Heart Health: Hypertension and High Blood Pressure
Sample Chapter on High Blood Pressure from Encyclopedia of Natural Medicine
by Michael Murray, N.D. and Joseph Pizzorno, N.D.

• Borderline high blood pressure: 120-160/90-94
• Mild high blood pressure: 140-160/95-104
• Moderate high blood pressure: 140-180/105-114
• Severe high blood pressure: 160+/115+

Introduction

Elevated blood pressure is a major risk factor for a heart attack or stroke. In fact, it is generally regarded as the greatest of the risk factors for a stroke. Over sixty million Americans have high blood pressure (also referred to as hypertension), including more than half (54.3 percent) of all Americans aged sixty-five to seventy-four years, and almost three fourths (71.8 percent) of all African Americans in the same age group.

The blood pressure denotes the resistance produced each time the heart beats and sends blood coursing through the arteries. The peak reading of the pressure exerted by this contraction is the systolic pressure. Between beats the heart relaxes, and blood pressure drops. The lowest reading is referred to as the diastolic pressure.

A normal blood pressure reading for an adult is:

• 120 (systolic) / 80 (diastolic).

High blood pressure is divided into different levels:

• Borderline (120-160/90-94)
• Mild (140-160/95-104)
• Moderate 140-180/105-114)
• Severe (160+/115+)

Although physicians are primarily concerned with diastolic pressure (the second number in the blood pressure reading), systolic pressure is also an important factor. Individuals with a normal diastolic pressure (<82 mm Hg) but elevated systolic pressure (> 158 mm Hg) have a twofold increase in their cardiovascular death rates compared to individuals with normal systolic pressures « 130 mm Hg).

Therapeutic Considerations

Since over eighty percent of patients with high blood pressure are in the borderline-to-moderate range, most cases of high blood pressure can be brought under control through changes in diet and lifestyle. In fact, in head-to-head comparisons, many nondrug therapies - such as diet, exercise, and relaxation -have proven superior to drugs in cases of borderline-to-mild hypertension. These nondrug therapies are discussed in detail this chapter.

Another strike against drugs is the increasing evidence indicating that they may be doing more harm than good. In some people, these drugs may be producing the very thing they are trying to prevent: a heart attack. Several well-designed long-term clinical studies have found that people who take blood-pressure-lowering drugs (typically diuretics and/or beta-blockers) actually suffer from unnecessary side-effects (e.g. fatigue, headaches, and impotence), including increased rick of heart disease.

FIGURE 1: Blood Pressure and sudden death from heart disease and high blood pressure.

Virtually every medical authority (textbook, organization, journal, etc.), including the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, has recommended that nondrug therapies be used in the treatment of borderline-to-mild hypertension. The drugs carry no benefit, yet they possess significant risks. The two most definitive trials - the Australian and Medical Research Council trials - as well as five other large trials, including the famous Multiple Risk Factor Intervention Trial (MRFIT), have shown that drugs offer no benefit in protecting against heart disease in borderline-to-moderate hypertension. 1-7 Opposed to these seven negative trials, there are two that found treatment was somewhat effective. 8,9 However, upon further examination, both of these studies turn out to be unreliable. The European Working Party on Hypertension in the Elderly Trial was relatively small, and in the Hypertension Detection and Follow-Up Program there was an inadequate control group.

The most startling thing is that these studies compared drug treatment to no treatment (placebo). If the natural alternatives outlined in this chapter were compared to standard drug treatment in borderline-to-moderate hypertension, there is little doubt that the nondrug approach would yield substantial benefit. A quote from an article in the American Journal of Cardiology, examining drug treatment for hypertension, is consistent with current medical opinion: "Few patients with uncomplicated marginal hypertension require drug treatment. ... There is little evidence these patients (with marginal hypertension) will achieve enough benefit to justify the costs and adverse effects of anti-hypertensive drug treatment."10

