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Natural Ways for Treating Mild to Moderate High Blood Pressure


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High blood pressure affects approximately 25% of adults in developed countries, including the United States and Canada. Of these, 75% have mildly high blood pressure, which can often be managed without the use of drugs, through nutrition, supplementation and lifestyle practices1, 2

In fact, medical authorities and pharmacology textbooks instruct doctors to counsel all persons with high blood pressure on nutrition and lifestyle practices that are proven to lower blood pressure.2

High blood pressure, known as the silent killer, is a cardinal risk factor for heart attack and stroke. Studies reveal that lowering one’s blood pressure from 160/90 to 140/80 mm Hg may decrease risk of heart disease by more than 30 percent.3  

All high blood pressure medications are associated with some undesirable side effects and therefore, if possible, it’s in your best interest to keep your blood pressure within the normal range through nutrition and lifestyle factors alone.

Many Patients Don’t Take Their Medications Due To Side Effects

Although many pharmacologic agents are commonly prescribed to lower blood pressure, many patients neglect to take their medication due to side effects such as fatigue, impotence, elevated cholesterol levels and other undesirable symptoms (see  Side Effects Appendix at end of article regarding side effects caused by the most commonly used high blood pressure medications) .4

In Canada 22 percent of adults have high blood pressure, but only 16 percent of these individuals are treated and have their blood pressure under control. Thus, 84 percent of patients are either unaware of their high blood pressure problem or are not complying with recommendations to lower their blood pressure due to side effects of medications.5,6

As a result, many individuals and health practitioners are currently seeking a more natural approach to lowering blood pressure that eliminates the risk of side effects or can be used to help lower the dosage of blood pressure drugs in order to achieve a normal blood pressure reading. The truth is that most cases of mild to moderately high blood pressure can be managed exclusively through dietary, exercise and supplementation interventions.1,2

Proven Nutrition and Lifestyle Practices To Reduce High Blood Pressure

Lifestyle changes effective in reducing blood pressure include weight loss (4.5 kg or 10 lbs. Minimum) for those who are overweight. In fact, two-thirds of hypertensive patients who are overweight are able to reduce their blood pressure to normal by losing some of their excess (10-15 lbs.) weight. (You don’t need to lose all of the excess body fat.)7,8

Regular physical activity (optimum 45 to 60 minutes of moderate activity [brisk walk] four to five times weekly), and low alcohol consumption (two or fewer drinks per day; fewer than 14 drinks weekly for men, nine for women), as well as limiting salt additives and foods with excessive added salt are all proven lifestyle practices that have been shown to lower blood pressure 7,8,9,1,2

In addition to these well-known nutrition and exercise practices, there is good evidence that specific dietary supplements can also assist in reducing high blood pressure. Here is a brief summary of the best-researched blood pressure lowering agents:

Calcium And Magnesium A number of well-designed human intervention trials reveal that calcium supplementation (1,000-1,500 mg calcium and 500-700 mg of magnesium)  can lower blood pressure, particularly in sodium-sensitive high blood pressure patients. Calcium encourages sodium excretion from the body via the kidneys and, in concert with magnesium, helps to relax the muscle lining of arterioles. In turn, this reduces resistance to blood flow, thereby lowering blood pressure10,11 Calcium and magnesium supplements are best taken with meals in order to enhance their absorption.29 Of course, calcium, magnesium, vitamin D and other nutrients also support bone health, reducing risk of osteoporosis. So, taking a bone support supplement in addition to a high potency multiple vitamin and mineral supplement can help improve bone health and better regulate blood pressure.

Essential Fatty Acid Supplementation - Over sixty double-blind studies have demonstrated that either fish oil or flaxseed oil supplementation can be effective in lowering blood pressure. A moderate amount of flaxseed oil alone can lower systolic and diastolic blood pressure by up to 9 mm Hg.12 These three oils work synergistically to help the body produce the mini-hormones (prostaglandins) that relax and open-up blood vessels, hence lowering blood pressure and improving blood flow in general. For best results, I suggest you take an essential fatty acid supplement that contains flaxseed, borage seed and fish oil (a capsule containing 400 mg of each of these oils). I take 3 capsules myself every day for general health and disease prevention purposes. This should be adequate to help lower blood pressure as well.

