/day of taurine. Their average
systolic blood pressure decreased 9 mm Hg (Fujita T et al 1987).
Researchers speculate that taurine may modulate an overactive
sympathetic nervous system (Militante JD et al 2002).
Soy protein. Soy is a high-protein, low-fat food
derived from soybean. Protein comprises nearly half its calories, and
carbohydrate and fat roughly equal the other half. Soy holds only a
trace amount of saturated fat and no cholesterol. In search of a
natural approach to treating high blood pressure, a recent study
addressed the effects of increased dietary soy protein on blood
pressure. Researchers confirmed previous studies that showed higher
intake of vegetable protein lowers blood pressure (He J et al 2005).
Data from the Shanghai Women’s Health Study found higher intake of
soy was associated with lower levels of blood pressure (Yang G et al
2005). The mechanism responsible for the reduction of blood pressure is
not well understood. One plausible explanation concludes that soy
protein (or an overall increase in protein) may lead to dietary
arginine-induced increases in nitric oxide, which helps dilate blood
vessels and improve endothelial function (Cuevas AM et al 2004).
Garlic. Many patients who have high blood pressure
use garlic to lower high blood pressure or help prevent fatty plaque
buildup in the arteries and blockages that can lead to heart attack or
stroke. The sulfur compounds, especially allicin, are the active
ingredients in garlic (Tattelman E 2005). More medical research is
underway to assess the usefulness of garlic to prevent heart disease,
stroke, and high blood pressure (Edwards QT et al 2005).
Hawthorn (Crataegus oxyacantha; Crataegus monogyna).
Hawthorn berries have been used traditionally for cardiovascular
health. Hawthorn appears to mildly reduce blood pressure, possibly via
blood vessel dilation (Chang WT et al 2005; Schussler M et al 1995;
Leuchtgens H 1993). One study examined the effects of varying doses of
hawthorn (500 mg, 600 mg, and a combination of both dosages) on
essential hypertension. Researchers found a promising reduction in the
resting diastolic blood pressure of (as well as a reduction in anxiety
in) the patients who were taking hawthorn (Walker AF et al 2002).
Hawthorn’s beneficial effects may be caused by its antioxidant
flavonoid components (Chang WT et al 2005). In a study of patients who
had congestive heart failure, a dosage of 30 drops of hawthorn extract
three times a day was well tolerated and safe. In another study,
patients who were taking digoxin (an anticoagulant) were also
administered 450 mg of hawthorn twice a day. The study found that it
was safe to coadminister hawthorn and digoxin (Tankanow R et al 2003).
Arjuna. Arjuna bark from the Terminalia arjuna tree
has been used in traditional Indian ayurvedic medicine for more than
three centuries, often to treat cardiovascular disorders. A recent
trial showed that arjuna was capable of improving endothelial function
in smokers (Bharani A et al 2004). In another study, patients whose
angina was stable had a 50 percent reduction in angina episodes and a
significant decrease in systolic blood pressure (Dwivedi S et al 1994).
Prolonged treatment with 500 mg of arjuna showed no adverse effects on
the kidneys, liver, or blood (Dwivedi S et al 1994).
Olive leaf (Olea europaea) extract. One of
the primary active constituents of olive leaf extract is oleuropein, a
complex of flavonoids, esters, and iridoid glycosides, which may have
vasodilative properties. Research on the hypotensive effects of this
plant found that, when an extract was given for 3 months, blood
pressure was reduced in all patients and there were no adverse effects
(Cherif S et al 1996).
Hormone Modulation
The risk of developing essential hypertension is significantly
higher in a postmenopausal woman, as well as in men older than 55 years
of age. As hormone levels decline, the risk of high blood pressure and
heart disease rise. One study used progesterone to reduce blood
pressure in pregnant women who had preeclampsia, pregnancy induced
hypertension (Sammour MB et al 2005).
Vascular endothelium and smooth muscle cells have sex steroid
receptors (Natoli AK et al 2005). Research has supported bioidentical
hormone restoration of estrogen, progesterone, and testosterone for use
in the management of blood pressure and overall cardiac health. Sex
hormones stimulate endothelial cell growth, inhibit smooth muscle
proliferation and contraction, and relax the vascular endothelium via
nitric oxide, prostacyclin, and hyperpolarization pathways (Khalil RA
2005). When hormones are present at youthful concentrations, vascular
function in patients who have high blood pressure may be modulated
(Khalil RA 2005).
Vitamin Depot Online.comFoundation Recommendations
Endothelial dysfunction is closely linked to high blood pressure,
atherosclerosis, and cardiovascular risk. Management of high blood
pressure, a critical factor in endothelial risk, requires frequent
self-monitoring and a multifaceted approach, including taking blood
pressure–lowering medications, making lifestyle changes, and watching
your diet and nutritional intake. Vitamin Depot Online.comrecommends people
strive for an optimal blood pressure of 115/75 mm Hg.