Despite this substantial evidence and medical opinion, blood-pressure-lowering drugs are still among the most widely prescribed. Why? According to an article in JAMA (Journal of the American Medical Association), "Treatment of hypertension has become the leading reason for visits to physicians as well as for drug prescriptions."11 In other words, blood-pressure-lowering drugs are big business to the drug companies and to physicians. Yearly sales of blood pressure medications are estimated to be greater than ten billion dollars. Since it is estimated that approximately fifty percent of patients with high blood pressure are in the borderline-to-mild range, if the doctors prescribed the nondrug protocols that have been recommended by the authorities, it could mean a loss of more than five billion dollars to the drug companies each year, as well as a substantial loss to physicians.

Dietary and Lifestyle Factors in High Blood Pressure

High blood pressure is closely related to lifestyle and dietary factors. Some of the important lifestyle factors that may cause high blood pressure include: coffee consumption, alcohol intake, lack of exercise, stress, and smoking. Some of the dietary factors include: obesity; high sodium-to-potassium ratio; low-fiber, high-sugar diet; high saturated-fat and low essential-fatty-acid intake; and a diet low in calcium, magnesium, and vitamin C.

Several of these dietary and lifestyle factors are discussed in HEART AND CARDIOVASSCULAR HEALTH, since the health of the artery is critical to maintaining normal blood pressure. When the arteries become hard due to the buildup of plaques that contain cholesterol, blood pressure rises. Therefore, it is important to prevent arteriosclerosis (hardening of the arteries). The role of potassium and stress in high blood pressure will be discussed in greater detail later in this chapter, followed by a shorter discussion of selected natural blood-pressure-lowering agents.

Some Specific Dietary Recommendations

Next to attaining ideal body weight, perhaps the most important dietary recommendation is to increase the consumption of plant foods in the diet. Vegetarians generally have lower blood pressure, and a lower incidence of high blood pressure and other cardiovascular diseases, than nonvegetarians.12 While dietary levels of sodium do not differ Significantly between these two groups, a vegetarian's diet typically contains more potassium, complex carbohydrates, essential fatty acids, fiber, calcium, magnesium, and vitamin C, and less saturated fat and refined carbohydrate, all of which have a favorable influence on blood pressure.

Special foods for people with high blood pressure include: celery (for its 3-n-butyl phthalide content; see next paragraph); garlic and onions (for their sulfur-containing compounds); nuts and seeds or their oils (for their essential fatty acid content); cold-water fish (salmon, mackerel, etc.); green leafy vegetables (as a rich source of calcium and magnesium); whole grains and legumes (for their fiber); and foods rich in vitamin C, such as broccoli and citrus fruits.

Celery is a particularly interesting recommendation for high blood pressure. Two researchers at the University of Chicago Medical Center have performed studies on a compound found in celery, 3-n-butyl phthalide, and found that it can lower blood pressure. In animals, a very small amount of 3-n-butyl phthalide lowered blood pressure by twelve to fourteen percent, and also lowered cholesterol levels by seven percent. The equivalent dose in humans can be supplied by four ribs of celery. The research was prompted by the father of one of the researchers; after eating a quarter-pound of celery every day for a week, he observed that his blood pressure dropped from 158/96 to a normal 118/82. The celery is certainly worth a try.

Garlic and onions are also important foods for lowering blood pressure. Although most recent research has focused on the cholesterol lowering properties of garlic and onions, both have been shown to lower blood pressure in cases of hypertension. 13 Both garlic and onion should be used liberally in the diet. Commercial garlic supplements may also be of benefit; follow the dosage recommendations given in CHOLESTEROL. The usual response when using garlic is fairly modest: a drop in roughly 8 to 11 mm Hg for the systolic and 5 to 8 mm Hg for the diastolic is common.