Coenzyme Q10 and Hawthorn Supplementation: A number of randomized, double-blind trials have demonstrated that Coenzyme Q10 (CoQ10) supplementation can lower blood pressure in high blood pressure patients. CoQ10 is directly involved in allowing the heart muscle to produce the energy required to maintain a normal heart beat. Research reveals that 39 percent of patients with high blood pressure have a deficiency of CoQ10. The daily dosage of CoQ10 to aid in blood pressure lowering is usually 60 mg, twice per day,18 although 100 mg once per day has been tested12 and in mild cases of high blood pressure 30-75 mg, once per day may be sufficient to normalize blood pressure.19,20 However, it is always best to take CoQ10 in a supplement that also contains hawthorn, in regards to blood pressure and cardiovascular health in general (unless you are on the drug digoxin or digitalis). Hawthorn The hawthorn plant and its berries are a rich source of unique flavonoids, which, like CoQ10, improve energy generation in the heart muscle. A number of studies show that hawthorn can lower blood pressure and improve circulation of blood flow to the heart muscle itself.  The daily dosage required to lower blood pressure ranges from 100-250 mg, up to three times daily if taken alone to lower blood pressure. To ensure sufficient levels of flavonoids, the formula must be standardized to 3-5 percent flavonoid content. Thus, a well designed CoQ10 and Hawthorn supplement should contain 37.5 mg of hawthorn for every 30 mg of CoQ10. In most cases taking 2 capsules, twice or three times daily, will provide your body with therapeutic levels of each nutrient. It usually takes 4 to 12 weeks of supplementation to see a decline in blood pressure values. 14,15,16,17   However, I take a this supplement every day, and recommend that you do so as well in order maintain overall good cardiovascular health. Note that both CoQ10 and hawthorn should not be taken by patients taking digitalis or digoxin. 30

The preceding recommendations can be safely used in conjunction with standard high blood pressure drugs, if necessary.

At present, there is sufficient evidence from well-designed medical intervention trials to show that lifestyle interventions are successful in reducing or eliminating the need for drug therapy in a high percentage of hypertensive patients.25,26,27,28 

So, if you’re one of the millions taking medications to control blood pressure, I urge you to slowly change your eating habits, develop an aerobic exercise regiment at least 3-4 times per week, and start using the supplements recommended above. Be sure to have your doctor check your pressure often in order to guard against an unsafe drop in pressure. If your pressure begins to drop, ask your doctor if he can reduce the amount of medication you’re taking. Unfortunately, there are some cases that will require medication for life

Appendix: Side Effects From High Blood Pressure Medications

1. Calcium Channel Blockers

Commonly Used Brand Names in the United States: Adalat (nifedipine), Calan (verapamil), Cardene (nicardipine), Cardizem (diltiazem), Cardizem CD (diltiazem), Cardizem SR (diltiazem), Cartia (diltiazem), Covera-HS (verapamil), Dilacor XR (diltiazem), Diltia XT (diltiazem), DynaCirc (isradipine), Isoptin (verapamil), Lotrel (amlodipine), Nimotop (nimodipine), Norvasc (amlodipine), Plendil (felodipine), Procardia (nifedipine), Procardia XL (nifedipine), Sular (nisoldipine), Tiamate (diltiazem),Tiazac (diltiazem), Vascor (bepridil), Verelan (verapamil)

Commonly Used Brand Names in Canada: Adalat (nifedipine), Apo-Diltiaz (diltiazem), Apo-Nifed (nifedipine), Apo-Verap (verapamil), Cardene (nicardipine), Cardizem (diltiazem), Cardizem SR (diltiazem), Isoptin (verapamil), Nimotop (nimodipine), Novo-Diltazem (diltiazem), Novo-Nifedin (nifedipine), Novo-Veramil (verapamil), Nu-Diltiaz (diltiazem), Nu-Nifed (nifedipine), Nu-Verap (verapamil), Plendil (felodipine), Renedil (felodipine), Sibelium (flunarizine), Syn-Diltiazem (diltiazem), Verelan (verapamil)

Common side effects:

  • Feeling tired
  • Flushing
  • Swelling of the abdomen, ankles, or feet
  • Heartburn

Less common side effects:

  • Very fast or very slow heartbeat
  • Wheezing, coughing, or shortness of breath
  • Trouble swallowing
  • Dizziness
  • Numbness or tingling in the hands or feet
  • Upset stomach
  • Constipation (especially when taking verapamil)

Rare side effects:

  • Headache
  • Fainting
  • Chest pain
  • Yellowing of the skin or eyes (jaundice)
  • Fever
  • Rash
  • Bleeding, swollen, or tender gums
  • Vivid dreams

2. Diuretics

A. Thiazide diuretics

Commonly used brand names in the United States: Aquatensen (methyclothiazide), Diucardin (hydroflumethiazide), Diulo (metolazone), Diuril (chlorothiazide), Enduron (methyclothiazide), Esidrix (hydrochlorothiazide), Hydro-chlor (hydrochlorothiazide), Hydro-D (hydrochlorothiazide), HydroDIURIL (hydrochlorothiazide), Hydromox (quinethazone), Hygroton (chlorthalidone), Metahydrin (trichlormethiazide), Microzide (hydrochlorothiazide), Mykrox (metolazone), Naqua (trichlormethiazide), Naturetin (bendroflumethiazide), Oretic (hydrochlorothiazide), Renese (polythiazide), Saluron (hydroflumethiazide), Thalitone (chlorthalidone), Trichlorex (trichlormethiazide), Zaroxolyn (metolazone)

Commonly used brand names in Canada: Apo-Chlorthalidone (chlorthalidone), Apo-Hydro (hydrochlorothiazide), Diuchlor H (hydrochlorothiazide), Duretic (methyclothiazide), HydroDIURIL (hydrochlorothiazide), Hygroton (chlorthalidone), Naturetin (bendroflumethiazide), Neo-Codema (hydrochlorothiazide), Novo-Hydrazide (hydrochlorothiazide), Novo-Thalidone (chlorthalidone), Uridon (chlorthalidone), Urozide (hydrochlorothiazide), Zaroxolyn (metolazone)

B. Potassium-sparing diuretics

Commonly used brand names in the United States: Aldactone (spironolactone), Dyrenium (triamterene), Midamor (amiloride)

Commonly used brand names in Canada: Aldactone (spironolactone), Dyrenium (triamterene), Midamor (amiloride), Novospiroton (spironolactone)

Potassium-sparing diuretics are used to reduce the amount of water in the body. Unlike the other diuretic medicines, these medicines do not cause your body to lose potassium.

C. Loop-acting diuretics

Commonly used brand names in the United States: Bumex (bumetanide), Demadex (torsemide), Edecrin (ethacrynic acid), Lasix (furosemide), Myrosemide (furosemide)

Commonly used brand names in Canada: Apo-Furosemide (furosemide), Edecrin (ethacrynic acid), Furoside (furosemide), Lasix (furosemide), Lasix Special (furosemide), Novosemide (furosemide), Uritol (furosemide)

Side effects of diuretics include:

  • Increased thirst.
  • Increased urination for a few days after beginning the medicine (thiazide diuretics).
  • Reduced levels of potassium, magnesium, and sodium in the blood. Very low levels of potassium can lead to serious irregular heartbeats (arrhythmias).
  • Increased levels of uric acid (which may lead to gout), calcium, blood sugar (which may complicate control of diabetes), and cholesterol.
  • Weakness.
  • Erection problems (impotence).
  • Excess fluid loss from the body (dehydration) and fainting at higher doses, especially in older adults.
  • Dry mouth.
  • Tooth decay (dental caries).
  • Interaction with other medicines, such as non-steroidal anti-inflammatory drugs (NSAIDs), certain cholesterol-lowering drugs (such as cholestyramine), and lithium, a medicine used to treat certain mental illnesses.

