Dr. James Manos (MD)
July 5, 2019
July 5, 2019
Herbs & dietary supplements used for the treatment of hypertension
Herbs & dietary supplements for hypertension
(with green color are the herbs & dietary supplements that I personally consider more important for this issue)
(with green color are the herbs & dietary supplements that I personally consider more important for this issue)
· Anthocyanins
· Beetroot juice
2 studies showed that beetroot juice consumption significantly, and in a near dose-dependent manner, lowered systolic blood pressure (SBP) and diastolic blood pressure (DBP) over a period of 24 hours, compared with water control – the studies demonstrated significant hypotensive effects of a low dose (100 g) of beetroot which was unaffected by processing or the presence of betacyanins.
· Black chokeberry
A human study showed that chokeberry flavonoids reduce the severity of inflammation, regardless of statins, and can be used clinically for secondary prevention of ischemic heart disease; the study also showed a significant increase in adiponectin levels and reduction in systolic and diastolic blood pressure by a mean average of 11 and 7.2 mmHg, respectively.
· Argan oil
A study examined the effect of Virgin Argan Oil (VAO) obtained from the fruit of Argania spinosa in a model of type 2 diabetes and hypertensive (with increased blood pressure) rats. Neonatal diabetes was induced by a single i.p. Injection of streptozotocin (90 mg/kg) 2 days after birth. To induce NO-deficient hypertension, the adult diabetic animals were treated with l-nitroarginine methylester (l-NAME) (30 mg/kg/day) given orally for 21 days. The results showed that following treatment with VAO for 21 days, hyperglycemia (high blood sugar) decreased to 1.3 ± 0.07 g/l compared with 1.92 ± 0.09 g/l in the untreated diabetic-hypertensive rats. The simultaneous administration of VAO with l-NAME prevented the increase in blood pressure during the 3 weeks of treatment. In untreated animals, blood pressure remained constant at 131 ± 1 mm Hg after 21 days - vs. 157 ± 0.64 mm Hg. The results also showed that the treatment with VAO in diabetic-hypertensive rats caused a significant increase in hepatic glycogen levels (13.3 ± 1.8 vs. 6.34 ± 0.75 mg/g tissue in the untreated diabetic-hypertensive control group). In conclusion, the findings indicate that Virgin Argan Oil (VAO) possesses antidiabetic and antihypertensive activity in n-stz/l-NAME rats. This effect may be related to its high content of tocopherols, phenolic compounds, and unsaturated fatty acids.
· Kale
Glutathione S-transferase (GST) forms a multigene family of phase II detoxification enzymes involved in detoxifying reactive oxygen species (ROS). A study examined whether daily supplementation of kale juice can modulate blood pressure (BP), levels of lipid profiles, and blood glucose and whether this modulation could be affected by the GSTM1 and GSTT1 polymorphisms. In the study, eighty-four subclinical hypertensive (with high blood pressure) patients showing systolic BP over 130 mmHg or diastolic BP over 85 mmHg received 300 ml/day of kale juice for 6 weeks. Blood samples were collected on 0-week and 6-week to evaluate plasma lipid profiles (total cholesterol, triglyceride, HDL-cholesterol, and LDL-cholesterol) and blood glucose. The results showed that systolic and diastolic blood pressure was significantly decreased in all patients regardless of their GSTM1 or GSTT1 polymorphisms after kale juice supplementation.
· L – arginine
There is early evidence that taking L-arginine by mouth can reduce blood pressure in healthy people, people with high blood pressure, and people with slightly elevated blood pressure with or without diabetes.