Quick Review

• Elevated blood pressure is a major risk factor for a heart attack or stroke.
• Since over eighty percent of patients with high blood pressure are in the borderline-to-moderate range, most cases of high blood pressure can be brought under control through changes in diet and lifestyle.
• Virtually every medical authority (textbook, organization, journal, etc.), including the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, has recommended that non drug therapies be used in the treatment of borderline-to-mild hypertension (high blood pressure).
• Vegetarians generally have lower blood pressure levels and a lower incidence of high blood pressure and other cardiovascular diseases than nonvegetarians.
• A high potassium-to-sodium intake is associated with lower blood pressure.
• Relaxation techniques, such as deep exercises, biofeedback, transcendental meditation, yoga, progressive muscle relaxation, and hypnosis, have all been shown to have some value in lowering blood pressure.
• Population-based and clinical studies have shown that the higher the intake of vitamin C the lower the blood pressure.
• Chronic exposure to lead from environmental sources, including drinking water, is associated with high blood pressure and increased cardiovascular mortality.
• CoQ10 deficiency has been shown to be present in thirty-nine percent of patients with high-blood pressure.
• Over sixty double-blind studies have demonstrated that either fish oil supplements or flaxseed oil are very effective in lowering blood pressure.
• Hawthorn extracts exert mild blood-pressure-lowering effects.
  

Potassium and Blood Pressure

It is a well-established fact that a diet low in potassium and high in sodium is associated with high blood pressure. Potassium, along with sodium and chloride, is an electrolyte - a mineral salt that can conduct electricity when dissolved in water. Although sodium and chloride are important, potassium is the most important dietary electrolyte. Potassium functions in the maintenance of:

• water balance and distribution
• blood pressure
• acid-base balance
• muscle and nerve cell function
• heart function
• kidney and adrenal function

Over ninety-five percent of the potassium in the body is found within cells. In contrast, most of the sodium in the body is located outside the cells in the blood and other fluids. Cells pump sodium out and potassium in via the sodium-potassium pump. This pump is found in the membranes of all cells in the body, and is perhaps the most important aspect of maintaining cellular health. The sodium-potassium pump also functions to maintain the electrical charge within the cell. This is particularly important to muscle and nerve cells.

During nerve transmission and muscle contraction, potassium exits the cell and sodium enters, resulting in a change in electrical charge. This change is what causes a nerve impulse or muscle contraction. It is not surprising that a potassium deficiency affects muscles and nerves first. In addition to functioning as an electrolyte, potassium is essential for the conversion of blood sugar into glycogen in the storage form of blood sugar found in the muscles and liver. A potassium shortage results in lower levels of stored glycogen. Because glycogen is used by exercising muscles for energy, a potassium deficiency will produce great fatigue and muscle weakness. These are typically the first signs of potassium deficiency.

The Sodium-to-Potassium Ratio

Just as important as the total potassium content of food, sodium and potassium should be consumed in the proper balance. Too much sodium in the diet can lead to disruption of this balance. Numerous studies have demonstrated that a low-potassium, high-sodium diet plays a major role in the development of cancer and cardiovascular disease (heart disease, high blood pressure, strokes, etc.).14,15 Conversely, a diet high in potassium and low in sodium is protective against these diseases and, in the case of high blood pressure, it can be therapeutic. 1,16-18

It is also well-known that excessive consumption of dietary sodium chloride (table salt), coupled with diminished dietary potassium, is a common cause of high blood pressure, especially in "salt-sensitive" individuals. Numerous studies have shown that sodium restriction alone does not improve blood pressure control in most people; it must be accompanied by a high potassium intake. 1,16,17 In our society, only five percent of sodium intake comes from the natural ingredients in food. Prepared foods contribute forty-five percent of our sodium intake, forty five percent is added in cooking, and another five percent is added as a condiment. All the body requires in most instances is the salt that is supplied in the food.

