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| Hypertension |
Last updated: May 12, 2008 |
Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Other conditions that may be present | It can lead to... | Recommendations
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Blood pressure is measured with a blood pressure cuff and recorded as two numbers that represent systolic (peak pressure, shown first) and diastolic (base pressure, shown second). Either or both numbers can be elevated. When the first number is the only one elevated the condition is called Isolated Systolic Hypertension (ISH).
Optimal blood pressure is below 120/80mm Hg. When a person has a reading above 140/90, she/he is considered to have high blood pressure. In the past, many physicians relied on diastolic blood pressure to diagnose hypertension. Recent research, however, has found that diastolic blood pressure rises until about age 55 and then declines, while systolic blood pressure increases steadily with age.
Systolic hypertension is a major health threat, especially for older people. For many years we have been taught that diastolic (the bottom number) blood pressure counts more. That may be true for younger people but we now know that, as people get older, systolic blood pressure becomes more important. If you are middle aged or older, systolic blood pressure is a better blood pressure indicator than diastolic of your risk of heart disease and stroke, which are the first- and third-leading causes of death among Americans. High blood pressures can lead to other conditions, such as congestive heart failure, kidney damage, dementia and blindness. While it cannot be cured, systolic hypertension can be treated and its complications prevented.
Many older Americans suffer from ISH, defined as a systolic reading at or above 140mm Hg and diastolic reading under 90mm Hg. In fact, for older Americans, ISH is the most common form of high blood pressure: 65% of all hypertensives older than age 60 have ISH. Unfortunately, many older Americans do not have their blood pressure under control.
Peaks of fluctuating hypertension can be as strong a risk factor for cardiovascular disease as established hypertension.
To find out if you have ISH - or any type of high blood pressure - see your doctor and have your blood pressure checked regularly. Everyone - including children - should have their blood pressure measured every time they see a doctor. Special attention should be paid when there is a family history of hypertension requiring at least annual measurements beginning at age 20.
Untreated or poorly treated hypertension can cause stroke, heart attacks, kidney failure and severe circulatory problems. In most people hypertension occurs without any symptoms whatsoever and there is thus far no identifiable cause for hypertension in most people. They are classified as having "essential" hypertension. About 5% of people have a cause for their elevated blood pressure (such as pre-existing kidney disease) that can be reversed and this places them in the category of "secondary" hypertension.
Recent work possibly explains the cause of 30-40% of essential hypertension. Parathyroid Hypertensive Factor (PHF) is a hormone produced by the parathyroid gland. When elevated, it can cause any increase in blood pressure. PHF levels can be tested, and elevated levels could serve to predict salt sensitivity, and calcium treatment responsiveness. Meridian Valley Laboratory in Seattle, Washington is one lab that performs this test.
Treatment options for ISH are the same as for other types of high blood pressure, in which both systolic and diastolic pressures are high. The key for the treatment of ISH is to bring the blood pressure under control, to less than 140/90.
Diastolic Hypertension is when the lower number is sustained at pressures greater than 90mm Hg. Hypertension, otherwise known as chronic high blood pressure, can be treated in a number of natural ways.
Dietary salt (NaCl) restriction, dietary potassium supplementation, weight reduction, physical exercise, selected nutrients, meditation and other therapies (e.g., biofeedback) have all been found to be effective.
You should try to achieve normal pressure by a lifestyle and diet change, such as weight loss, reducing salt intake, exercising and supplementation as a first attempt in an effort to avoid medications. No one, however, has to put his or her health at risk from uncontrolled hypertension; but treatment for hypertension must begin early to prevent organ damage - whatever the patient's age.
Pulse Pressure
Although current guidelines for the management of high blood pressure (BP) rest almost completely on the measurement of systolic (top) and diastolic (bottom) blood pressure, a new study has found that something known as the "pulse pressure" may actually be a better predictor of heart disease risk. The pulse pressure is the difference between the systolic and diastolic pressures. For example someone with a blood pressure of 120/80 has a pulse pressure of 40.
This study was a meta-analysis combining the results of several studies, including nearly 8,000 elderly patients.
