hypertension

Hypertension or high blood pressure is a chronic medical condition in which the blood pressure in the arteries is elevated. It is classified as either primary (essential) or secondary. About 90-95% of cases are termed "primary hypertension", which refers to high blood pressure for which no medical cause can be found. The remaining 5-10% of cases (Secondary hypertension) are caused by another conditions that affect the kidneys, arteries, heart, or endocrine system. From a naturopathic perspective there is a plethora of dietary, lifestyle and supplement and herbal medicine advice that will address the causes of hypertension and lower blood pressure naturally

Hypertension is one of the risk factors for

  • Strokes
  • Heart attacks
  • Heart failure
  • Arterial aneurysm
  • Chronic kidney failure (the leading cause)

Classification

Systolic pressure

 

Diastolic pressure

 
 

mmHg

kPa

mmHg

kPa

Normal

90–119

12–15.9

60–79

8.0–10.5

Prehypertension

120–139

16.0–18.5 

80–89

10.7–11.9

Stage 1

140–159

18.7–21.2  

90–99

12.0–13.2

Stage 2

≥160

≥21.3

≥100

≥13.3

Isolated systolic hypertension

≥140

≥18.7

<90

<12.0

Signs and symptoms

Mild to moderate essential hypertension is usually asymptomatic.

Accelerated hypertension is associated with;

  • Headache
  • Drowsiness
  • Confusion
  • Vision disorders
  • Nausea and vomiting

Chronic hypertension leads to enlargement of the heart, which can cause shortness of breath during exercise or sleep (paroxysmal nocturnal dyspnoea).

Hypertension can also cause narrowing of the blood vessels in the eye that leads to eye-related disorders including changes in the appearance of eye vessels, fluid leakage, spontaneous bleeding, or swelling

Complications

  • Hardening of the arteries (atherosclerosis). Peripheral arterial disease (obstruction of the arteries in the arms and legs)
  • Stroke
  • Heart attack
  • Heart failure
  • Thickening of the heart muscle (Left ventricular hypertrophy).
  • Eye damage (Hypertensive retinopathy)
  • Kidney disease (Hypertensive nephropathy) - chronic renal failure due to chronically high blood pressure "benign nephrosclerosis”
  • Compromised brain function (Hypertensive encephalopathy)

Causes

Essential hypertension

Essential hypertension is the most prevalent hypertension type, affecting 90-95% of hypertensive patients. Although no direct cause has identified itself, there are many factors such as;

  • sedentary lifestyle
  • Stress,
  • Obesity
  • Potassium deficiency (hypokalemia)
  • Excess salt
  • Excess alcohol
  • Vitamin D deficiency
  • Insulin resistance, which is a component of syndrome X, or the metabolic syndrome is also thought to contribute to hypertension.
  • Consuming foods that contain high fructose corn syrup may increase one's risk of developing hypertension.

Secondary hypertension

  • Hypertension caused by other hormone disorders such as
  • Cushings syndrome (adrenal glands overproduce the hormone cortisol)
  • Hyperthyroidism
  • Hypothyroidism
  • Growth hormone excess
  • Hyperaldosteronism
  • Phaeochromocytoma
  • Kidney disease
  • Obesity/metabolic disorder
  • Pre-eclampsia during pregnancy
  • Certain prescription and illegal drugs.

Pathophysiology of Essential Hypertension

Cardiac output is raised early in the disease course, with total peripheral resistance (TPR) normal.

Over time however, cardiac output drops to normal levels but TPR is increased.

Three theories have been proposed to explain this:

  1. The kidneys fail to excrete sodium, resulting in natriuretic factors such as Atrial Natriuretic Factor ANP being secreted to promote salt excretion with the side effect of raising total peripheral resistance. ANP, is a powerful vasodilator, released by muscle cells in the heart in response to high blood pressure. ANP acts to reduce the water and sodium, thereby reducing blood pressure. The paradoxical result is to increase Blood pressure as the drop in BP causes the peripheral arterioles to constrict therefore pushes up the BP.
  2. An overactive Renin-angiotensin system leads to vasoconstriction and retention of sodium and water. The increase in blood volume leads to hypertension.