Because many of the nutrients that lower blood pressure act along
the same metabolic pathways as blood pressure–lowering medications, it
is important to let your physician know which supplements you are
taking before beginning conventional blood pressure medication.
Nutrients that may help lower blood pressure include:
Hormone modulation can be achieved with blood testing to determine
appropriate doses of dehydroepiandrosterone (DHEA), pregnenolone, and
bioidentical topical preparations of estrogen, testosterone, and
progesterone. See the chapters on Female Hormone Modulation and Male
Hormone Modulation for more details. |
Product Availability
All the nutrients and supplements discussed in this section are
available through the Vitamin Depot Online.comFoundation Buyers Club, Inc. For
ordering information, call anytime toll-free 1-800-544-4440, or visit
us online at www.LifeExtension.com.
The blood tests discussed in this section are available through Vitamin Depot Online.comNational Diagnostics, Inc. For ordering information, call
anytime toll-free 1-800-208-3444, or visit us online at
www.LifeExtension.com.
High Blood Pressure Safety Caveats
An aggressive program of dietary supplementation should not be
launched without the supervision of a qualified physician. Several of
the nutrients suggested in this protocol may have adverse effects.
These include:
Coenzyme Q10
- See your doctor and monitor your blood glucose level frequently if
you take CoQ10 and have diabetes. Several clinical reports suggest that
taking CoQ10 may improve glycemic control and the function of beta
cells in people who have type 2 diabetes.
- Statin drugs (such as lovastatin, simvastatin, and pravastatin) are known to decrease CoQ10 levels.
Calcium
- Do not take calcium if you have hypercalcemia.
- Do not take calcium if you form calcium-containing kidney stones.
- Ingesting calcium without food can increase the risk of kidney stones in women and possibly men.
- Calcium can cause gastrointestinal symptoms such as constipation, bloating, gas, and flatulence.
- Large doses of calcium carbonate (12 grams or more daily or 5 grams
or more of elemental calcium daily) can cause milk-alkali syndrome,
nephrocalcinosis, or renal insufficiency.
EPA/DHA
- Consult your doctor before taking EPA/DHA if you take warfarin
(Coumadin). Taking EPA/DHA with warfarin may increase the risk of
bleeding.
- Discontinue using EPA/DHA 2 weeks before any surgical procedure.
Garlic
- Garlic has blood-thinning, anticlotting properties.
- Discontinue using garlic before any surgical procedure.
- Garlic can cause headache, muscle pain, fatigue, vertigo, watery
eyes, asthma, and gastrointestinal symptoms such as nausea and diarrhea.
- Ingesting large amounts of garlic can cause bad breath and body odor.
Hawthorn
- High doses of hawthorn are toxic and may induce sedation and abnormally low blood pressure.
- Do not take hawthorn if you take digoxin. Hawthorn can interfere with the effects of digoxin.
L-Arginine
- Do not take L-arginine if you have the rare genetic disorder argininemia.
- Consult your doctor before taking L-arginine if you have cancer. L-arginine can stimulate growth hormone.
- Consult your doctor before taking L-arginine if you have kidney failure or liver failure.
- Consult your doctor before taking L-arginine if you have herpes simplex. L-arginine may increase the possibility of recurrence.
Magnesium
- Do not take magnesium if you have kidney failure or myasthenia gravis.
Olive Leaf Oil
- Do not take olive leaf oil if you have a history of gallstones.
Potassium
- Do not take potassium if you have hyperkalemia (a greater-than-normal concentration of potassium in the blood).
- Consult your doctor before taking potassium for potassium deficiency.
- Potassium can cause rash and gastrointestinal symptoms such as nausea, vomiting, and diarrhea.
Soy
- Do not take soy if you have an estrogen receptor-positive tumor.
- Soy has been associated with hypothyroidism.
Vitamin C
- Do not take vitamin C if you have a history of kidney stones or of
kidney insufficiency (defined as having a serum creatine level greater
than 2 milligrams per deciliter and/or a creatinine clearance less than
30 milliliters per minute.
- Consult your doctor before taking large amounts of vitamin C if you
have hemochromatosis, thalassemia, sideroblastic anemia, sickle cell
anemia, or erythrocyte glucose-6-phosphate dehydrogenase (G6PD)
deficiency. You can experience iron overload if you have one of these
conditions and use large amounts of vitamin C.
Vitamin D
- Do not take vitamin D if you have hypercalcemia.
- Consult your doctor before taking vitamin D if you are taking digoxin or any cardiac glycoside.
- Only take large doses of vitamin D (2000 international units or 50 micrograms or more daily) if prescribed by your doctor.
- See your doctor frequently if you take vitamin D and thiazides or
if you take large doses of vitamin D. You may develop hypercalcemia.
- Chronic large doses (95 micrograms or 3800 international units or more daily) of vitamin D can cause hypercalcemia.
For more information see the Safety Appendix |