A 10mm Hg increase in pulse pressure was found to increase the risk of major cardiovascular complications and mortality by nearly 20%. The authors contend that this association of pulse pressure to risk of heart disease helps to explain the apparent elevations in risk associated with low diastolic pressure. The authors of the study note that some high blood pressure medications may actually increase the pulse pressure. For example, if someone has an elevated BP of 150/95 (pulse pressure = 55) and medication brings it down to 140/80 (pulse pressure = 60), then according to this study's findings, this person may actually be at GREATER risk of heart disease than before.
Researchers found that a diuretic, or water pill, is more effective in treating high blood pressure and preventing cardiovascular disease than newer, more expensive medications. It was 10 to 20 times less expensive than the other drugs used in the trial. The eight-year study, led by a doctor at Wake Forest University Baptist Medical Center, included 623 clinical sites in North America. There should be less side effects also.
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 Signs, symptoms & indicators of Hypertension: | | | | | | Lab Values - Common |  High systolic blood pressure
High diastolic blood pressure |
Symptoms - Head - Nose |
 Occasional/frequent nosebleeds | Recurrent nosebleeds are a sometimes a sign of an underlying disorder, such as hypertension, a bleeding disorder, or a tumor of the nose or sinuses. |
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Symptoms - Reproductive - Female Cycle |
Hot flashes| | Women who get hot flashes have higher blood pressure than those who don't, according to a new study led by Weill Cornell Medical College.
High blood pressure is a major risk factor for heart disease -- the latter being responsible for half of all deaths among American women 50 and older.
"One-third of the women we studied reported having had hot flashes within the past two weeks. Among these women, systolic blood pressure was significantly higher -- even after adjusting for whether they were pre-menopausal, menopausal or post-menopausal," says Dr. Linda Gerber, the study's senior author, professor of public health and medicine and director of the biostatistics and research methodology core at Weill Cornell Medical College. "Future research will help us better understand the mechanisms underlying this relationship and may help to identify potential interventions that would reduce the impact of hot flashes on blood pressure."
While previous research has linked menopause to high blood pressure, the new Weill Cornell study, published in the March/April, 2007 issue of Menopause: The Journal of the North American Menopause Society, may be the first to link hot flashes to high blood pressure. |
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Conditions that suggest Hypertension:
Risk factors for Hypertension: | | | | | | Circulation | Atherosclerosis |
Diet |
Salt Sensitivity |
Environment / Toxicity |
Heavy Metal Toxicity| | In some individuals with hypertension, high levels of heavy metals were found. When treated for these heavy metals with chelation therapy, the hypertension improved or resolved. |
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Hormones |
Hypopituitarism / Empty Sella Syndrome
Cushing's Syndrome / Hypercortisolism |
Lab Values - Common |
Counter-indicators:
 Having very/having low diastolic BP or having normal diastolic BP
Having very/having low systolic BP or haivng normal systolic BP |
Metabolic |
 Acute, Intermittent Porphoria
Nephrotic Syndrome (NS)| | Hypertension can be both a cause and the result of NS. This hypertension must be treated aggressively to prevent further damage to the kidneys. |
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Personal Background |
African ethnicity| | New research shows that higher levels of uric acid are strongly associated with high blood pressure in blacks, suggesting that a simple blood test could predict risk and that treatments to lower uric acid may be a novel way to reduce hypertension-related complications in this population.
Uric acid levels are influenced by dietary factors, such as high levels of protein, and by the breakdown of the body's cells. Most uric acid is eliminated in urine. However, if excess uric acid is being produced or if the kidneys cannot remove enough of it, levels build up in the blood.
Very high levels of uric acid cause gout, but recent animal and human studies suggest that modest elevations of uric acid are one cause of hypertension. Currently, studies are under way to evaluate whether lowering uric acid prevents hypertension.
"If these studies show that lowering uric acid is an effective treatment, our research suggests that it may be especially appropriate for blacks," said Mellen.
