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Hypertension

 

Hypertension Introduction

Hypertension is defined as an elevation in systolic or diastolic blood pressure. The condition is divided into several groups, including;

  • Pre-hypertension [120-139/80-94]
  • Mild hypertension [140-160/95-104]
  • Moderate hypertension [140-180/105-114]
  • Severe hypertension [160+/115]

Patients with high blood pressure divided into two specific categories; those with essential or primary hypertension and those with secondary hypertension. Essential hypertension is high blood pressure with no known cause. Secondary hypertension results from another disease process in the body, such as kidney disease, cancer, or Cushing’s disease to name a few. A person can be diagnosed with hypertension with elevations in the systolic pressure, diastolic pressure, or both. [1]

Hypertension Statistics

  • More than 60 million Americans have high blood pressure.
  • 80% of patients with high blood pressure are in the pre-hypertension to moderate hypertension range. [2]
  • 53% of Americans age 65-74 have high blood pressure. It is more common in African Americans than Caucasians. Mexican Americans have a lower incidence than African Americans and Caucasians.
  • Morbidity and mortality are greatest in African Americans. If persons with high isolated systolic and diastolic blood pressures were to be included in statistical findings; statistics would be frightening. More than half of African American and Caucasian men would be classified as having hypertension, and more than 60% of all women. [3]
  • More than 19,000 deaths per year are attributed to hypertension alone. [4]
  • 85-90% of cases are due to essential (primary) hypertension, 5-10% are due to kidney disease, and only 1-2% are caused by a curable condition. [5]

Hypertension Symptoms

Essential or primary hypertension is without symptoms until complications occur. The symptoms develop when a target organ (heart, brain, blood vessels, kidney, eyes) begins to be adversely affected by the rise in blood pressure. Severe hypertension can cause hypertension encephalopathy and cerebral edema, which can result in dizziness, headache, nervousness, flushed facies, fatigue, and nosebleeds.

Symptoms of heart and vessel damage that can develop due to high blood pressure include;

  • a fourth heart sound
  • a dissecting aorta or aneurysm
  • enlargement of the left side of the heart.

Specific kidney symptoms include;

  • increased frequency of urination
  • blood or protein in the urine
  • electrolyte and nitrogen imbalances

Eye symptoms include;

  • retinal hemorrhage
  • papilledema
  • vascular accidents [6]

Hypertension Treatment

For mild to moderate hypertension, without accompanying organ disease complications, the conventional treatment recommendations are focused on adjusting dietary and lifestyle choices to adjust the elevated blood pressure. Non-drug therapies are recommended over prescription drugs, due the possibility of adverse side effects. [7] For moderate and severe hypertension, drugs such as beta-blockers, ACE inhibitors, calcium channel blockers, and diuretics are recommended. Prescription medications may also be used in the incidence of complications arising from mild hypertension, which cannot be controlled with diet and lifestyle changes alone. [8]

Non-drug treatment is very successful in lowering blood pressure when applied towards both the mild to moderate range. Severe hypertension should be monitored by a physician and treated with pharmacologic drugs.

Supplements helpful for Hypertension

Magnesium

Magnesium is an effective treatment for mild to moderate hypertension. It activates cellular processes to lower the blood pressure. Magnesium is most effective in individuals who exhibit a deficiency of this mineral. It also helps to regulate potassium levels in the body.

In one particular study, individuals with mild to moderate hypertension experienced a systolic decrease by a mean of 2.7 mmHg and a diastolic decrease by a mean of 3.4 mmHg greater than placebo. [9]

Calcium

High blood pressure is linked to low calcium. Individuals with high blood pressure that respond to salt restriction, often react better to the use of supplemental calcium to lower blood pressure. Calcium mainly affects systolic pressure, and is very useful in isolated systolic hypertension.

In a study of individuals with essential hypertension, supplementation caused a 2mmHg reduction in both the systolic and diastolic pressures. [10] Another study concerning elderly individuals produced a similar reduction. [11]

Vitamin C

High intake of vitamin C is correlated with lower blood pressures. It has a modest effect on individuals with mild hypertension. Vitamin C promotes excretion of lead from the body. Lead is associated with an increase in blood pressure.

A study of individuals with mild hypertension compared dosages of 500, 1000, and 2000mg of Vitamin C, and its effect on blood pressure. In the first month of study, systolic pressure decreased by a mean of 4.5 mmHg and the diastolic by a mean of 2.8 mmHg. Although the reduction trend did not continue, it remained constant throughout trial period .[12] In another comparative study of individuals with isolated systolic hypertension and essential hypertension, the systolic pressure decreased by a mean of 10 mmHg and the diastolic by a mean of 6 mmHg. [13]

Coenzyme Q10

Coenzyme Q10 is deficient in 39% of patients with hypertension, and has been shown to lower blood pressure by as much as 10%. [14] These results, however, do not appear until 1-3 months of treatment. CoQ10 is recommended for use with moderate hypertension. Coenzyme Q10 also favorably affects the cholesterol levels and resistance in the blood vessels of arms and legs. Its mechanism of action is not fully understood.

In one study of individuals with isolated systolic hypertension, CoQ10 supplementation resulted in a systolic pressure decrease of 17.8 mmHg. [15] In another study, CoQ10 produced a decrease in systolic pressure by a mean of 6.1 mmHg and decreased the diastolic pressure by a mean of 3 mmHg. [16]

Omega 3 Fatty Acids

Increased intake of fish oil and flaxseed oil can lower blood pressure. Fish oil has proven more effective than flaxseed oil in various studies. Although the mechanism is not known, it is theorized that the anti-inflammatory effects of essential fatty acids produce the blood pressure lowering effects.