Previous studies suggest that L-arginine, an amino acid, and a substrate of nitric oxide synthase (NOS), may have a blood pressure (BP)-lowering effect. Because some studies were performed with a limited number of patients with hypertension and, therefore, limited statistical power with sometimes inconsistent results, the authors aimed to examine the effect of oral L-arginine supplementation on BP by conducting a meta-analysis of randomized, double-blind, placebo-controlled trials. Databases were searched to identify randomized, double-blind, placebo-controlled trials of oral L-arginine supplementation on BP in humans. The authors included 11 randomized, double-blind, placebo-controlled trials involving 387 participants with oral L-arginine intervention ranging from 4 to 24 g/day. In conclusion, this meta-analysis provides further evidence that oral (taken by mouth) L-arginine supplementation significantly lowers both systolic and diastolic BP (blood pressure).
· Bilberry
An in vitro study showed that after 10 min of incubation of cultured endothelial cells from human umbilical veins with bilberry 25E, significant, dose-dependent inhibition of ACE activity was seen, and after incubation with myrtillin chloride, significant inhibition was seen; the study concluded that Vaccinium myrtillus (bilberry) may have the potential to prevent and protect against cardiovascular diseases].
· Salvia miltiorrhiza (danshen) and Pueraria lobata (kudzu; gegen)
Radix (root) Salviae miltiorrhizae (Danshen) and Radix (root) Pueraria lobata (kudzu; Gegen) have long been used in traditional Chinese Medicine and serve as the principal herbs in treating cardiovascular disease. In a study, an aqueous extract comprising Danshen and Gegen in the ratio of 7:3 (DG) was investigated for its anti-hypertension in vivo, and vasodilative activities ex vivo (experimentation or measurements were done in or on tissue from an organism in an external environment with the minimum alteration of natural conditions). In conclusion, the results of in vivo spontaneously hypertensive rat (SHR) animal model suggested that an aqueous extract comprising Danshen and Gegen in the ratio of 7:3 (DG) possessed a blood pressure-lowering effect on both pre-and post-hypertensive rats, which could be explained by its endothelium-independent vasodilation via the opening of K(ATP), Kir and K(v) channels.
· Blueberries
Studies have shown that blueberries lower systolic and diastolic blood pressure; a study on rats concluded that dietary blueberries may be effective in managing early stages of hypertension (high blood pressure), partially due to inhibiting soluble ACE activity.
· Celery seed
· Chlorella (a green algae; e.g. Chlorella pyrenoidosa)
The results of a study on rats suggest that the beneficial effect of Chlorella regularis on stroke-prone spontaneously hypertensive rats (SHRSP) is caused by the synergistic action of several Chlorella ingredients that play a role in the sustention of a vascular function of rats.
· Cinnamon
The results of a study showed that acute intravenous injection of the Cinnamomum zeylanicum Blume stem bark aqueous extract (5, 10, and 20 mg/kg) induced a significant reduction in mean arterial blood pressure in anesthetized normotensive (with normal blood pressure) Wistar rats, salt-loaded hypertensive, L-NAME hypertensive and spontaneously hypertensive rats.
· Coenzyme Q-10
Taking coenzyme Q-10 for treating high blood pressure seems to help.
Several clinical studies involving small numbers of people suggest that CoQ10 may lower blood pressure. However, it may take 4 – 12 weeks to see any change. In one analysis, after reviewing 12 clinical studies, researchers concluded that CoQ10 has the potential to lower systolic blood pressure by up to 17 mm Hg and diastolic blood pressure by 10 mm Hg without significant side effects.
A human study showed that CoQ supplementation may improve blood pressure and long-term glycaemic control in subjects with type 2 diabetes. Still, these improvements were not associated with reduced oxidative stress, as assessed by F2-isoprostanes.
A meta-analysis concluded that coenzyme Q10 has the potential in hypertensive (with high blood pressure) patients to lower systolic blood pressure by up to 17 mm Hg and diastolic blood pressure by up to 10 mm Hg without significant side effects.
· Concord grape
A human study concluded that consuming Concord grape juice, which is high in polyphenolic compounds, may favorably affect blood pressure in hypertensive individuals.