Uric acid can be lowered by medications such as allopurinol and newer agents under development. [Hypertension Nov 7, 2006] |
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Supplements and Medications |
Prednisone use| | A side-effect of treatment with prednisone can be hypertension. |
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Symptoms - Food - Intake |
Counter-indicators:
Eating sizable chocolate portions| | Foods rich in cocoa appear to reduce blood pressure but drinking tea may not, according to an analysis of previously published research in the April 9, 2007 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Current guidelines advise individuals with hypertension (high blood pressure) to eat more fruits and vegetables, according to background information in the article. Compounds known as polyphenols or flavonoids in fruits and vegetables are thought to contribute to their beneficial effects on blood pressure and cardiovascular risk. "Tea and cocoa products account for the major proportion of total polyphenol intake in Western countries," the authors write. "However, cocoa and tea are currently not implemented in cardioprotective or anti-hypertensive dietary advice, although both have been associated with lower incidences of cardiovascular events."
Dirk Taubert, M.D., Ph.D., and colleagues at the University Hospital of Cologne, Germany, conducted a meta-analysis of 10 previously published trials, five of cocoa's effects on blood pressure and five involving tea. All results were published between 1966 and 2006, involved at least 10 adults and lasted a minimum of seven days. The studies were either randomized trials, in which some participants were randomly assigned to cocoa or tea groups and some to control groups, or used a crossover design, in which participants' blood pressure was assessed before and after consuming cocoa products or tea.
The five cocoa studies involved 173 participants, including 87 assigned to consume cocoa and 86 controls, 34 percent of whom had hypertension (high blood pressure). They were followed for a median (middle) duration of two weeks. Four of the five trials reported a reduction in both systolic (the top number, when the heart contracts) and diastolic (the bottom number, when the heart relaxes) blood pressure. Compared with those who were not consuming cocoa, systolic blood pressure was an average of 4.7 millimeters of mercury lower and diastolic blood pressure was an average of 2.8 millimeters of mercury lower.
The effects are comparable to those achieved with blood pressure-lowering medications, the authors note. "At the population level, a reduction of 4 to 5 millimeters of mercury in systolic blood pressure and 2 to 3 millimeters of mercury in diastolic blood pressure would be expected to substantially reduce the risk of stroke (by about 20 percent), coronary heart disease (by 10 percent) and all-cause mortality (by 8 percent)," they write.
Of the 343 individuals in the five tea studies, 171 drank tea and 172 served as controls, for a median duration of four weeks. Drinking tea was not associated with a reduction in blood pressure in any of the trials.
Tea and cocoa are both rich in polyphenols, but while black and green tea contain more compounds known as flavan-3-ols, cocoa contains more of another type of polyphenol, procyanids. "This suggests that the different plant phenols must be differentiated with respect to their blood pressure-lowering potential and thus cardiovascular disease prevention, supposing that the tea phenols are less active than cocoa phenols," the authors write. |
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Uro-Genital |
Eclampsia / Preeclampsia |
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Hypertension suggests the following may be present: | | | | | | Hormones | Cushing's Syndrome / Hypercortisolism |
Metabolic |
Acute, Intermittent Porphoria
Nephrotic Syndrome (NS)| | Hypertension can be both a cause and the result of NS. This hypertension must be treated aggressively to prevent further damage to the kidneys. |
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Musculo-Skeletal |
Gout / Hyperuricemia |
Organ Health |
Diabetes Type II / Risk| | Statistical analyses showed that the relationship between blood pressure and the onset of type 2 diabetes was similar among women who were normal weight, overweight or obese. There was a three-fold increase in risk from the lowest to the highest BP category within all three weight categories. This analysis showed that the association between blood pressure and diabetes was not explained by weight alone.
Women who had an increase in BP during the study also had an increased risk of developing diabetes. Those whose BP rose but who remained within the range of normal BP had an increased risk of 26% compared to women who had stable or decreasing BP. Women who progressed to hypertension had a 64% increased risk. [European Heart Journal Oct 2007] |
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Risks |
Counter-indicators:
Increased Risk of Hypertension |
Uro-Genital |
Eclampsia / Preeclampsia |
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Hypertension can lead to: | | | | | | Aging | Senile Dementia |
Circulation |
Increased Risk of Stroke
Aneurysm / Weakened Arteries |
Risks |
Increased Risk of Alzheimer's / Dementia| | A study in Journal of Neuroimaging (July 2007) suggests that cognitively normal adults exhibiting atrophy of their temporal lobe or damage to blood vessels in the brain are more likely to develop Alzheimer's disease. Older adults showing signs of both conditions were seven-times more likely to develop Alzheimer's than their peers.