Most Americans have a potassium-to-sodium (K:Na) ratio of less than 1:2. This 1:2 ratio means that most people ingest twice as much sodium as potassium. Researchers recommend a dietary potassium-to-sodium ratio of greater than 5:1 to maintain health. This is ten times higher than the average intake. However, even this may not be optimal. A natural diet rich in fruits and vegetables can produce a K:Na ratio greater than 100:1, as most fruits and vegetables have a K:Na ratio of at least 50:1. (See Table 4 in A HEALTH PROMOTING DIET.)

Potassium Supplementation in High Blood Pressure

Many studies have now shown that increasing dietary potassium intake can lower blood pressure. 1,l9 In addition, there are now several studies which show that potassium supplementation alone can produce significant reductions in blood pressure in hypertensive subjects. Typically, these studies have utilized dosages ranging from 2.5 to 5.0 grams of potassium per day. Significant drops in both systolic and diastolic values have been achieved. 19-24 In one study, thirty-seven adults with mild blood pressure received either 2.5 grams of potassium per day, 2.5 grams of potassium plus 480 mg of magnesium per day, or a placebo for eight weeks. They were then crossed over to receive one of the other treatments for another eight weeks, and then again for another eight weeks.23 The results demonstrated that potassium supplementation lowered systolic blood pressure an average of 12 mm Hg and diastolic blood pressure an average of 16 mm Hg. Interestingly, the additional magnesium offered no other reduction in blood pressure. However, magnesium supplementation has been shown to be helpful in other studies (discussed later).

Potassium supplementation may be especially useful in the treatment of high blood pressure in persons over the age of sixty-five. The elderly often do not fully respond to blood-pressure-lowering drugs, making the use of potassium supplementation an exciting possibility. In one double-blind study, eighteen untreated elderly patients (average age seventy-five years), with a systolic blood pressure of greater than 160 mm Hg and/or a diastolic blood pressure of greater than 95 mm Hg, were given either potassium potassium chloride (supplying 2.5 grams of potassium) or a placebo each day for four weeks.24 After this relatively short treatment period, the group that took potassium was found to drop 12 mm Hg in the systolic and 7 mm Hg in the diastolic. These results compare favorably to the reduction of blood pressure produced by drug therapy, but without the side effects.25

Potassium and Magnesium Interactions

Potassium interacts with magnesium in many body systems. Magnesium is second only to potassium in terms of concentration within the individual cells of the body. Low intracellular potassium levels may be the result of low magnesium intake. It is therefore appropriate to supplement magnesium (400 to 1,200 mg per day in divided doses) along with potassium. This suggestion may also lower blood pressure.

For example, in one double-blind clinical study, twenty-one male patients with high blood pressure were given 600 mg of magnesium daily (as magnesium oxide) or a placebo.26 Mean blood pressure (the average between the systolic and diastolic) decreased from 111 to 102 mm Hg. The patients who responded best were those with reduced red blood cell potassium levels. After therapy, with magnesium, the levels of intracellular sodium, potassium, and magnesium normalized, suggesting that one of the ways in which magnesium lowers blood pressure is through activation of the cellular membrane pump that pumps sodium out of and potassium into the cell.

There is considerable evidence from population studies that a high intake of magnesium is associated with lower blood pressure. The principle source of magnesium in early studies was water. Water that is high in minerals like magnesium is often referred to as "hard water." Numerous studies have demonstrated that an inverse correlation exists between water hardness and high blood pressure. In other words, where magnesium content of the water was high, there were fewer cases of high blood pressure and heart disease. 27

These early studies led to more extensive dietary studies looking at the association between magnesium and high blood pressure. These dietary studies found the same results as the hard water studies: when magnesium levels were high, blood pressure was lower. In one of the most extensive studies - the Honolulu Heart Study - systolic blood pressure was 6.4 mm Hg lower, and diastolic blood pressure was 3.1 mm Hg lower, in the highest-magnesium-intake group compared to the lowest-magnesium-intake group. 28

Because of the evidence that magnesium prevents heart disease, researchers began investigating the effect of magnesium supplementation in the treatment of high blood pressure. The results have been mixed. Some of the studies have shown a good blood-pressure-lowering effect; others have not. The distinction of whether magnesium supplementation will lower blood pressure depends on several factors.