Review

Blood pressure and the renin angiotensin pathway

  • Decrease in blood volume due to dehydration, Na deficiency or haemorrhage, stimulate the renin angiotensin pathway.
  • Low BP stimulates the juxtaglomerular cells to secrete a hormone, renin.
  • Renin converts angiotensin, a plasma protein produced by the liver, into angiotensin 1
  • Angiotensin I circulates to the lungs where angiotensin converting enzyme (ACE) converts angiotensin I into angiotensin II
  • Angiotensin II has two target tissues. One is the adrenal cortex, where it stimulates aldosterone.
  • Aldosterone increases Na reabsorption and water follows by osmosis. Aldosterone also causes increased K secretion in the urine
  • Blood volume increases and blood pressure normalises.(with ADH ). ADH present in neurons of the brain stem and spinal chord improves memory, regulates water resorption by the kidneys and causes vasoconstriction.
  • The other target tissue for angiotensin II is the smooth muscle cells of the arteriole walls. Here it results in vasoconstriction which works further to normalise the blood pressure

Another mechanism for control of aldosterone secretion is blood K levels. Increased K concentration (interstitial fluid) in the blood stimulates aldosterone secretion by the adrenal cortex. Aldosterone increases Na reabsorption and water follows by osmosis and resulting in the kidneys eliminating excess K. A decline in blood K has the opposite effect

  1. 3. An overactive sympathetic nervous system, leading to increased stress responses.

Western Medical Treatment of Hypertension

Lifestyle modifications

Sometimes overlooked, the following lifestyle changes have all been shown to significantly reduce blood pressure

  • Dietary change
  • Physical exercise
  • Weight loss

Medications

  • ACE inhibitors such as captopril, enalapril, fosinopril (Monopril), lisinopril (Zestril), quinapril, ramipril (Altace)
  • Angiotensin II receptor antagonists may be used where ACE inhibitors are not tolerated: e.g., telmisartan (Micardis, Pritor), irbesartan (Avapro), losartan (Cozaar), valsartan (Diovan), candesartan (Amias), olmesartan (Benicar, Olmetec)
  • Calcium channel blockers such as nifedipine (Adalat)amlodipine (Norvasc), diltiazem, verapamil
  • Diuretics: e.g., bendroflumethiazide, chlorthalidone, hydrochlorothiazide (also called HCTZ). Diuretics such a furosemide or low-dosages of spironolactone
  • Beta blockers such as atenolol, labetalol, metoprolol (Lopressor, Toprol-XL), propranolol. Whilst once were first line agents, now they are less commonly used because they increase the risk of diabetes.

Naturopathic Causes of Hypertension

Hyperhomocysteinaemia

Hyperhomocysteinaemia is a medical condition characterised by an abnormally large level of homocysteine in the blood. Simply put high homocysteine results in low levels of Nitric Oxide NO also know as Endothelial Derived Relaxing Factor EDRF. Whilst adrenalin causes vasoconstriction in peripheral arterioles and raises blood pressure, it is NO that allows these to relax resulting in a decrease in BP.

Several studies have linked plasma homocysteine levels to blood pressure. Homocysteine-lowering therapies with folic acid-based treatments have resulted in decreases in blood pressure.

How does homocysteine decrease Nitric Oxide levels?

Homocysteine elevates blood levels of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase the enzyme involved in the production of NO.The effect is associated with the reduced activity of dimethylarginine dimethylaminohydrolase (DDAH), the enzyme that degrades ADMA.

Conclusion

Homocysteine post-translationally inhibits DDAH enzyme activity, causing ADMA to accumulate and inhibit nitric oxide synthesis. This may explain the known effect of homocysteine to impair endothelium-mediated nitric oxide–dependent vasodilatation.

Homocysteine and folic acid, B12 and B 6

Deficiencies of the vitamins folic acid, B6 or B12. results in the poor methylation of homocysteine and thus accumulation. Supplementation with pyridoxine, folic acid, B12 or trimethylglycine (betaine) reduces the concentration of homocysteine in the bloodstream.

Hyperhomocysteinaemia and Heart Disease

A high level of homocysteine in our blood makes us more prone to having blood clots which come in heart attacks and strokes.

