Hypertension

Newsletter #3 - March 2009

What is hypertension?

Hypertension is the medical term for high blood pressure, a condition with many causes. Approximately 90% of people with high blood pressure have “essential” hypertension (also called “idiopathic” or “primary” hypertension), for which the cause is poorly understood.

As with conventional drugs, the use of natural substances sometimes controls blood pressure if taken consistently but does not lead to a cure for high blood pressure. Thus, someone whose blood pressure is successfully reduced by weight loss, avoidance of salt, and increased intake of fruits and vegetables would need to maintain these changes permanently in order to maintain control of blood pressure.

What are the symptoms of hypertension?

Essential hypertension is usually without symptoms until complications develop. The symptoms of complications depend on the organs involved.

Conventional treatment options

Essential hypertension has no cure, but treatment can modify its course. Many drug combinations are used to treat hypertension, as are diuretics.

Several classes of diuretics exist, including thiazide diuretics (e.g., chlorthalidone [Hygroton®], chlorothiazide [Diuril®], hydrochlorothiazide [Esidrix®, HydroDIURIL®]), loop diuretics (e.g., bumentanide [Bumex®], ethacrynic acid [Edecrin®], furosemide [Lasix®], torsemide [Demadex®]), and potassium-sparing diuretics (e.g., amiloride [Midamor®], spironolactone [Aldactone®], triamterene [Dyrenium®]). Diuretics are usually combined with beta-blockers (e.g., propranolol [Inderal®], metoprolol [Lopressor®], atenolol [Tenormin®], timolol [Betimol®], bisoprolol [Zebeta]) or ACE inhibitors (e.g., captopril [Capoten], benazepril [Lotensin®], lisinopril [Prinivil®], enalapril [Vasotec®]).

Alternatively, calcium channel blockers (e.g., amlodipine [Norvasc®]) may be combined with diuretics. Healthcare practitioners may also recommend lifestyle modifications, such as moderate weight reduction and dietary sodium restriction. 

Key Nutritional supplements

• Coenzyme Q10 (CoQ10) (50 mg twice a day for at least ten weeks): CoQ10 has been shown in several clinical trials to significantly lower blood pressure in people with hypertension.
  
• Fish oil (10 grams of fish oil per day): EPA and DHA, the omega-3 fatty acids found in fish oil, lower blood pressure, according to a meta-analysis of 31 trials.
  
• Potassium (for people not taking potassium-sparing diuretics): The best way to supplement potassium is with fruit, which contains more of the mineral than amounts found in potassium supplements. However, fruit contains so much potassium that people taking “potassium-sparing” drugs (as some hypertensives do) can end up with too much potassium by eating several pieces of fruit per day. Therefore, people taking potassium-sparing diuretics should consult the prescribing doctor before increasing fruit intake.

Other Nutritional Supplements that may be helpful

• Calcium (800–1,500 mg per day): Only modest results can be expected.
  
• Fiber*
  
• Magnesium (for people taking depleting diuretics): 350–500 mg per day.

Key herbs - None

Other herbs that may be helpful

• Achillea wilhelmsii : In a double-blind trial, people with mild hypertension took a tincture of Achillea wilhelmsii, an herb used in traditional Persian medicine. Participants in the trial used 15–20 drops of the tincture twice daily for six months. At the end of the trial, participants experienced significant reductions in both systolic and diastolic blood pressure compared to those who took placebo. No adverse effects were reported.
  
• Garlic (Allium sativum) (600–900 mg of garlic extract per day): Garlic lowers blood pressure, according to a meta-analysis that included ten double-blind studies.
  

Lifestyle changes that may be helpful

• Stop smoking: Smoking is particularly injurious for people with hypertension. The combination of hypertension and smoking greatly increases the risk of heart disease-related sickness and death.
  
• Alcohol in moderation: Drinking three or more alcoholic beverages per day increases blood pressure in proportion to the amount of alcohol consumed.
  
• Exercise: Daily exercise can lower blood pressure significantly. A 12-week program of Chinese T’ai Chi was reported to be almost as effective as aerobic exercise in lowering blood pressure in sedentary elderly people with high blood pressure.
  
• Weight loss: Many people with high blood pressure are overweight. Weight loss can lower blood pressure significantly in those who are both overweight and hypertensive.

Dietary changes that may be helpful

• Cut back on salt: Salt intake has also been definitively linked to hypertension in western societies. Eliminating salt from the diet lowers blood pressure in most people. The more salt is restricted, the greater the blood pressure-lowering effect.
  
• Eat vegetables: Vegetarian diets have been reported to significantly lower blood pressure. This occurs partly because fruits and vegetables contain potassium—a known blood pressure-lowering mineral. The fiber provided by vegetarian diets may also help reduce high blood pressure.
  
• Avoid sugar: Sugar has been reported to increase blood pressure in animals and humans. Though the importance of this experimental effect remains somewhat unclear, some doctors recommend that people with high blood pressure cut back on their intake of sugar.
  
• Avoid caffeine: Although the effects of long-term avoidance of caffeine (from coffee, tea, chocolate, cola drinks, and some medications) on blood pressure remain unclear, many doctors tell people with high blood pressure to avoid caffeine-containing food and drink due to possible blood pressure–raising effects.
  
• Avoid food allergens: Food allergy was reported to contribute to high blood pressure in a study of people who had migraine headaches. In that report, all 15 people who also had high blood pressure experienced a significant drop in blood pressure when put on a hypoallergenic diet.
  
• Exposure to lead and other heavy metals: Exposure to this material has been linked to high blood pressure in some, but not all, research. If other approaches to high blood pressure prove unsuccessful, it makes sense for people with hypertension to have their body’s burden of lead evaluated by a healthcare professional.

* Although evidence suggests that this supplement/herb may be beneficial, an effective dose has not been clearly established. Consult with your healthcare practitioner. 

All health-related material and links contained in this document are provided for information purposes only. The information in this document does not replace medical advice. Advice on treatment or care of an individual patient should be obtained through consultation with a physician or trained health care practitioner who has examined that patient or is familiar with that patient's medical history.