First, if the individual is taking a diuretic, there is a good chance that magnesium supplementation will lower blood pressure by overcoming the magnesium depletion induced by the diuretic. Another scenario in which magnesium supplementation may be of great value is when the high blood pressure is associated with a high level of renin - an enzyme released by the kidneys that eventually leads to the formation of angiotensin and the release of aldosterone These compounds cause the blood vessels to constrict and the blood pressure to increase. And finally, patients with elevated intracellular sodium or decreased intracellular potassium levels (as measured by red blood cell studies) respond better to magnesium supplementation than subjects with normal intracellular potassium and sodium levels.

Rather than performing a blood test to measure renin or intracellular potassium and sodium, we recommend giving magnesium supplementation a four-week trial. We also recommend consuming a high-potassium diet or having your doctor prescribe a potassium supplement.

Dosage Information for Potassium

The estimated safe and adequate daily dietary intake of potassium, as set by the Committee on Recommended Daily Allowances, is 1.9 to 5.6 grams. If body potassium requirements are not being met through diet, supplementation is essential to good health. This statement is particularly true for the elderly, athletes, and people with high blood pressure.

Potassium supplements are available either by prescription or over the counter (OTC). However, the FDA restricts the amount of potassium available in OTC potassium supplements to a mere 99 mg per dose because of problems associated with high-dosage prescription potassium salts. However, so-called salt substitutes, such as the popular brands NoSalt and Nu-Salt, are in fact potassium chloride at a dosage of 530 mg of potassium per one-sixth teaspoon! The prescription and OTC supplements are either potassium salts (chloride and bicarbonate), potassium bound to various mineral chelates (e.g., aspartate, citrate, etc,), or food-based potassium sources.

Potassium chloride preparations are the most popular by prescription and are available in a vast array of formulations (timed-release tablets, liquids, powders, and effervescent tablets) and flavors. Potassium salts are commonly prescribed in the dosage range of 1.5 to 3.0 grams per day. However, potassium salts can cause nausea, vomiting, diarrhea, and ulcers when given in pill form at high dosages. These effects are not seen when potassium levels are increased through the diet only. This difference highlights the advantages of using foods or food-based potassium supplements to meet the human body's high potassium requirements rather than pills.

Dosage Information for Magnesium

Many nutritional experts feel that the ideal intake for magnesium should be based on weight (6 mg/2.2 pounds of body weight). For a 110-pound person, the recommendation would be 300 mg; for a 154 pound person, 420 mg, and for a 200 pound person, 540 mg. Rather than relying on intake to achieve this amount of magnesium, for most people we recommend supplementing the diet with additional magnesium corresponding to the recommendation of 5 mg per 2.2 pounds of body weight. In the treatment of the conditions discussed above, we usually recommend twice this amount: 12 mg per 2.2 pounds of body weight.

Magnesium is available in several forms. In general, all forms are equally absorbed. However, we prefer magnesium bound to aspartate or to Krebs-cycle intermediates (malate, succinate, fumarate, and citrate), as opposed to magnesium oxide, gluconate, sulfate, and chloride. Absorption studies indicate that magnesium is easily absorbed orally, especially when it is bound to citrate (and presumably aspartate and other members of the Krebs cycle).29.30 In addition, magnesium bound to aspartate or Krebs-cycle intermediates may help fight off fatigue. Aspartate feeds into Krebs cycle - the final common pathway for the conversion of glucose, fatty acids, and amino acids to chemical energy (ATP) - while citrate, fumarate, malate, and succinate are actual components of the Krebs cycle. There is evidence to suggest that minerals chelated to the Krebs-cycle intermediates better absorbed, utilized, and tolerated than inorganic or relatively insoluble salts (magnesium chloride, oxide, carbonate). In addition, while inorganic magnesium salts often cause diarrhea at higher dosages, organic forms of magnesium generally do not.