Hyperhomocysteinaemia also damages the lining of veins and arteries which prevents build up.

Hyperhomocysteinaemia is a risk factor for coronary artery disease Coronary artery disease (plaque builds up on coronary arteries)

Causes of hyperhomocysteinaemia

  1. 1. Two Gene Defects
  • Hyperhomocysteinaemia usually occurs in people with at least one defective gene, which affects the breakdown of homocysteine. The first gene codes for an enzyme. This gene is known as Methylenetetrahydrofolate reductase or MTHFR.
  • The second common defective gene is methioninesynthetase or MS.
  1. 2. Dietary deficiencies of  Folate and vitamin B6 and B12

The effect upon those people is greater than the people with only one gene defect.

Insulin resistance and hypertension

Insulin resistance (IR) is a condition in which body cells become less sensitive to the glucose-lowering effects of the hormone insulin. High plasma levels of insulin and glucose due to insulin resistance are a major component of metabolic syndrome.

Many people with hypertension are either diabetic or pre-diabetic and have elevated insulin levels due to insulin resistance.

Insulin and Arterial Muscle Tone

One of insulin's effects is to control arterial wall tension throughout the body. Insulin forces arterial wall muscle to relax, increasing blood flow, especially in micro arteries; lack of insulin reduces flow by allowing these muscles to contract.

Sugar

Sucrose elevates the Blood pressure

Sugar causes Na retention. This is because insulin pushes calcium and magnesium out of the cells and retains Na.

Sugar also causes;

  • Increased aldosterone secretion
  • Increase insulin levels
  • Increased catecholamine secretion.
  • Increase in plasma cholesterol
  • Increased triglycerides and uric acid
  • Increases platelet adhesion

Most likely Mechanism

  • Increased catecholamines.
  • Increased sympathetic tone.
  • Increased Na retention.
  • Hyperinsulinaemia inhibits Delta 6 and Delta 5 EFA pathways. Zn, Mg and B6 are part of Glucose Tolerance Factor GTF and used to make insulin.

Other causes of hypertension

Caffeine

5 or 6 cups a day or 2 litres of Coca Cola is hypertensive

Smoking

Actively increases blood pressure via adrenal stimulation.

Stress

Increased catecholamines, adrenalin and noradrenalin both vasoconstrictive

Weight and hypertension

Studies show that obesity is a major contributing factor in hypertension

Possible mechanisms include:

  • Increased NO.
  • Increased body Na due to hyperinsulinaemia or abnormal aldosterone / renin relationship.
  • Neuroendocrine abnormalities due to increased noradrenergic activity / opiate suppression.
  • Weight reduction reduces BP in normotensive, hypotensive and hypertensive patients.

Na and K Excess

NaCl results in deficient potassium resulting in increased ECF volume, which impairs the blood regulating mechanisms. This can causes hypertension in susceptible individuals.

Naturopathic lifestyle advice for prevention of hypertension

  • Weight reduction
  • Regular exercise. Regular exercise improves blood flow and helps to reduce the resting heart rate and blood pressure. Exercise increases endothelium- derived relaxing factor (EDRF)/nitric oxide (NO).
  • Reducing dietary sugar intake.
  • Reducing sodium (salt) in the diet.
  • Additional dietary changes beneficial to reducing blood pressure include the DASH diet (dietary approaches to stop hypertension) which is rich in fruits and vegetables and low-fat or fat-free dairy products.
  • In addition, an increase in dietary potassium, which offsets the effect of sodium has been shown to be highly effective in reducing blood pressure.
  • Discontinuing tobacco use and alcohol consumption has been shown to lower blood pressure. The exact mechanisms are not fully understood, but blood pressure (especially systolic) always transiently increases following alcohol or nicotine consumption. Probably something to di with nitric oxide also.
  • Reducing stress, for example with relaxation therapy, such as meditation and other mindbody relaxation techniques, by reducing environmental stress such as high sound levels and over-illumination can also lower blood pressure.

Nutritional for Hypertension

Mediterranean Diet

Data analysis confirmed that the Mediterranean diet as a whole is significantly associated with lower systolic and diastolic blood pressure as were olive oil, vegetables and fruit. On the other hand, consumption of cereals, meat and meat products, and alcohol intake is associated with higher blood pressure.

