High Blood Pressure-2

Additional Nutritional Support
While the three nutrients discussed can form the backbone of a natural approach to lowering blood pressure (and may work in conjunction with blood pressure–lowering medication), there are many other nutrients that may also help lower blood pressure.

Minerals. Magnesium works in conjunction with calcium, potassium, vitamin D, and other nutrients to control the contraction and relaxation of muscles. It is very important to maintain the correct balance for proper blood pressure maintenance. A Canadian study concluded that daily intake of calcium, potassium, and magnesium is essential in the management of high blood pressure (Touyz RM et al 2004). The study recommended calcium, potassium, and magnesium supplementation for people who don’t currently have high blood pressure but are at risk of developing it.

Based on a large body of evidence, the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure also recommends increasing your intake of potassium, calcium, and magnesium to control blood pressure (National Institutes of Health 2006). Calcium supplementation should always be complemented with magnesium because calcium stimulates muscle contraction, and magnesium is needed for relaxation. Supplemental potassium should only be taken on the advice of a physician because proper potassium balance is based on individual blood test values. For more information, see the Safety Caveats section of this chapter.

Magnesium seems especially beneficial for heart patients. Low levels of magnesium are associated with an improper balance of sodium, potassium, and calcium. Magnesium deficiency is frequently documented in alcoholics, in patients who have high blood pressure or congestive heart failure, and in people who have had a heart attack (Kurabayashi M 2005). Multiple studies recommend that people who have high blood pressure (or who are at risk of developing it) maintain an adequate intake of magnesium (Touyz RM et al 2004). In recent years, researchers in Japan have been focusing on the benefits of magnesium because magnesium intake has diminished in Japan as the traditional Japanese diet of seafood and vegetables is being replaced by a diet high in fat and animal products (Kumeda Y et al 2005).

Researchers have found that:
Magnesium is necessary for the activity of chemicals that lower cholesterol in the body, which contributes to its ability to fight atherosclerosis and endothelial dysfunction (Inoue I 2005).
Women taking magnesium supplements have a significantly lower risk of developing metabolic syndrome (Song Y et al 2005).
A diet low in magnesium is associated with a potassium deficiency, which alters the balance of sodium and potassium in favor of sodium. Also, a low magnesium level is associated with high intracellular calcium levels, which contributes to vasoconstriction and high blood pressure (Rosanoff A 2005). The author of this study recommended long-term, adequate intake of magnesium to ensure a healthy balance of potassium to sodium and of magnesium to calcium.
For people who are taking diuretics or have kidney problems, retaining an adequate amount of magnesium in the body is more difficult. Most Americans get far less magnesium from their diets than they need, so supplementation is a good option. There is some evidence that magnesium improves insulin sensitivity, which decreases the risk of developing high blood pressure (Guerrero-Romero F et al 2004). Another study showed that taking magnesium along with beta blockers significantly reduced blood pressure compared to taking beta blockers alone (Wirell MP et al 1994).

Vitamin E.
Vitamin E is an antioxidant that detoxifies (reduces) strong oxidants in the body. It stabilizes cell membranes and regulates oxidation reactions, as well as protects polyunsaturated fatty acids and vitamin A. Meta-analyses have suggested that vitamin E may be particularly beneficial for patients who have high blood pressure or cardiovascular problems (Taber M 2006). Small studies have shown that vitamin E, even when taken at fairly low doses, increases nitric oxide synthase activity, which leads to vessel dilation and lowered blood pressure. A larger study reported a significant reduction in systolic blood pressure when subjects took 600 mg/day of vitamin E (Galley HF et al 1997). A study of 895 participants reported that vitamin E supplementation might have an antihypertensive effect even among those who get an adequate supply from their diets (Mayer-Davis EJ et al 2002).

Vitamin C.
Vitamin C, also known as ascorbic acid, is an antioxidant that protects other biochemicals from oxidation by being oxidized itself. A small, well-controlled study of 39 participants showed that treatment with vitamin C significantly lowered blood pressure after 30 days, while placebo had no effect (Duffy SJ et al 1999). Although specific mechanisms have not been identified for vitamin C, it may be that it can help promote vessel dilation. As an antioxidant, it may also enhance the synthesis or prevent the destruction of nitric oxide, which directly helps blood vessels dilate and lower blood pressure (Khosh F et al 2001).