Potassium and Magnesium: Safety Issues

Most people can handle any excess potassium. The exception if people with kidney disease. These people do not handle potassium in the normal way, and are likely to experience heart disturbances and other consequences of potassium toxicity. Individuals with kidney disorders usually need to restrict their potassium intake and follow the dietary recommendations of their physicians. Also, potassium supplementation is contraindicated when using a number of prescription medications, including digitalis, potassium-sparing diuretics, and the angiotensin-converting-enzyme-inhibitor class of blood-pressure-lowering drugs, unless supervised by a physician. If you are not sure whether you are taking a member of these classes of drugs, check with your physician before taking potassium.

People with kidney disease or severe heart disease (such as high-grade atrioventricular block) should not take magnesium or potassium unless under the direct advice of a physician.

In general, magnesium is well tolerated. Magnesium supplementation can sometimes cause a looser stool, particularly if taken in the forms of magnesium sulfate (Epsom salts), hydroxide, or chloride.

Stress

Stress can cause high blood in many instances. Relaxation techniques, such as deep breathing exercises, biofeedback, autogenics, transcendental meditation, yoga, progressive muscle relaxation, and hypnosis, have all been shown to have some value in lowering blood pressure. 31 Although the effect is only modest, using a stress-reduction technique is a necessary component in a natural blood program.

One of the most powerful methods of reducing stress and increasing energy in the body is by breathing with the diaphragm (See Stress Management for more information). A recent study has shed some light on the effect of breathing on hypertension. 32 Volunteers with normal blood pressure were taught how breathe very shallowly. Measurement of the amount of sodium and potassium excreted in their urine indicated that shallow breathing led to the retention of sodium in the body. It was suggested that this breathing pattern may play a causative role in some cases of high blood pressure due to the retention of sodium.

Vitamin C and Blood Pressure

Population-based and clinical studies have shown that the higher the intake of vitamin C the lower the blood pressure. Several preliminary studies have shown a modest blood-pressure-lowering effect (a drop of 5 mm Hg) from vitamin C supplementation in people with mild elevations of blood pressure. 33

One of the ways in which vitamin C may help keep blood pressure in the normal range is by promoting the excretion of lead. Chronic exposure to lead from environmental sources, including drinking water, is associated with high blood pressure and increased cardiovascular mortality. 34 Areas with a soft water supply have higher lead concentrations in drinking water due to the acidity of the water; people who live in these areas may be predisposed to high blood pressure. It should be noted that soft water is also, of course, low in calcium and magnesium - two minerals which also protect against high blood pressure.

Vitamin B6 Supplementation for High Blood Pressure

Vitamin B6 supplementation has been shown to lower blood pressure. In one study, twenty people with high blood pressure were given oral vitamin B6 at a dosage of 5 mg per day per 2.2 pounds of body weight for four weeks. The subjects demonstrated significant reductions in systolic and diastolic blood pressure as well as serum norepinephrine (noradrenaline) levels. These results indicate that vitamin B6 influences the nervous system in a manner which leads to reduction in blood pressure. The effect on blood pressure may have tremendous clinical significance, as the systolic pressure dropped from 167 to 153 mm Hg and the diastolic pressure dropped from 108 to 98 mm Hg in the study.35

Calcium Supplementation for High Blood Pressure

Population-based studies have suggested a link between high blood pressure and a low intake of calcium.36 However, the association is not as strong as the one for magnesium and potassium. In addition to the epidemiological data, several clinical studies have demonstrated that calcium supplementation can lower blood pressure in cases of hypertension, but the results have been inconsistent.36