"Alzheimer's disease, a highly debilitating and ultimately fatal neurological disease, is already associated with other risk factors such as poor cognitive scores, education or health conditions," says study author Caterina Rosano. "This study, because it focused on healthy, cognitively normal adults, shows that there other risk factors we need to consider."
MRI images of participants' brains were examined to identify poor brain circulation, damaged blood vessels and/or atrophy of the medial temporal lobe. Subjects showing any one or a combination of these symptoms were more likely to develop Alzheimer's in the following years.
"Similarly to heart disease, brain blood vessel damage is more likely to occur in patients with high blood pressure, high cholesterol or diabetes," says Rosano. "Since we know that prevention of these conditions can lower risk of heart attack and stroke, it is likely that it would also lower the risk of developing Alzheimer's." |
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Recommendations for Hypertension: | | | | | | Amino Acid / Protein |  Theanine (L-Theanine)| | High blood pressure is a feature of stress that can be lowered by lowering the stress. The simple act of drinking a cup of tea (which contains theanine) can lower blood pressure by forcing a person to slow down and relax. |
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Animal-based |
 Fish Byproducts| | Vasotensin is the proprietary name of a product from Metagenics. It supports healthy vascular function for optimal blood flow and healthy blood pressure levels by supplying bioactive peptides from bonito fish. It helps prevent the formation of angiotensin II a potent vasoconstrictor through their interaction of bonito peptides with angiotensin converting enzyme.
Fast-acting formula that provides a clinically effective dose in just 2 tablets twice daily. No rebound effect observed in human clinical trials when supplementation is discontinued. Excellent safety profile no adverse effects associated with bonito peptides have been reported.
May be used as a complement to other heart support programs including prescription drugs. |
Fish Oils| | In a review of 36 clinical studies, just under 4gm of fish oil per day was associated with modest reductions in both systolic and diastolic pressure, especially if subjects were older and had hypertension. [Journal of Hypertens 2002;20(8): pp.1493-1499] |
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Botanical |
 Grape Seed Extract (Pycnogenol)| | A study published in the October 2006 journal of Clinical and Applied Thrombosis/Hemostasis shows Pycnogenol® (pic-noj-en-all), an antioxidant plant extract from the bark of the French maritime pine tree reduced edema, a typical side-effect of antihypertensive medications, by 36 percent in patients taking these medications.
According to Dr. Gianni Belcaro, lead researcher of the study, more than 35 percent of patients taking antihypertensive medications are believed to suffer from edema as a side-effect. This happens because the antihypertensive medications cause blood vessels to dilate, which allows easier blood flow and thus lowers blood pressure. However, as a side-effect this causes blood to pool in the vessels of the lower legs. In result they stretch and liquid seeps into tissue causing swelling (edema). Hypertension is a serious risk factor for developing severe cardiovascular incidents some time in the future and thus the necessity for treatment justifies the development of edema as a side-effect.