· Cranberry
A study that evaluated the water-soluble cranberry-based phytochemical combinations with oregano, rosemary, and Rhodiola rosea found that, among the water extracts, 100% cranberry had the highest ACE-I inhibitory activity, and among the combination, the 75% cranberry with 25% rosemary had the highest ACE-I inhibitory activity; the high ACE-I inhibitory activity indicates the potential for hypertension (high blood pressure (BP)) management.
· Dark chocolate
In a Cochrane review that assessed the effect of cocoa products on blood pressure in adults when consumed daily for a minimum of two weeks, a meta-analysis of 20 studies involving 856 mainly healthy participants revealed a small but statistically significant blood pressure-reducing the effect of -2.8 mm Hg systolic and -2.2 mm Hg diastolic.
A meta-analysis concluded that dark chocolate is superior to placebo in reducing systolic blood pressure (systolic hypertension) or diastolic blood pressure (diastolic prehypertension). Still, it did not significantly reduce mean BP below 140 for systolic BP or 80 for diastolic BP.
A human study that investigated the effect of two doses of polyphenol-rich dark chocolate (DC) showed that the 500 mg polyphenol dose was equally effective in reducing fasting blood glucose levels, systolic blood pressure (SBP) and diastolic blood pressure (DBP) as the 1 000 mg polyphenol dose suggesting that a saturation effect might occur with increasing dose of polyphenols], omega – 6 fatty acids alone or in combination with omega – 3 fatty acids [there is some preliminary evidence that gamma-linolenic acid (GLA) may help reduce high blood pressure, either alone or in combination with omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), found in fish oil.
In one study, men with borderline high blood pressure who took 6 g of blackcurrant oil had a reduction in diastolic blood pressure (DBP) compared to those who received the placebo. Another study examined people with intermittent claudication (leg pain while walking caused by blockages in the blood vessels). Those who took GLA combined with EPA had a reduction in systolic blood pressure (SBP) compared to those who received the placebo.
A study in rats concluded that the n-6 (omega – 6) and n-3 (omega – 3) unsaturated fatty acids (FA) mix slowed the development of hypertension in young spontaneously hypertensive rats (SHR) and decreased blood pressure in adult and aged SHR; in addition, the present treatment altered the n-3 and n-6 polyunsaturated fatty acid (PUFA) content of SHR lipids to that seen in normotensive (with normal blood pressure) rats.
· Soy protein isoflavones (phytoestrogens, i.e., plant estrogens, with cholesterol-lowering effects) containing genistein and daidzein.
In a study, it reduced diastolic blood pressure.
· Bee pollen
Enzymatic hydrolysates were prepared from bee bread (the bee pollen with added honey and bee secretions and stored in brood cells, chambers of wood, and mud created by female ground-nesting bees) using three proteases. The present studies reveal that enzymatic hydrolysates from bee bread are of benefit not only for the materials of healthy food diets but also for patients undergoing various diseases such as cancer, cardiovascular diseases, diabetes, and hypertension. Note: the angiotensin I-converting enzyme (ACE) inhibitory activity implies that it may have blood-pressure-lowering effects.
· Garlic/ aged garlic extract (also known as ‘Kyolic™’)
A Cochrane review concluded that, based on data from two randomized controlled trials (RCTs) that compared garlic to placebo in patients with hypertension, it appears that garlic may have some blood pressure-lowering effect compared to a placebo. Still, the evidence currently available is insufficient to determine whether garlic provides a therapeutic advantage versus placebo in reducing the risk of cardiovascular morbidity and mortality.
Some research shows that garlic can reduce blood pressure in people with high blood pressure by as much as 7% or 8%. It also seems to lower blood pressure in people with normal blood pressure.
Garlic may slightly lower blood pressure (BP), between 5% and 8%.
A study that assessed a popular garlic preparation containing 1.3% allicin at a large dose (2 400 mg) in 9 patients with rather severe hypertension (diastolic blood pressure equal to or more than 115 mm Hg) showed that sitting blood pressure fell 7/16 mm Hg at peak effect approximately 5 hours after the dose, with a significant decrease in diastolic blood pressure from 5 – 14 hours after the treatment.