Eat more

  • Cold water fish such as salmon, tuna, herring, mackerel and halibut for their beneficial omega 3 fatty acid
  • Onions and garlic
  • Olive oil
  • Celery
  • Organically grown fruits and vegetables, especially beetroot, leafy greens and cruciferous vegetables such as broccoli, cauliflower and cabbage
  • Whole grains
  • Legumes

Avoid

  • saturated fat
  • sugar
  • caffeine
  • alcohol
  • excess sodium

Deep Sea Fish

High cholesterol

People who follow a Mediterranean-style diet tend to have higher HDL or “good” cholesterol levels, which help promote heart health. Inuit Eskimos, who get high amounts of omega-3 fatty acids from eating fatty fish, also tend to have increased HDL cholesterol and decreased triglycerides (fats in the blood). Several studies have shown that fish oil supplements reduce triglyceride levels.

High blood pressure

Several clinical studies suggest that diets or fish oil supplements rich in omega-3 fatty acids lower blood pressure in people with hypertension.

An analysis of 17 clinical studies using fish oil supplements found that taking 3 or more grams of fish oil daily may reduce blood pressure in people with untreated hypertension. Heart disease One of the best ways to help prevent heart disease is to eat a diet low in saturated fat and to eat foods that are rich in monounsaturated and polyunsaturated fats (including omega-3 fatty acids).

Clinical evidence suggests that EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid, the two omega-3 fatty acids found in fish oil) help reduce risk factors for heart disease, including high cholesterol and high blood pressure.

Fish oil has been shown to lower levels of triglycerides (fats in the blood), and to lower risk of death, heart attack, stroke, and abnormal heart rhythms in people who have already had a heart attack. Fish oil also appears to help prevent and treat atherosclerosis (hardening of the arteries) by slowing the development of plaque and blood clots, which can clog arteries.

Large population studies suggest that getting omega-3 fatty acids in the diet, primarily from fish, helps protect against stroke caused by plaque build-up and blood clots in the arteries that lead to the brain. Eating at least 2 servings of fish per week can reduce the risk of stroke by as much as 50%.

Caution

People who eat more than 3 grams of omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may have higher risk for hemorrhagic stroke, a potentially fatal type of stroke in which an artery in the brain leaks or ruptures.

Olive oil

The polyphenols found in olive oil are potent antioxidants that protect LDL (the potentially harmful form of cholesterol) from oxidation (damage by free radicals). Oxidised LDL cholesterol contributes to the development of atherosclerosis.

Helps Prevent Central Obesity and Improve Insulin Sensitivity

Central obesity is associated with insulin resistance, which leads to further weight gain and increases risk of type 2 diabetes.

When researchers fed type 2 diabetic patients different diets –

  1. A high carbohydrate diet
  2. A diet rich in either saturated fat
  3. A diet rich in olive oil (Mediterranean diet)

The high carb diet increased abdominal fat compared to the fat-rich diets.

Olive Oil and Adiponectin

Of the three diets, the diet rich in olive oil prevented abdominal fat accumulation, improved insulin sensitivity and saw an increase in a hormone called adiponectin.

Adiponectin is a hormone produced and secreted by fat cells (adipocytes).

Adionpectin

  • regulates sugar and fat metabolism
  • improves insulin sensitivity
  • has anti-inflammatory effects on the cells lining the blood vessel walls

Low blood levels of adiponectin are a marker for metabolic syndrome, are common in obesity, and are also associated with increased heart attack risk.

Levels of Adiponectin, are inversely correlated with body fat percentage in adults. The hormone plays a role in the suppression of the metabolic derangements that may result in;

  • type 2 diabetes
  • obesity
  • atherosclerosis
  • non-alcoholic fatty liver disease (NAFLD) and
  • an independent risk factor for metabolic syndrome

Potent anti-inflammatory compound called Oleocanthal discovered in olive oil

Research has discovered a compound that suppresses the prostaglandin system, the same pain pathway as non-steroidal anti-inflammatory agents, such as ibuprofen.