Antihypertensive medications reduce pressure by inhibiting constriction of blood vessels. "The larger the blood vessel diameter, the easier blood will flow with less pressure," said Dr. Belcaro. "In order to avoid blood pooling in the lower legs and feet (edema), blood vessel diameters must adjust when a person changes positions from laying down to standing up. Results of this study show Pycnogenol to improve blood circulation, avoiding blood pools and reducing edema." |
Gingko Biloba| | One effect of Ginkgo extract is that of promoting vasodilation and blood flow. |
Chlorella / Algae Products| | Fifty-five subjects with fibromyalgia, 33 with hypertension, and 9 with ulcerative colitis consumed 10gm of pure chlorella in tablet form and 100mL of a liquid containing an extract of chlorella each day for 2 or 3 months. Daily dietary supplementation with chlorella was seen to reduce high blood pressure, lower serum cholesterol levels, accelerate wound healing and enhance immune functions. Researchers concluded that the potential of chlorella to relieve symptoms, improve quality of life, and normalize body functions in patients with fibromyalgia, hypertension, or ulcerative colitis suggests that larger, more comprehensive clinical trials of chlorella are warranted. [Altern Ther Health Med. 2001 May-Jun; 7(3): pp.79-91. Review] |
Pomegranate| | In an Israeli study, systolic blood pressure was reduced by 21% after one year of pomegranate juice consumption. This effect is believed to be related to the particularly potent antioxidant properties of pomegranate polyphenols. [Clin Nutr. 2004 Jun;23(3):pp. 423-33]
A similar study at the same research facility examined consumption of pomegranate juice to ascertain its effectiveness in lowering blood pressure. Researchers studied the effect on hypertensive patients of daily consumption of 50 ml of pomegranate juice. After two weeks, a 5% reduction in systolic blood pressure was noted, along with a 36% decrease in serum angiotensin converting enzyme (ACE) activity. Reduc-tion in serum ACE activity has previously been shown to attenuate atherosclerosis, independent of its effects on blood pressure. The study authors concluded, “Pomegranate juice can offer wide protection against cardiovascular diseases, which could be related to its inhibitory effect on oxidative stress and on serum ACE activity.” [Atherosclerosis. 2001 Sep;158(1):pp. 195-8] |
Rhodiola rosea
Garlic| | One study found that aged garlic extract at 7.2gm per day reduced total and LDL cholesterol, as well as systolic and diastolic blood pressure. |
Noni
Mistletoe (Viscum album)| | Mistletoe is known to relieve pain from headaches caused by high blood pressure. Mistletoe reduces the heart rate, and at the same time strengthens the capillary walls. Its cardiotonic action is thought to be due to the lignans, while the hypotensive action is believed to be due to a choline derivative related to acetylcholine. Choline derivatives bring about parasympathetic stimulation and vasodilatation. |
Stephania tetrandra |
Diet |
Weight Loss| | At least a half dozen controlled studies of patients with hypertension concluded that short-term weight loss is usually associated with a reduction of blood pressure. In patients who experienced a weight loss of 11.7 kg ( about 25.7 lbs), an average blood pressure reduction of -20.7/-12.7mm Hg was recorded. A similar study found that a decrease in blood pressure of -2.5/-1.5mm Hg per kilogram of reduction of weight, and further demonstrated a significant correlation between weight change and blood pressure change. |
Raw Food Diet| | In a study of 32 patients whose diets were changed to include 62% of calories from raw foods, their mean diastolic pressure reduction was 17mm Hg. This study was conducted over a period of 6 months. Of these patients, 28 were also overweight. [South Med J 1985 Jul;78(7): pp.841-4] |
Increased Fruit/Vegetable Consumption| | Fruit and vegetable consumption (minimum of five portions daily) was associated with modest reductions of systolic and diastolic blood pressures in a controlled study of 690 healthy people ages 25-64. [Lancet May 28, 2002] |
Soy Isoflavones (genistein, daidzein)| | Soy milk consumption (about 2 cups twice per day) reduced systolic and diastolic blood pressure in a double-blind study of 40 men and women with mild to moderate hypertension, when compared to cow's milk. [J Nutr 2002;132(7): pp.1900-1902] The average systolic blood pressure was reduced 18.4mm Hg, diastolic 15.9mm Hg and mean blood pressure 16.7mm Hg.
The mechanism of action may be independent of isoflavone content, as another study showed no blood pressure lowering benefits with the use of isoflavones alone. |
Therapeutic Fasting| | Fasting is a way to correct high blood pressure without drugs. Fasting will normalize blood pressure in the vast majority of cases; the blood pressure will remain low after the fast if a person follows a health-supporting diet and lifestyle. |
High/Increased Fiber Diet| | A study suggests that oatmeal can improve blood pressure and reduce drug costs for 60 million hypertensive Americans. The study found that 73% of participants, each of whom who ate oat cereal daily for 12 weeks, were able to reduce or eliminate their need for blood-pressure medication. Consumption of high-fiber cereals is an easy and simple way for a person
to increase total and soluble fiber intakes, thus helping to reach the dietary fiber goal of 25-30gm per day. [Preventive Medicine in Managed Care; March 1, 2002] |
Low Fat Diet| | The DASH diet is rich in fruits, vegetables, and lowfat dairy foods and reduced in total and saturated fat . It also is reduced in red meat, sweets, and sugar-containing drinks. It is rich in potassium, calcium, magnesium, fiber, and protein.