3. Calcium-Channel Blockers

Commonly Used Brand Names in the United States: Adalat (nifedipine), Calan (verapamil), Cardene (nicardipine), Cardizem (diltiazem), Cardizem CD (diltiazem), Cardizem SR (diltiazem), Cartia (diltiazem), Covera-HS (verapamil), Dilacor XR (diltiazem), Diltia XT (diltiazem), DynaCirc (isradipine), Isoptin (verapamil), Lotrel (amlodipine), Nimotop (nimodipine), Norvasc (amlodipine), Plendil (felodipine), Procardia (nifedipine), Procardia XL (nifedipine), Sular (nisoldipine), Tiamate (diltiazem),Tiazac (diltiazem), Vascor (bepridil), Verelan (verapamil)

Commonly Used Brand Names in Canada: Adalat (nifedipine), Apo-Diltiaz (diltiazem), Apo-Nifed (nifedipine), Apo-Verap (verapamil), Cardene (nicardipine), Cardizem (diltiazem), Cardizem SR (diltiazem), Isoptin (verapamil), Nimotop (nimodipine), Novo-Diltazem (diltiazem), Novo-Nifedin (nifedipine), Novo-Veramil (verapamil), Nu-Diltiaz (diltiazem), Nu-Nifed (nifedipine), Nu-Verap (verapamil), Plendil (felodipine), Renedil (felodipine), Sibelium (flunarizine), Syn-Diltiazem (diltiazem), Verelan (verapamil)

Common Side Effects:

  • Feeling tired
  • Flushing
  • Swelling of the abdomen, ankles, or feet
  • Heartburn

Less common side effects:

  • Very fast or very slow heartbeat
  • Wheezing, coughing, or shortness of breath
  • Trouble swallowing
  • Dizziness
  • Numbness or tingling in the hands or feet
  • Upset stomach
  • Constipation (especially when taking verapamil)

Rare side effects:

  • Headache
  • Fainting
  • Chest pain
  • Yellowing of the skin or eyes (jaundice)
  • Fever
  • Rash
  • Bleeding, swollen, or tender gums
  • Vivid dreams

 

4. Angiotensin-Converting Enzyme (ACE) Inhibitors

Brand Names: Accupril (quinapril), Aceon (perindopril), Altace (ramipril), Capoten (captopril), Lotensin (benazepril), Mavik (trandolapril), Monopril (fosinopril), Prinivil (lisinopril), Prinzide (lisinopril with a diuretic), Univasc (moexipril), Vaseretic (enalapril with a diuretic), Vasotec (enalaprilat, enalapril), Zestoretic (lisinopril with a diuretic), Zestril (lisinopril)

Common side effects:

  • A dry cough, which may make it hard to talk.

Less common side effects:

  • Diarrhea.
  • Headache.
  • Loss of taste or a taste of stainless steel in your mouth.
  • Loss of appetite.
  • Upset stomach.
  • Skin that is sensitive to sunlight.
  • Feeling very tired.
  • Dizziness, lightheadedness, or fainting.
  • Fever.
  • Joint pain.
  • Numbness or tingling in hands or feet.

Rare side effects:

  • Fever and chills.
  • A hoarse voice.
  • Swelling of your face, mouth, hands, or feet.
  • Trouble swallowing or breathing.
  • Severe upset stomach and throwing up.
  • Unusual bruising.
  • Yellow eyes or skin (called jaundice).

4. Angiotensin II Receptor Blockers

Brand Names: Atacand (candesartan cilexetil), Avapro (irbesartan), Benicar (olmesartan), Cozaar (losartan), Diovan (valsartan), Hyzaar (losartan), Micardis (telmisartan), Teveten (eprosartan mesylate)

Common side effects:

  • Headache (with Cozaar)

Less common side effects:

  • Cough
  • Fever
  • Sore throat
  • Dizziness
  • Back pain
  • Diarrhea
  • Fatigue
  • Upset stomach
  • Nervousness
  • Heartburn

Rare side effects:

  • Stuffy nose or cough
  • Chills
  • A hoarse voice
  • Swelling of the face, mouth, hands, or feet
  • Trouble swallowing or breathing
  • Trouble sleeping
  • Dizziness, lightheadedness, or fainting

Primary References For All Drug Side Effects Listed Above:

  1. Texas Heart Institute (www.texasheartinstitute.org)

Pharmacology for Primary Care Providers (Edmunds M and Mayhew M). Elsevier/Mosby Publishers – 2nd edition 2004

References Quick Reference to Clinical Nutrition, Halpern, S. (ed.); Nutrition and Cardiovascular Disease; J.B. Lippincott Company, Philadelphia, 1987: 139-153