Although its chemical structure is quite different from the anti-inflammatory compounds in non-steroidal drugs, olive oil's anti-inflammatory component, which researcher Beauchamp named "oleocanthal," has a similar effect.

A 50 gram dose (about 4 tablespoons) of extra-virgin olive oil supplies enough oleocanthal to produce an effect equivalent to that of about 10% of the ibuprofen dose recommended for adult pain relief.

Garlic and onions are hypotensive

Onions and garlic are rich in sulphur-containing compounds including

  • thiosulfinates (of which the best known compound is allicin)
  • sulphoxides (among which the best known compound is alliin)
  • dithiins (in which the most researched compound is ajoene)

Garlic's numerous beneficial cardiovascular effects are due to not only its sulphur compounds, but also to its vitamin C, vitamin B6, selenium and manganese.

Garlic and vitamin C

Garlic is a very good source of vitamin C, the body's primary antioxidant defender in all aqueous (water-soluble) areas, such as the bloodstream, where it prevents the oxidation of LDL cholesterol.

Garlic and B6

Garlic's vitamin B6 lowering levels of homocysteine. An intermediate product of an important cellular biochemical process called the methylation cycle, homocysteine can directly damage blood vessel walls.

Garlic and Selenium

The selenium in garlic is a cofactor to glutathione peroxidase (one of the body's most important internally produced antioxidants), selenium also works with vitamin E in a number of vital antioxidant systems.

Garlic and Manganese

Garlic is also rich  in another trace mineral, manganese, which also functions as a cofactor in a number of other important antioxidant defence enzymes, for example, superoxide dismutase.

Studies have found that in adults deficient in manganese, the level of HDL (the "good form" of cholesterol) is decreased.

Anti-inflammatory, antibacterial and antiviral activity of garlic

Garlic, like onions, contains compounds that inhibit lipoxygenase and cyclooxygenase, (the enzymes that generate inflammatory prostaglandins and thromboxanes), thus markedly reducing inflammation.

Walnuts prevent and control high blood pressure

Individuals whose diets provide greater amounts of omega-3 fatty polyunsaturated fatty acids-and walnuts are an excellent source of these essential fats-have lower blood pressure than those who consume less, shows data gathered in the International Study of Macro- and Micro-nutrients and Blood Pressure (INTERMAP) study (Ueshima H, Stamler J, et al. Hypertension).

Higher omega-3 fatty acid intake among the 2,238 subjects who were not using drugs, supplements, or a special diet for hypertension, heart disease, or diabetes was associated with a 1.01/0.98 mm Hg reduction in systolic and diastolic blood pressure, respectively.

Lead author Hirotsugu Ueshima, MD of Shiga University of Medical Science in Japan, noted that the beneficial effect of omega-3 fats was even greater in people who had not yet developed high blood pressure. The researchers also found that omega-3s from nuts, seeds, and vegetable oils-such as walnuts and flaxseed-had just as much impact on blood pressure as omega-3s from fish.

"With blood pressure, every millimeter counts. The effect of each nutrient is apparently small but independent, so together they can add up to a substantial impact on blood pressure. If you can reduce blood pressure a few millimeters from eating less salt, losing a few pounds, avoiding heavy drinking, eating more vegetables, whole grains and fruits (for their fibre, minerals, vegetable protein and other nutrients) and getting more omega-3 fatty acids, then you've made a big difference," said Ueshima.

High fat foods and hypertension

The research suggests that some high-fat foods - like olive oil and avocados can be beneficial for persons with high blood pressure. In the case of olive oil, it's the polyphenols in this food that can help to relax the blood vessels through an increase in nitric oxide production

Beetroot juice and hypertension

Drinking just 2 glasses (16.9 ounces) of beetroot juice a day can significantly reduce blood pressure, shows a study in the American Heart Association journal Hypertension, which could have major implications for the treatment of cardiovascular disease. (Web AJ, Patel N, et al.)

Previously, the protective effects of a diet high in vegetables was  thought to be due to their high antioxidant content, but this study reveals that it is the dietary nitrate in beetroot juice and in all green leafy vegetables can result in a decrease in blood pressure.

The nitrate in beetroot juice is converted by bacteria on the tongue into nitrite and swallowed in saliva, which, in the acidic environment of the stomach, is either converted into nitric oxide or re-enters the circulation as nitrite.