One month of a DASH (Dietary Approaches to Stop Hypertension) diet and reduced sodium intake were each associated with reduced blood pressure in untreated hypertension (systolic blood pressure of 120-160 mm and diastolic blood pressure of 80-95 mm. DASH diet plus reduced sodium intake produced the greatest reductions in blood pressure. [Ann Intern Med 2001;135(12): pp.1019-1028] |
Coconut
Vegetarian/Vegan Diet
Sugars Avoidance / Reduction
Cabbage Family Vegetables| | Researchers put broccoli sprouts to the test and found that they contain high levels of glucoraphanin, also known as sulforaphane glucosinolate (SGS). In addition to being a cancer preventative, SGS boosts production of Phase 2 enzymes, which are part of the body's antioxidant system. This extra boost lowers blood pressure and the body's inflammatory response, leading to better cardiovascular health overall. Just 5 grams of broccoli sprouts contain concentrations of SGS equal to that found in 150 grams of mature broccoli. |
Caffeine/Coffee Avoidance| | An increased risk of developing hypertension was associated with drinking five or more cups of coffee per day in a large study of former white male medical students followed for an average of 33 years. [Arch Intern Med 2002;162(6): pp.657-662] |
Olive Oil| | The relationship between dietary fats and blood pressure is not definitively answered. However, evidence suggests that the multiple components of the Mediterranean diet, i.e. low saturated fatty acids (SFAs), high monounsaturated fatty acids (MUFAs), and carbohydrate, fiber, and micronutrient content have favorable blood pressure effects, and therefore that this diet is desirable for health. Dietary MUFAs may have a greater protective effect than initially realized.
In 207 men without hypertension, 175 men with hypertension, 406 women without hypertension and 232 women with hypertension, the risk of hypertension was positively and independently associated with the intake of cooking oil polar compounds (read polyunsaturated oils), and inversely related to blood levels of monounsaturated fatty acids (read primarily olive oil). [Am JClin Nutr. 2003;78: pp.1092-1097]
Examples of foods high in MUFA are olives, olive oil, canola oil, peanuts, peanut oil, almonds, pecans, hazelnuts, cashew nuts, macadamia nuts, pistachio nuts, and avocados. |
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Digestion |
Not recommended:
 Bromelain| | While bromelain is considered to have very low toxicity, caution is advised when treating individuals with hypertension. One report has indicated that those with pre-existing hypertension might experience tachycardia following high doses of bromelain. [Hawaii Med J 1978;37: pp.143-146] |
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Drug |
Conventional Drugs / Information| | While hypertension may be controlled naturally, if you have very elevated pressure and are having trouble getting it down, prescription drug use may be necessary. When additional factors in your live change down the road, you can try tapering off your medication to see if it is still needed. It is best to do this with your doctor's help. The dangers of untreated hypertension are too great to ignore.
Hypertension is caused by a variety of factors, and different classes of drugs are used to treat these different factors. The main classes of hypertension drugs and the added benefits they can provide are listed below.
Diuretics (furosemide, hydrochlorothiazide, indapamide, others). Commonly referred to as water pills, diuretics reduce the amount of fluid in your body. They cause your kidneys to excrete more sodium in your urine than they would normally. The sodium takes with it water from your blood. This means there's a smaller volume of blood pushing through your arteries and, consequently, less pressure on your artery walls.
Beta blockers (atenolol, metoprolol, propranolol, others). Beta blockers primarily work by blocking the effects of certain adrenaline-related chemicals in your body, causing your heart to beat more slowly and less forcefully.
Angiotensin-converting enzyme (ACE) inhibitors (benazepril, enalapril, lisinopril, others). ACE inhibitors help relax your blood vessels by blocking the formation of a natural chemical inside your body that narrows blood vessels.
Angiotensin II receptor blockers (ARB) (candesartan, irbesartan, losartan, others). ARBs act in a manner similar to ACE inhibitors, but they block the action of the chemical instead of the formation of the chemical.