A meta-analysis in 8 trials showed that a garlic powder preparation (Kwai™) may be of some clinical use in subjects with mild hypertension (increased blood pressure (BP)).
A human study concluded that aged garlic extract is superior to placebo in lowering systolic blood pressure, like current first-line medications in patients with treated but uncontrolled hypertension.
A human study concluded that dietary supplementation with aged garlic extract has beneficial effects on the lipid (blood fats) profile and blood pressure of moderately hypercholesterolemic (with high blood cholesterol) subjects.
· Hawthorn (Crataegus)
A pilot study investigated the hypotensive potential of hawthorn extract and dietary magnesium supplements individually and in combination, compared with a placebo. Thirty-six mildly hypertensive subjects completed the study. Compared with the other groups, the factor analysis in ANOVA showed a promising reduction in the resting diastolic blood pressure at week ten in the nineteen subjects assigned to the hawthorn extract. Also, a trend towards a reduction in anxiety was also observed in those taking hawthorn compared with the other groups.
A randomized controlled trial investigated the effects of hawthorn for hypertension (increased blood pressure) in patients with type 2 diabetes taking prescribed drugs. In the study, 79 patients with type 2 diabetes were randomized to daily 1 200 mg hawthorn extract (39 patients) or placebo (40 patients) for 16 weeks. The results showed a significant difference in mean diastolic blood pressure reductions: the hawthorn group showed more significant declines than the placebo group. There was no group difference in systolic blood pressure reduction from baseline. The study showed a hypotensive effect of hawthorn in patients with diabetes taking medication.
Crataegus (hawthorn) has long been used as a folk medicine all around the world. A study investigated the blood pressure and the structure of the coronary arterial wall of L-NAME-induced hypertensive rats given an aqueous leaf extract of Crataegus tanacetifolia (100 mg/kg) for 4 weeks via gavage. It was observed that C. tanacetifolia, especially the hyperoside fraction, prevented L-NAME-induced hypertension in rats and had beneficial effects on the cardiovascular system.
Note: People with high blood pressure should talk with their doctor before taking hawthorn.
· Kudzu
· Ligusticum wallichii (Chuan Xiong) & Angelica gigas (Dang Gui)
A study concluded that the combination of Ligusticum wallichii (Chuan Xiong) and Angelica gigas (Dang Gui) elicits a synergistic effect on vasorelaxation in isolated rat aortas and antihypertension in spontaneously hypertensive rats (SHRs)
· Lycopene (a carotenoid contained in tomato juice; it gives the red color to tomatoes)
Lycopene is an antioxidant that has many benefits for the cardiovascular system.
· Oat
A study showed that adding oat cereals to the regular diet of patients with hypertension significantly reduces systolic blood pressure (SBP) and diastolic blood pressure (DBP). Soluble fiber-rich whole oats may be a useful dietary therapy for hypertension prevention.
· Extra – Virgin olive oil
A study in a Mediterranean population showed that olive oil consumption is associated with a reduced risk of hypertension only among men.
Another study concluded that olive oil intake, per se, is inversely associated with systolic and diastolic blood pressure.
· Omega – 3 fatty acids/ fish oil
Omega-3 fatty acids seem to have a small, dose-dependent, hypotensive (BP lowering) effect, the extent of which seems to be dependent on the degree of hypertension (increased BP).
Appel et al. found that blood pressure was decreased by −5.5/−3.5 mm Hg in trials of untreated hypertensives given >3 grams/day of omega-3 fatty acids.
DHA seems to be more effective than EPA in lowering blood pressure.