Nitric oxide lowers blood pressure because it signals the endothelium (the lining of our blood vessels) to relax.

In healthy volunteers, blood pressure began to lessen within just 1 hour of drinking beet juice, with the peak drop of -10.48 mm/Hg occurring about 3 hours after ingestion. And beneficial blood pressure lowering effects continued to some degree for up to 24 hours!

Herbal medicine for hypertension

See Carahealth Heart Tonic

Herbal Actions Required

  • Circulatory stimulants
  • Vascular tonics
  • Hypotensives
  • Peripheral vasodilators
  • Circulatory nervines
  • Kidney tonics
  • Muscle relaxants

Herbs

  • Cratageous oxycanthiodes Hawthorn berry - trophorestorative to heart
  • Zanthoxylum americanum Zanthox– circulatory stimulant and alterative
  • Viscum album Mistletoe – hypotensive
  • Stachys betonicas Wood betony – Cerebral circulatory stimulant, bitter and sedative
  • Acillea millefolium Yarrow - thrombotic conditions with hypertension including cerebral and coronary thrombosis. Yarrow, Tilia and sambuccus for hypertension
  • Tilia europa Lime flowers – peripheral vasodilator and relaxant aused for arteriosclerosis and hypertension.

Nervines with a circulatory action

  • Rosmarinus officinalis Rosemary– cerebral circulatory stimulant, palpitations and nervous debility (intercostal neuralgia)
  • Leon uris cardiaca Motherwort
  • Tilia europa Lime Flowers

Diuretics

  • Equisetum arvense Horsetail
  • Taraxacum Officinalis Dandelion leaf
  • Verbena officinalis Vervain

Digestive bitters

  • Cynara scolymus Globe artchoke
  • Stachys betonica Wood betony – bitter, nervine, circulatory stimulant and vascular tonic
  • Taraxacum officinalis Dandelion

Dandelion is used for high blood pressure, and congestive heart failure. In the spring dandelion leaves and roots produce mannitol, a substance used in the treatment of hypertension and weak heart throughout Europe. A tea is made of the roots and leaves are good to take during this period, from about mid-March to mid-May.

Bring 1 quart of water to a boil, reduce heat and add 2 tblsp. of cleaned and chopped fresh roots.

Simmer for 1 minutes, covered, then remove from heat and add 2 tblsp. of chopped, freshly picked leaves.

Steep for 40 minutes.

Strain and drink 2 cups per day.

Shiitake mushrooms

Shiitake mushrooms contain lentinan. Lentinan has been shown to reduce both blood pressure and cholesterol, suggesting usefulness in preventing and treating heart disease and stroke. In a half-dozen Japanese studies, daily servings of 1/3 of an ounce of shiitakes reduced cholesterol an average of 7%. Every 1% reduction in cholesterol means a 2% reduction in heart attack risk, so the mushroom cut heart attack risk 14%.

Barberry

Barberry contains chemicals that may help reduce elevated blood pressure by enlarging blood vessels, thus lending support to the herb's traditional Russian use as a treatment for high blood pressure. Bayberry changes the way the body uses sodium and potassium.

Black cohosh

A study published in Nature shows black cohosh reduces blood pressure by opening the blood vessels in the limbs (peripheral vasodilation). The herb may help manage high blood pressure, lower cholesterol, helps cardiovascular and circulatory disorders.

Caution with congestive heart failure and the above herbs

There are a number of herbs contraindicated in hypertension

  • Liquorice
  • Ginseng
  • Ephedra
  • Rosemary

Nutritional supplements for hypertension

Folic acid, B12 and B 6

Deficiencies of the vitamins folic acid, B6 or B12. results in the poor methylation of homocysteine and thus accumulation. Supplementation with B6, folic acid, B12 or trimethylglycine (betaine) reduces the concentration of homocysteine in the bloodstream.

Vitamin D

There is an inverse correlation between low blood levels of vitamin D and increased risk of hypertension.

Coenzyme Q10 (CoQ10)

Coenzyme Q10 (CoQ10) Coenzyme Q10 or CoQ10 is an essential component of the mitochondria. Although CoQ10 can be synthesised within the body, deficiency has been found in 39% of patients with high blood pressure.