Calcium channel blockers (calcium antagonists) (amlodipine, diltiazem, nifedipine, verapamil, others). These medications help relax blood vessel muscles. Some slow your heart rate.
Each of these classes may have additional benefits which will help your doctor select the one that is the most appropriate for you. |
Not recommended:
GHB (Gamma-Hydroxybutyrate)| | GHB should be avoided in cases of severe hypertension. |
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Electrical |
Biofeedback| | One device that could be considered using feedback methods has been proven to lower blood pressure through changing breathing habits. Information about RESPeRATE can be found here.
RESPeRATE is the first and only non-drug medical device clinically proven to lower high blood pressure with no side effects. It provides you with a new option for lowering blood pressure, and can be safely used along with your current medication(s) and lifestyle modifications such as diet and exercise. |
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Extract |
Fibrinolytic Enzymes
Plant Sterols / Sterolins (Phytosterols) |
Habits |
Aerobic Exercise| | Postmenopausal women with hypertension who walked 3km per day experienced an 11 point drop in systolic blood pressure over 6 months. [Med Sci Sports Exerc 2001;33(11): pp.1825-1831] |
Tobacco Avoidance |
Hormone |
Melatonin| | Researchers discovered that if men take melatonin before bedtime, their blood pressure may decrease as much as if they were taking a antihypertensive drug. The participants in the study took 2.5mg of melatonin for a three week period. As expected, melatonin also increased their quality and quantity of sleep. [Hypertension. 2004 Feb;43(2): pp.192-7]
The authors of this study caution that melatonin should not be used for treating hypertension based on this single trial, and that more studies are required. |
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Lab Tests/Rule-Outs |
Test Uric Acid Levels| | New research shows that higher levels of uric acid are strongly associated with high blood pressure in blacks, suggesting that a simple blood test could predict risk and that treatments to lower uric acid may be a novel way to reduce hypertension-related complications in this population.
Uric acid levels are influenced by dietary factors, such as high levels of protein, and by the breakdown of the body's cells. Most uric acid is eliminated in urine. However, if excess uric acid is being produced or if the kidneys cannot remove enough of it, levels build up in the blood.
Very high levels of uric acid cause gout, but recent animal and human studies suggest that modest elevations of uric acid are one cause of hypertension. Currently, studies are under way to evaluate whether lowering uric acid prevents hypertension.
"If these studies show that lowering uric acid is an effective treatment, our research suggests that it may be especially appropriate for blacks," said Mellen.
Uric acid can be lowered by medications such as allopurinol and newer agents under development. [Hypertension Nov 7, 2006] |
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Mineral |
Salt Intake Reduction| | If you have high blood pressure, reducing the level of salt in your diet may reduce your blood pressure. In some people with mild high blood pressure this could free them from blood-pressure-lowering medications entirely. In people with marked high blood pressure, it should mean that a reduction in medications is possible. If you are taking medication for high blood pressure, particularly diuretics, let your doctor know that you are reducing your salt intake.
Salt restriction is recommended for those individuals with hypertension who are "salt-sensitive" or are prone to retaining sodium, gaining weight, and developing a rise in blood pressure as a result of a high-salt diet. Those who are "salt-resistant", on the other hand, do not experience change in weight or blood pressure on either high- or low-salt diets. For the salt-sensitive population, extreme amounts of salt restriction are not needed for improvement of blood pressure. Several studies have shown that diets containing 1600 to 2300mg of sodium per day are associated with average reductions in systolic pressure of -9 to -15mm Hg and in diastolic pressure of -7 to -16mm Hg in salt-sensitive individuals. Thus, salt restriction in this range is recommended in the dietary management of most individuals with hypertension.
However, for those who like salt, it was found in a review of many studies, that the degree of reduction in sodium intake and change in blood pressure were NOT related. This review included a total of 2,326 normotensive people, 387 with untreated hypertension and 801 being treated for hypertension [BMJ 2002;325(7365): pp.628-632]. So you may not have to limit salt strictly, but you will need to experiment to find out if, and to what degree, you are sensitive. |
Potassium| | The blood pressure lowering effect of supplemental potassium may be greater in patients receiving a high-salt diet. The amount of dietary potassium required to achieve this effect is, however, not easily obtained. |
Calcium
Magnesium| | In a double-blind, placebo-controlled trial, it was demonstrated that oral magnesium resulted in a significant dose-dependent reduction of systolic and diastolic blood pressure. A mean reduction of 6mm Hg in diastolic pressure in patients with hypertension results in approximately 10% lower risk of coronary artery disease, and a 40% reduction in risk of strokes.