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  3. Complete Guide to Prescription and Non-Prescription Drugs (1999 edition) Griffith H.W. The Body Press, 1998: 168-169, 194-195, 54-55
  4. Murray, C.J.L.M., et al. Evidence-based health policy – lessons from the global burden of disease study. Science 1996; 274: 740-743
  5. Joffres, M.R., et al. Awareness, treatment, and control of hypertension in Canada. Am J Hypertens. 1997; 10, (Pt-1): 1097-1102
  6. 2000 Canadian hypertension recommendations (summary of recommendations affecting family physicians) – the Canadian Hypertension Recommendations Working Group. Canadian Family Physician. April 2001; 47: 793-794
  7. Modern Nutrition in Health and Disease (sixth edition) Goodhart, R., and Shils, M. Lea and Febiger: 733
  8. Pate, R.R., et al. Physical Activity and Public Health. JAMA. Feb. 1, 1995; 272, 5: 402-407
  9. Meese, R.B., et al. The inconsistent effects of calcium supplements upon blood pressure in primary hypertension. Am J Med Sci. 1987; 29: 4219-4224
  10. Motoyama, T., et al. Oral magnesium supplementation in patients with essential hypertension. Hypertension, 1989; 13: 227-232
  11. Murray, M., and Pizzorno, J. Encyclopedia of Natural Medicine (2nd edit.) Prima Publishing, 1997; 425-535
  12. Foushee, D.B., et al. Garlic as a natural agent for the treatment of hypertension. A preliminary report. Cytobios. 1982; 34: 145-162
  13. Digiesi, V., et al. Mechanism of action of Coenzyme Q10 in essential hypertension. Curr Ther Res. 1992; Res 51: 668-672
  14. Langsjoen, P., et al. Treatment of essential hypertension with Coenzyme Q10. Mol Aspects Med. 1994; Med 15 (suppl): 265-272
  15. Digiesi, V., et al. Coenzyme Q10 in essential hypertension. Mol Aspects Med. 1994; Med 15 (suppl): 257-263
  16. McCarty, M.F. Coenzyme Q versus hypertension: does CoQ decrease endothelial superoxide generation? Med Hypotheses. 1999; 53, 4: 300-304
  17. Singh, R.B., et al. Effect of hydrosoluble Coenzyme Q10 on blood pressure and insulin resistance in hypertensive patients with coronary artery disease. J Hum Hypertens. 1999; 13, 3: 203-208
  18. Yamagami, T., et al. Bioenergetics in Clinical Medicine. Studies on Coenzyme Q10 and Essential Hypertension. Research Comm in Chem. Path and Pharmacol 1975; 11, 2: 273-288
  19. Yamagami, T., et al. Bioenergetics in Clinical Medicien, VIII. Administration of Coenzyme Q10 to patients with essential hypertension. Research Comm in Chem Path and Pharmacol. 1976; 14, 4: 721-727
  20. Encyclopedia of Nutritional Supplements. Murray, M., PRIMA publishing, 1996: 300-301
  21. Nutritional Influences on Illness. Werbach, M.R. Third Line Press., Inc. 1987: 227-240
  22. Encyclopedia of Natural Medicine (2nd edit) Murray, M. and Pizzorno, J. Prima Publishing 1997: 524-535
  23. Petrella, R.J. Lifestyle approaches to managing high blood pressure. Can Family Phys. 1999; 45: 1750-1755
  24. Elmer, J.P., et al. Lifestyle intervention: results of the Treatment of Mild Hypertension Study. (TOHMS). Prev Med 1995; 24: 378-388
  25. Stamler, R., et al. Nutritional therapy for high blood pressure. Final report of a four-year randomized controlled trial – the hypertension control program. JAMA. 1987; 257: 1484-1491
  26. Iso, H., et al. Community-based education classes for hypertension control: a 1.5-year randomized controlled trial. Hypertension. 1996; 27: 968-974
  27. Appel, L.J., et al. A clinical trial of the effects of dietary patterns on blood pressure (DASH-study) N Engl J Med 1997; 336: 1117-1124
  28. Levenson, D., et al. A review of calcium preparations. Nutr Reviews. 1994; 52, 7: 221-232
  29. Shariff, S., et al. Herbal Fervor and Vitamin Vigor: Herbs and vitamins for cardiac disease. Perspective in Cardiology. 2000; 16, 1: 21-29

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