In a study of individuals with high blood pressure, supplementation with EPA and DHA from fish oil for 16 weeks lead to a reduction in systolic pressure by a mean of 3.8 mmHg and diastolic pressure by a mean of 2 mmHg. [17] In another study with omega 3 fatty acids, flaxseed and fish oils, the systolic pressure decreased by a mean of 4.1 mmHg and the diastolic by a mean of 2.4 mmHg. [18] Another large, population based study, witnessed a reduction in systolic pressure (6.4 mmHg) and diastolic pressures (2.8 mmHg) with the supplementation of 6g/day of EPA and DHA rich fish oils. [19]

Crataegus species (Hawthorne)

Hawthorn is a well-known botanical medicine for cardiovascular conditions. It improves the functioning of the heart, as well as decreases blood pressure. It is also a potent anti-oxidant because of its high flavonoid content. The blood pressure lowering effects of Hawthorn are mild, and can take several weeks to have a noticeable effect.

In one study comparing Hawthorn to magnesium supplementation in individuals with high blood pressure, a similar reduction was seen in both groups. Although the Hawthorn group exhibited a greater reduction in diastolic pressure than the systolic. [20]

Allium species (Garlic)

Garlic has long been studied for its cardiovascular effects, especially concerning lipid reduction. Garlic is also effective at lowering one’s overall blood pressure.

In one clinical study, a high dose garlic supplementation given to patients with severe hypertension decreased systolic pressure by a mean of 7 mmHg and the diastolic decreased by a mean of 16 mmHg. These results were obtained in just five hours after the initial dosage. [21] In another study of individuals with isolated diastolic hypertension, supplementation with garlic over a 12 week period caused a mean reduction of diastolic pressure by 11 mmHg. [22]

References

[1] Beers M and Berkow R. The Merck Manual 17th Ed. Pages: 1629-1648.

[2] Pizzorno J, Murray M, and Joiner-Bey H. The Clinician’s Handbook of Natural Medicine. 2002 Churchill Livingstone New York. Pages: 237-241.

[3] Beers M and Berkow R. The Merck Manual 17th Ed. Pages: 1629-1648.

[4] http://www.pdrhealth.com/drug_info/nmdrugprofiles/herbaldrugs/101840.shtml National Center for Health Statistics. Oct 2004.

[5] Beers M and Berkow R. The Merck Manual 17th Ed. Pages: 1629-1648.

[6] Beers M and Berkow R. The Merck Manual 17th Ed. Pages: 1629-1648.

[7] Pizzorno J, Murray M, and Joiner-Bey H. The Clinician’s Handbook of Natural Medicine. 2002 Churchill Livingstone New York. Pages: 237-241.

[8] Beers M and Berkow R. The Merck Manual 17th Ed. Pages: 1629-1648.

[9] Witteman JC et al. Reduction of blood pressure with oral magnesium supplementation in women with mild to moderate hypertension. Am J Clin Nutr. 1994 Jul; 60(1): 129-135.

[10] Kawano Y et al. Calcium supplementation in patients with essential hypertension: assessment by office, home, and ambulatory blood pressure. J Hypertens. 199 Nov; 16(11): 1693-1699.

[11] Pizzorno J, Murray M, and Joiner-Bey H. The Clinician’s Handbook of Natural Medicine. 2002 Churchill Livingstone New York. Pages: 237-241.

[12] Hajjar IM et al. A randomized double blind controlled trial of vitamin C in the management of hypertension and lipids. Am J Ther. 2002 Jul-Aug; 9(4): 289-293.

[13] Ghosh SK et al. A double blind placebo controlled parallel trial of vitamin C treatment in elderly patients with hypertension. Gerontology 1994; 40(5): 268-272.

[14] Pizzorno J, Murray M, and Joiner-Bey H. The Clinician’s Handbook of Natural Medicine. 2002 Churchill Livingstone New York. Pages: 237-241.

[15] Burke BE, Neuenschwander R, and Olsen RD. Randomized double blind placebo controlled trial of coenzyme Q10 in isolated systolic hypertension. South Med J. 2001 Nov; 94(11): 1112-1117.

[16] Hodgson JM et al. Coenzyme Q10 improves blood pressure and glycemic control: a controlled trial in subjects with Type II diabetes. Eur J Clin Nutr. 2002 Nov; 56(11): 1137-1142.

[17] Toft I et al. Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. Ann Intern Med. 1995 Dec 15; 123(`12): 911-918.

[18] Radack K, Deck C and Huster G. The effects of low doses of omega 3 fatty acid supplementation on blood pressure in hypertensive subjects: a randomized controlled trial. Arch Intern Med. 1991 June; 151(6): 1173-1180.

[19] Bonaa KH et al. Effect of eicosapentaenoic and docosahexaenoic acids on blood pressure in hypertension: a population based intervention trial from TromasA Study. N Engl J Med. 1990 Mar 22; 322(12): 795-801.

[20] Walker AF et al. Promising hypotensive effect of Hawthorn extract: a randomized double blind pilot study of mild essential hypertension. Phytother Res. 2002 Feb; 16(1): 48-54.

[21] McMahon FG and Vargas R. Can garlic lower blood pressure? A pilot study. Pharmacotherapy 1993 Jul-Aug; 13(4): 406-407.

[22] Auer W et al. Hypertension and hyperlipidemia: garlic helps in mild cases. Br J Clin Suppl. 1990 Aug; 69:3-6.