A meta-analysis concluded that fish oil has a dose-response effect on blood pressure of -0.66/-0.35 mm Hg/g omega-3 fatty acids. The hypotensive effect may be strongest in hypertensive subjects and those with clinical atherosclerotic disease or hypercholesterolemia (high blood cholesterol)]
ALA (alpha-linolenic acid; an omega – 3 fatty acid)/ Flaxseed (linseed) oil
Flaxseed oil is rich in ALA (alpha-linolenic acid), an omega-3 fatty acid that helps the cardiovascular system (distinct from EPA& DEA, which are omega-3 fatty acids in fish oil).
Alpha-linolenic acid (ALA, an omega-3 fatty acid) from walnuts and flax and linoleic acid (LA, an omega-6 fatty acid)
A study showed that ALA and LA diets significantly reduced diastolic blood pressure (-2 to -3 mm Hg) and total peripheral resistance (-4%), and this effect was evident at rest and during stress. The brachial artery's flow-mediated dilation (FMD) increased (+34%) on a diet containing additional ALA. Also, AVP (arginine vasopressin) increased by 20%, and endothelin-1 was unchanged. In conclusion, these results suggest novel mechanisms for walnuts and flax's cardioprotective (protective for the heart) effects.
· Fiber/ Psyllium (Ispaghula)
Although studies are not entirely conclusive, adding fiber to the diet, particularly psyllium, may help lower blood pressure// taking psyllium fiber (husks) with soy protein seems to help reduce the systolic blood pressure by about 8 mmHg and the diastolic blood pressure by about 2 mmHg in adults.
· Pomegranate
In a limited study of hypertensive patients, consuming pomegranate juice for two weeks was shown to reduce systolic blood pressure by inhibiting serum ACE.
Pomegranate juice can offer comprehensive protection against cardiovascular diseases, which could be related to its inhibitory effect on oxidative stress and serum ACE activity.
Pomegranate juice consumption may reduce systolic blood pressure, inhibit serum ACE activity, and is convincingly a heart-healthy fruit.
A study concluded that the pomegranate juice (PJ) extract could prevent the development of high blood pressure induced by angiotensin II (Ang II) in diabetic rats, probably by combating the oxidative stress induced by diabetes and Ang II and by inhibiting ACE activity.
· Prebiotics
· Proanthocyanidins/ oligomeric proanthocyanidin complexes (OPCs), French maritime pine bark extract – Pycnogenol
Proanthocyanidins increase endothelial NO (nitric oxide), which causes vasodilation. Thus, by optimizing nitric oxide production in the artery walls, they relax them, allowing greater blood flow and reduced blood pressure.
Pycnogenol seems to lower systolic blood pressure but does not significantly reduce diastolic blood pressure.
A study showed that Pycnogenol over a period of 12 weeks helped to reduce the dose of the calcium antagonist nifedipine in a statistically significant manner. Also, the intake of Pycnogenol decreased endothelin-1 concentrations significantly compared to the placebo. Moreover, angiotensin II levels in plasma were lowered in the placebo group to a more considerable extent than in the Pycnogenol group.
· Probiotics
· Quercetin
· Reishi mushroom [Lingzhi mushroom (Ganoderma lucidum)]
A study concluded that the mechanism of hypotensive (blood pressure lowering) action of Ganoderma lucidum was due to its central inhibition of sympathetic nerve activity.
· Royal jelly
· Saffron (dried stigmas of the plant Crocus sativus)
A study concluded that the aqueous extract of saffron stigma has hypotensive (blood pressure lowering) properties which appear to be attributable, in part, to the actions of two major constitutes of this plant, crocin and safranal - it seems that safranal is more critical than crocin for lowering down blood pressure of rats.
· Sesame oil (sesame lignans)
Sesame oil has a high percentage of polyunsaturated omega-6 fatty acids. The effect of sesame oil on blood pressure may be due to polyunsaturated fatty acids (PUFA) and the compound sesamin, a lignan present in sesame oil. There is evidence suggesting that both compounds reduce blood pressure in hypertensive rats.
A human study indicated that substituting sesame oil as the sole edible oil has an additive effect in further lowering blood pressure (BP) and plasma glucose in hypertensive diabetics.