Omega-3 fatty acids.
Omega-3 fatty acids are essential fatty acids, which means the body needs these substances but is unable to manufacture them. They must come from food, such as cold-water fish or flaxseed. Studies that have looked at the incidence of high blood pressure and omega-3 fatty acids in large populations suggest that diets high in omega-3 fatty acids or dietary supplementation with omega-3 fatty acids can reduce blood pressure (Hirafuji M et al 2003). It appears that omega-3 fatty acids have a direct widening effect on blood vessels (Din JN et al 2004).

Coenzyme Q10 (CoQ10).
CoQ10 is found in the mitochondria, which is the energy-producing center of cells. It is involved in making the molecule known as adenosine triphosphate (ATP). ATP is the cell’s major energy source. CoQ10 also serves as an antioxidant. Some studies have suggested that CoQ10 may stimulate the immune system and increase resistance to disease (Folkers K et al 1988), as well as lower blood pressure (Hodgson JM et al 2002). One theory to explain the effectiveness of CoQ10 on blood pressure concerns its role as an antioxidant. Studies of diabetics have found that increased oxidative stress may underlie endothelial dysfunction by decreasing production and increasing consumption of nitric oxide, as well as generating free radicals. CoQ10 has been found to mitigate this effect by reducing oxidative stress, thereby normalizing nitric oxide production and consumption (Chew GT et al 2004; Watts GF et al 2002).

CoQ10 has been widely studied in patients who have congestive heart failure and take hypertensive medications. One study of 109 patients with essential hypertension who supplemented their diets with 225 mg/day of CoQ10 in addition to their hypertensive medication, found that participants gradually were able to decrease the need for drug therapy during the first 1 to 6 months. Fifty-one percent of the participants were able to completely discontinue some of their medications an average of 4.4 months after they began CoQ10 supplementation (Langsjoen P et al 1994).

Another study evaluating CoQ10 as a dietary supplement found that it significantly lowered blood pressure by a mean of 17.8 mm Hg in participants. It was also well tolerated and safe. The study broadly concluded that CoQ10 has a beneficial therapeutic effect as an alternative or complementary treatment of high blood pressure (Burke BE et al 2001). Studies indicate it may take 4 to 12 weeks before the blood pressure–lowering benefit is seen (Khosh F et al 2001).

L-arginine.
L-arginine is a basic amino acid found in many proteins and is essential to growth and health maintenance in all vertebrates. There is abundant evidence that it also plays an important role in maintaining endothelial function and blood vessel dilation and in reducing blood pressure. L-arginine is a precursor to nitric oxide, which is essential for the proper function of the endothelium. L-arginine has been shown to boost levels of nitric oxide, which reduces endothelial dysfunction (Boger RH et al 2005; Rasmussen C et al 2005). This helps maintain vascular integrity (Boger RH et al 2005).

Animal studies that reported L-arginine lowers blood pressure provided a launching pad for human studies of L-arginine. One human study found that diets naturally rich in foods containing L-arginine (and diets supplemented with L-arginine) lead to a decrease in blood pressure (Siani A et al 2000).

Taurine.
Taurine is a sulfur-containing amino acid that is classified as conditionally essential, since the body can produce it from other amino acids, such as cysteine, based on the body’s needs. A study was performed on 10 young adults who were borderline hypertensive and took 6 g/day of taurine. Their average systolic blood pressure decreased 9 mm Hg (Fujita T et al 1987). Researchers speculate that taurine may modulate an overactive sympathetic nervous system (Militante JD et al 2002).

Soy protein.
Soy is a high-protein, low-fat food derived from soybean. Protein comprises nearly half its calories, and carbohydrate and fat roughly equal the other half. Soy holds only a trace amount of saturated fat and no cholesterol. In search of a natural approach to treating high blood pressure, a recent study addressed the effects of increased dietary soy protein on blood pressure. Researchers confirmed previous studies that showed higher intake of vegetable protein lowers blood pressure (He J et al 2005).

Data from the Shanghai Women’s Health Study found higher intake of soy was associated with lower levels of blood pressure (Yang G et al 2005). The mechanism responsible for the reduction of blood pressure is not well understood. One plausible explanation concludes that soy protein (or an overall increase in protein) may lead to dietary arginine-induced increases in nitric oxide, which helps dilate blood vessels and improve endothelial function (Cuevas AM et al 2004).