When magnesium levels are low, more calcium flows into the vascular muscle cells, which contracts them - leading to tighter vessels and higher blood pressure. Adequate magnesium levels prevent this. |
Not recommended:
Increased Salt Consumption |
Nutrient |
CoQ10 (Ubiquin-one/ol)| | Eighty-three hypertensive patients were treated with either coenzyme Q10 (60mg bid with 150IU of vitamin E) or placebo with vitamin E. The coQ10 treated group experienced an average reduction in systolic blood pressure of 17.8mm without any significant side effects. [S Med J, November 2001;94(l]): pp.1112-1117] |
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Oriental Medicine |
Acupuncture| | A doctor Arabinda Das, MD reported using acupuncture points LIV-3, SP-9 and GB-34 bilaterally. After 2-3 visits he sutured the points. He reported immediate and lasting normalization of pressure in 80% of cases.[Townsend Letter for Doctors and Patients, Aug/Sept 2002; p.66]
A separate study suggests 12 treatments over a course of 6 weeks.
It was found that acupuncture at the Heart otoacupoint produced marked immediate depressor effects, with a short-term effective rate of 100% and long-term effective rate of 63%. [Journal of Traditional Chinese Medicine, 1992 Jun, 12(2): pp.133-6 ] |
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Physical Medicine |
Calming / Stretching Exercises| | The relaxation and exercise components of yoga have a major role to play in the treatment and prevention of high blood pressure. A combination of biofeedback and yogic breathing and relaxation techniques has been found to lower blood pressure and reduce the need for high blood pressure medication. In 20 patients with high blood pressure who practiced biofeedback and yoga techniques, 5 were able to stop their blood pressure medication completely, 5 were able to reduce significantly the amount of medication they were taking, and another 4 experienced lower blood pressure at the end of the 3 month study. |
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Vitamins |
Bioflavonoids| | Researchers reported that consuming dark chocolate and cocoa improves the function of blood vessels. In one study, consumption of cocoa in healthy volunteers, aged 18 to 77, resulted in significantly improved vascular responsiveness. The measure the researchers used looked at the "stiffness" of blood vessels. In patients whose blood vessels that are "stiff," hypertension is common. The beneficial effect was most pronounced in patients over 50 years of age and was due to the high flavonoid (polyphenol) content of dark chocolate.
In a second study, after volunteers ate 100 grams (3.5 ounces) of dark chocolate vascular responsiveness was again significantly improved. Investigators postulate that it is the flavonoids in chocolate that causes vascular improvement. Dark chocolate contains more flavonoids than lighter chocolate - and adding milk to chocolate (milk chocolate) inhibits the absorption of flavonoids. Any benefit gained by eating chocolate may be limited to dark chocolate (and cocoa).
These short-term studies demonstrated an immediate benefit, but it remains to be proven if there will be a long-term benefits. Polyphenols are a broad class of phytochemical compounds, to which flavanols belong. [JAMA, August 27, 2003] |
Vitamin C (Ascorbic Acid)| | A 1999 study found that in systolic and diastolic hypertension as well as elevated pulse rate, blood plasma vitamin C levels were reduced.
30 adults with adult onset diabetes experienced reduced blood pressure and improved arterial stiffness with 500mg of vitamin C per day. [Hypertension 2002;40(6): pp.804-9]
However, vitamin C at 50mg or 500mg had no effect on blood pressure in a controlled study of 439 Japanese patients. These patients had atrophic gastritis. [Hypertension 2002;40(6): pp.797-803] |
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KEY | | Weak or unproven link | | | Strong or generally accepted link | | | Proven definite or direct link | | | Strongly counter-indicative | | | May do some good | | | Likely to help | | | Highly recommended | | | Reasonably likely to cause problems |
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