Another human study suggested that sesame oil as edible oil lowered blood pressure, decreased lipid peroxidation, and increased antioxidant status in hypertensive patients.
· Chinese skullcap (Scutellaria baicalensis)
· Spirulina
· Strawberries
A study showed that the ellagitannins and ellagic acid contained in strawberries have good potential for the management of hyperglycemia and hypertension linked to type 2 diabetes. Another study indicated that the aqueous extract of wild strawberry leaves is a direct, endothelium-dependent vasodilator, the action of which is mediated by NO and cyclooxygenase products and potency like that of the aqueous hawthorn extract)
· Tannins/ green tea
A meta-analysis suggests that green tea and its catechins may improve blood pressure, and the effect may be more significant in those with systolic blood pressure equal to or more than 130 mm Hg. The meta-analysis also suggests that green tea catechins may improve total cholesterol (TC) and low-density lipoprotein cholesterol (LDL – cholesterol; also known as ‘bad’ cholesterol)
· Taraxacum officinale (the common dandelion) root
It has diuretic properties)
· Goji berry (wolfberry)
A study investigated the effects of Lycium barbarum (goji berry) polysaccharide (LBP) on endothelial function in the two-kidney, a clip model of hypertension. The results showed that the increase in blood pressure in hypertension rats (HR) could be prevented significantly by treatment with 10% LBP. In isolated aortic rings of LBP-treated rats, phenylephrine (PE) contraction was reduced compared to HR rats. The study concluded that the role of Lycium barbarum (goji berry) polysaccharide (LBP) in decreasing vasoconstriction to phenylephrine (PE) may be mediated by an increase of the effects or/and production of endothelium-derived relaxation factor (EDRF). LBP increased the formation of EDRF may be related to increasing the substrate of EDRF.
· L – carnosine
The findings of a study in rats suggest that low-dose L-carnosine suppresses and high-dose L-carnosine stimulates renal sympathetic nerve activity (RSNA) and blood pressure (BP), that the suprachiasmatic nucleus and histaminergic nerve are involved in the activities, and that L-carnosine acts in the brain and possibly other organs.
· Chromium (animal studies suggest chromium may help lower blood pressure. However, it has not been tested in people)].
· Astaxanthin
A study that investigated the effects of an astaxanthin-enriched diet in spontaneously hypertensive (with high blood pressure) rats (SHR) showed that systolic blood pressure (SBP) was lower in astaxanthin-treated groups than the control group from the first week of treatment and left ventricular hypertrophy (LVH) was significantly reduced. Astaxanthin improved endothelial function on the resistance of arteries but had no effect on the aorta. These effects were accompanied by decreased oxidative stress and improvements in NO (nitric oxide) bioavailability. Together, these results show that a diet supplemented with astaxanthin has beneficial effects on hypertension (high blood pressure) by decreasing blood pressure values and improving cardiovascular remodeling and oxidative stress.
· Cat’s claw
· Yarrow (Achillea millefolium)
· Brewer’s yeast
A randomized, double-blind clinical study investigated the effects of Brewer's yeast supplementation on serum lipoproteins and blood pressure in patients with type 2 diabetes mellitus. In the trial, 90 adults with type 2 diabetes mellitus were recruited and divided randomly into 2 groups, the trial group received brewer's yeast (1 800 mg/day), and the control group received a placebo for 12 weeks. The study concluded that supplementation with Brewer's yeast, besides the usual treatment of type 2 diabetes mellitus, can reduce systolic and diastolic blood pressures in diabetic patients.
· Red clover isoflavones (phytoestrogens, i.e., plant estrogens) containing genistein, daidzein, biochanin, and formononetin.
· Vitamin E (tocopherols; an excellent antioxidant)
· Red clover isoflavones (phytoestrogens, i.e., plant estrogens) containing genistein, daidzein, biochanin, and formononetin.
· Vitamin E (tocopherols; an excellent antioxidant)
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