Garlic.
Many patients who have high blood pressure use garlic to lower high blood pressure or help prevent fatty plaque buildup in the arteries and blockages that can lead to heart attack or stroke. The sulfur compounds, especially allicin, are the active ingredients in garlic (Tattelman E 2005). More medical research is underway to assess the usefulness of garlic to prevent heart disease, stroke, and high blood pressure (Edwards QT et al 2005).

Hawthorn (Crataegus oxyacantha; Crataegus monogyna).
Hawthorn berries have been used traditionally for cardiovascular health. Hawthorn appears to mildly reduce blood pressure, possibly via blood vessel dilation (Chang WT et al 2005; Schussler M et al 1995; Leuchtgens H 1993). One study examined the effects of varying doses of hawthorn (500 mg, 600 mg, and a combination of both dosages) on essential hypertension. Researchers found a promising reduction in the resting diastolic blood pressure of (as well as a reduction in anxiety in) the patients who were taking hawthorn (Walker AF et al 2002).

Hawthorn’s beneficial effects may be caused by its antioxidant flavonoid components (Chang WT et al 2005). In a study of patients who had congestive heart failure, a dosage of 30 drops of hawthorn extract three times a day was well tolerated and safe. In another study, patients who were taking digoxin (an anticoagulant) were also administered 450 mg of hawthorn twice a day. The study found that it was safe to coadminister hawthorn and digoxin (Tankanow R et al 2003).

Arjuna.
Arjuna bark from the Terminalia arjuna tree has been used in traditional Indian ayurvedic medicine for more than three centuries, often to treat cardiovascular disorders. A recent trial showed that arjuna was capable of improving endothelial function in smokers (Bharani A et al 2004). In another study, patients whose angina was stable had a 50 percent reduction in angina episodes and a significant decrease in systolic blood pressure (Dwivedi S et al 1994). Prolonged treatment with 500 mg of arjuna showed no adverse effects on the kidneys, liver, or blood (Dwivedi S et al 1994).

Olive leaf (Olea europaea) extract. One of the primary active constituents of olive leaf extract is oleuropein, a complex of flavonoids, esters, and iridoid glycosides, which may have vasodilative properties. Research on the hypotensive effects of this plant found that, when an extract was given for 3 months, blood pressure was reduced in all patients and there were no adverse effects (Cherif S et al 1996).

Hormone Modulation

The risk of developing essential hypertension is significantly higher in a postmenopausal woman, as well as in men older than 55 years of age. As hormone levels decline, the risk of high blood pressure and heart disease rise. One study used progesterone to reduce blood pressure in pregnant women who had preeclampsia, pregnancy induced hypertension (Sammour MB et al 2005).

Vascular endothelium and smooth muscle cells have sex steroid receptors (Natoli AK et al 2005). Research has supported bioidentical hormone restoration of estrogen, progesterone, and testosterone for use in the management of blood pressure and overall cardiac health. Sex hormones stimulate endothelial cell growth, inhibit smooth muscle proliferation and contraction, and relax the vascular endothelium via nitric oxide, prostacyclin, and hyperpolarization pathways (Khalil RA 2005). When hormones are present at youthful concentrations, vascular function in patients who have high blood pressure may be modulated (Khalil RA 2005).

Life Extension Foundation Recommendations

Endothelial dysfunction is closely linked to high blood pressure, atherosclerosis, and cardiovascular risk. Management of high blood pressure, a critical factor in endothelial risk, requires frequent self-monitoring and a multifaceted approach, including taking blood pressure–lowering medications, making lifestyle changes, and watching your diet and nutritional intake. Life Extension recommends people strive for an optimal blood pressure of 115/75 mm Hg.

Because many of the nutrients that lower blood pressure act along the same metabolic pathways as blood pressure–lowering medications, it is important to let your physician know which supplements you are taking before beginning conventional blood pressure medication.