To clarify the effectiveness of calcium supplementation for patients with hypertension, a recent double-blind placebo-controlled crossover study was performed on forty-six patients with either salt-sensitive or salt-resistant (salt-restriction produces no effect) high blood pressure.37 During the calcium supplementation phase, patients received 1.5 gram of calcium (as calcium carbonate) per day for eight weeks. The results of the study indicate that calcium supplementation can produce effective reductions in blood pressure in Blacks and in patients who are salt-sensitive, but not in patients who have salt-resistant hypertension. Given the safety and possible benefit of calcium supplementation in the treatment of high blood pressure, it is certainly worth a try. It should be pointed out that better results have been noted for calcium citrate than for calcium carbonate.38

Another group that appears to respond calcium supplementation is elderly hypertensives. One study used twenty-four-hour monitoring of blood pressure to evaluate the effect of calcium supplementation on mild-to-moderate essential hypertension in elderly hospitalized patients. Over a period of twenty-four hours, the mean systolic and diastolic blood pressures declined by 13.6 mm Hg and 5.0 mm Hg, respectively, in patients whose diet was supplemented with 1gram of elemental calcium.39

Coenzyme Q10 and High Blood Pressure

Coenzyme Q10 (CoQ10)' also known as ubiquinone, is an essential component of the mitochondria - the energy-producing unit of the cells of our body. CoQ10 is involved in the manufacture of ATP, the energy currency of all body processes. A good analogy for CoQ10's role in our body is the role of a spark plug in a car engine. Just as the car cannot function without that initial spark, the human body cannot function without CoQ10.

Although CoQ10 can be synthesized within the body, deficiency states have been reported. In fact, CoQ10 deficiency has been found in thirty-nine percent of patients with high blood pressure. This finding alone suggests a need for CoQ10 supplementation. But CoQ10 appears to provide benefits beyond correction of a deficiency.

In several studies, CoQ10 has actually been shown to lower blood pressure in patients with hypertension. 4o-42 However, the effect of CoQ10 on blood pressure is usually not seen until after four to twelve weeks of therapy. Thus, CoQ10 is not a typical blood-pressure-lowering drug. Rather, it seems to correct some metabolic abnormality which, in turn, has a favorable influence on blood pressure. In patients with high blood pressure, typical reductions in both systolic and diastolic blood pressure with CoQ10 are in the ten-percent range. In other words, in a patient with initial blood pressure reading of 150/100, CoQ10 supplementation would drop the pressure to 135/90.

While the mechanism of action of CoQ10 in angina is well understood (see Angina), how CoQ10 lowers blood pressure has been a mystery. Blood pressure is similar to water pressure as it passes through a garden hose; if an artery (or a hose) is constricted, pressure will increase. Elevated levels of renin, sodium, or aldosterone are associated with increased resistance to blood flow. When ten patients with high blood pressure were given 100 mg of CoQ10 daily for ten weeks, systolic blood pressure in the group dropped from 161.5 to 142 mm Hg and diastolic pressure dropped from 98.5 to 83 mm Hg, but there were no changes in renin, sodium, or aldosterone levels.4o These three compounds promote constriction of blood vessels and high blood pressure. Cholesterol levels did drop from 227 mg/dl to 204 mg/dl, and a sophisticated test that measures resistance within the arteries of the arms and legs did reveal significant improvements.

These results indicate that CoQ10 lowers blood pressure by unusual mechanisms of action: (1) by lowering cholesterol levels and (2) by stabilizing the vascular system via its antioxidant properties. As a result of actions, resistance to blood flow thorough the arteries is reduced. An analogy would be that CoQ10 acts in a manner similar to opening up the diameter of a sprayer at the end of a garden hose.

Omega-3 Oils and Blood Pressure

Increasing the intake of omega-3 fatty acids can lower blood pressure. Over sixty double-blind studies have demonstrated that either fish oil supplements or flaxseed oil are very effective in lowering blood pressure. 43-46. The fish oils have typically produced a more pronounced effect than flaxseed oil, because the dosage of fish oils used in the studies was quite high (equal to ten fish-oil capsules daily). However, flaxseed oil may be the better choice for lowering blood pressure, especially when cost-effectiveness is considered.