In several studies, CoQ10 has been shown to lower blood pressure approximately 10% in patients with hypertension; however, not until after four to twelve weeks of therapy. CoQ10 seems to lower blood pressure by lowering cholesterol levels and stabilising the vascular system via its antioxidant properties. These actions reduce resistance to blood flow through the arteries.

There is some evidence that the supplement CoQ10 may help to reduce high blood pressure. A 12 week double-blind, placebo-controlled trial of 83 people with systolic hypertension examined the effect of CoQ10 supplements (60 mg twice daily). After the 12 weeks, there was a mean reduction in systolic blood pressure of 17.8 mm Hg in the Coq10-treated group.

Another study conducted at the University of Western Australia looked at the effect of CoQ10 on blood pressure and glycemic control in 74 people with type 2 diabetes. Participants were randomly assigned to receive either 100mg CoQ10 twice daily, 200mg of the drug fenfibrate, both, or neither for 12 weeks. CoQ10 significantly reduced systolic and diastolic blood pressure(mean reduction 6.1 mm Hg and 2.9 mm Hg respectively). There was also a reduction in HbA1C, a marker for long-term glycemic control.

Vitamin C May Lower Blood Pressure The Lancet December 18, 1999;354.

The study of 45 people with high blood pressure (hypertension) had the levels fall by about 9.1% if they consumed a 500-milligram supplement of vitamin C each day for a month.

Potassium

Potassium, either from fruits and vegetables or in supplement form, can lower high blood pressure. Anyone who already has hypertension "should eat a diet high in potassium or take supplements," says Harvard researcher Frank M. Sacks, MD.

In a study of more than 300 women, he and colleagues learned that potassium is more important than magnesium or calcium for blood pressure control. "Surprisingly, when we put the three together, the effect was no greater than potassium alone. In fact, it was a little lower," he adds. About 1,600 milligrams of potassium was given to the study participants.

A glass of orange juice or banana contains about 400 milligrams of' potassium.

National Heart, Lung and Blood Institute

Vitamin E

In a recent large population study in Europe, it was found that low blood levels of vitamin E were much more predictive of heart disease than were high levels of blood cholesterol and elevated blood pressure.

High levels of blood cholesterol were predictive 29% of the time, high blood pressure was predictive 25% of the time, but a low blood level of vitamin E was predictive of a heart attack 69% of the time.

In perhaps, the most impressive study of vitamin E, published in the journal Lancet, daily doses of 400-800 IU of vitamin E were shown to decrease the incidence of heart attacks by 77% in a group of 2,000 people.

The death rate from all causes was 34% lower in older people taking vitamin E supplements, according to the National Institute on Aging Research

L-arginine

L-arginine is a common amino acid from food, but its importance increases in those with hypertension. In the body (specifically within those hard-working blood vessels) it is converted into nitric oxide, a chemical that helps keep the inner walls of blood vessels smooth and normally allows blood vessels to relax (among many other extremely important functions).

Individuals with hypertension have difficulty maintaining normal nitric oxide levels, which may also relate to other significant health issues such as diabetes and heart problems. The kidneys are particularly sensitive to the levels of l-arginine, nitric oxide, and related chemicals. Stressful experiences and aging may also result in lower l-arginine levels.

Dietary intake levels of l-arginine vary considerably, but they range from 1 to over 4 grams per day. The consumption of nuts, which contain relatively high levels of arginine, has a very strong negative correlation to the risk of coronary events. Soy flour, wheat bran, hazelnuts, and walnuts all contain high levels of both arginine and folic acid. Fish contains high levels of arginine and essential fats.

A major source of dietary arginine in the Western diet is meat; however, meat also contains high levels of saturated fats as well as methionine, the precursor to homocysteine. Soy flour, wheat bran, and most nuts contain relatively low levels of methionine.

It is advisable to limit arginine intake in those with active or latent herpes simplex or herpes zoster infections.

For further details or to arrange an appointment contact This email address is being protected from spambots. You need JavaScript enabled to view it. 

Carina Harkin BHSc.Nat.BHSc.Hom.BHSc.Acu.