Along with reducing intake of saturated fat, 1 tablespoon per day of flaxseed oil should lower both the systolic and diastolic readings by up to 9 mm Hg.45 One study found that for every absolute one-percent increase in body alpha-linolenic acid content, there was a decrease of 5 mm Hg in the systolic, diastolic, and mean blood pressure. 46

Botanicals

The two most popular herbal recommendations for high blood pressure are garlic (discussed earlier) and hawthorn (Crataegus monogyna). Extracts of hawthorn berries and extracts of the flowering tops of hawthorn are widely used by physicians in Europe for their cardiovascular effectiveness. Studies have demonstrated that hawthorn extracts are effective in lowering blood pressure and in improving heart function. However, in general it can be said that the blood pressure lowering effect of hawthorn is very mild.47,48 It usually requires at least two to four weeks before hawthorn begins to exert any effect.

Treatment Summary

High blood pressure should not be taken lightly. By keeping your blood pressure in the normal range, you will not only lengthen your life, but you will improve the quality of your life as well. This is especially true if natural measures rather than drugs, are used to attain proper blood pressure; the drugs carry significant side effects such as fatigue, headaches, and impotence. Here are some concise guidelines for the various classifications of high blood pressure:

For Mild Hypertension (140-160/90-104)

• Reduce excess weight
• Eliminate salt (sodium chloride) intake
• Follow a healthy lifestyle: avoid alcohol caffeine, and smoking; exercise and use stress-reduction techniques
• Follow a high-potassium diet rich in fiber and complex carbohydrates
• Increase dietary consumption of celery, garlic, and onions
• Reduce or eliminate the intake of animal fats while increasing the intake of vegetable oils
• Supplement the diet with the following:
  • High-potency multiple-vitamin-and-mineral formula: women's multi | men's multi (Amazon is not showing the correct image; it should be showing an image like the women’s multi)
  • Vitamin C: 500 - 1,000 mg three times per day
  • Vitamin E: 400 - 800 IU per day
  • Magnesium: 800-1,200 mg per day
  • Garlic: the equivalent of 4,000 mg of fresh garlic per day
  • Flaxseed oil: 1 tbsp per day
    

If, after following the above recommendations for a period of three to six months, blood pressure has not returned to normal, please consult a physician for further nondrug recommendations.

For Moderate Hypertension (140-180/105-114)

• Employ all the measures listed for Mild Hypertension
• Take Coenzyme Q10: 50 mg two to three times per day
• Take Hawthorn extract (10% procyanidins or 1.8% vitexin-4'-rhamnoside): 100-250 mg three times per day
  

Follow these guidelines for one to three months. If your blood pressure has not dropped below 140/105, you will need to work with a physician to select the most appropriate medication. If a prescription drug is necessary, calcium-channel-blockers or ACE-inhibitors appear to be the safest.

For Severe Hypertension (160+/115+)

Consult a physician immediately.

Employ all the measures listed for Mild and Moderate Hypertension. A drug may be necessary to achieve initial control. When satisfactory control over the high blood pressure has been achieved, work with your physician to taper off the medication.

Author Web Sites

• Joseph Pizzorno, ND
  • http://www.drpizzorno.com, http://www.whfoods.com, http://www.bastyr.edu, http://www.salugenecists.com, http://www.drpizzorno.net, http://www.imjournal.com, http://www.bioclinicnaturals.com
• Michael Murray, ND
  • http://www.doctormurray.com, http://www.naturalfactors.com, http://www.bioclinicnaturals.com
• Information on Naturopathic Medicine
  • http://www.johnlutz.com/natural-healthcare/naturopathic-medicine/index.php, http://www.naturopathic.org, http://www.panp.org

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