Nutrients that may help lower blood pressure include:
C12 casein peptide—200 to 400 milligrams (mg)/day
Grape seed extract—150 to 300 mg/day
Pomegranate extract—50 to 100 mg/day
Arjuna bark extract—250 to 500 mg twice a day
Calcium—1200 to 1500 mg/day
CoQ10—100 to 300 mg/day
Garlic—1200 mg/day
Hawthorn berry extract—240 mg twice a day between meals
L-arginine—2000 mg three times a day between meals
Magnesium—500 mg/day (or more), based on maximum bowel tolerance and hypotensive effect; take the most at night before bed
Olive leaf extract—500 mg/day
Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—1400 mg/day of EPA and 1000 mg/day of DHA
Potassium—99 mg/day (or more) when instructed to do so by a health care professional, based on blood test results
Soy protein—17 to 34 grams (g)/day
Taurine—1000 to 6000 mg/day
Vitamin C—1 to 3 g/day
Vitamin E (alpha-tocopherol succinate)—400 International Units (IU)/day with about 200 mg of gamma-tocopherol
Hormone modulation can be achieved with blood testing to determine appropriate doses of dehydroepiandrosterone (DHEA), pregnenolone, and bioidentical topical preparations of estrogen, testosterone, and progesterone. See the chapters on Female Hormone Modulation and Male Hormone Modulation for more details.


Product Availability
All the nutrients and supplements discussed in this section are available through the Life Extension Foundation Buyers Club, Inc. For ordering information, call anytime toll-free 1-800-544-4440, or visit us online at www.LifeExtension.com.

The blood tests discussed in this section are available through Life Extension National Diagnostics, Inc. For ordering information, call anytime toll-free 1-800-208-3444, or visit us online at www.LifeExtension.com.

High Blood Pressure Safety Caveats
An aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. These include:

Coenzyme Q10
See your doctor and monitor your blood glucose level frequently if you take CoQ10 and have diabetes. Several clinical reports suggest that taking CoQ10 may improve glycemic control and the function of beta cells in people who have type 2 diabetes.
Statin drugs (such as lovastatin, simvastatin, and pravastatin) are known to decrease CoQ10 levels.

Calcium
Do not take calcium if you have hypercalcemia.
Do not take calcium if you form calcium-containing kidney stones.
Ingesting calcium without food can increase the risk of kidney stones in women and possibly men.
Calcium can cause gastrointestinal symptoms such as constipation, bloating, gas, and flatulence.
Large doses of calcium carbonate (12 grams or more daily or 5 grams or more of elemental calcium daily) can cause milk-alkali syndrome, nephrocalcinosis, or renal insufficiency.

EPA/DHA
Consult your doctor before taking EPA/DHA if you take warfarin (Coumadin). Taking EPA/DHA with warfarin may increase the risk of bleeding.
Discontinue using EPA/DHA 2 weeks before any surgical procedure.

Garlic
Garlic has blood-thinning, anticlotting properties.
Discontinue using garlic before any surgical procedure.
Garlic can cause headache, muscle pain, fatigue, vertigo, watery eyes, asthma, and gastrointestinal symptoms such as nausea and diarrhea.
Ingesting large amounts of garlic can cause bad breath and body odor.

Hawthorn
High doses of hawthorn are toxic and may induce sedation and abnormally low blood pressure.
Do not take hawthorn if you take digoxin. Hawthorn can interfere with the effects of digoxin.

L-Arginine
Do not take L-arginine if you have the rare genetic disorder argininemia.
Consult your doctor before taking L-arginine if you have cancer. L-arginine can stimulate growth hormone.
Consult your doctor before taking L-arginine if you have kidney failure or liver failure.
Consult your doctor before taking L-arginine if you have herpes simplex. L-arginine may increase the possibility of recurrence.

Magnesium
Do not take magnesium if you have kidney failure or myasthenia gravis.

Olive Leaf Oil
Do not take olive leaf oil if you have a history of gallstones.

Potassium
Do not take potassium if you have hyperkalemia (a greater-than-normal concentration of potassium in the blood).
Consult your doctor before taking potassium for potassium deficiency.
Potassium can cause rash and gastrointestinal symptoms such as nausea, vomiting, and diarrhea.

Soy
Do not take soy if you have an estrogen receptor-positive tumor.
Soy has been associated with hypothyroidism.

Vitamin C
Do not take vitamin C if you have a history of kidney stones or of kidney insufficiency (defined as having a serum creatine level greater than 2 milligrams per deciliter and/or a creatinine clearance less than 30 milliliters per minute.
Consult your doctor before taking large amounts of vitamin C if you have hemochromatosis, thalassemia, sideroblastic anemia, sickle cell anemia, or erythrocyte glucose-6-phosphate dehydrogenase (G6PD) deficiency. You can experience iron overload if you have one of these conditions and use large amounts of vitamin C.

Vitamin D
Do not take vitamin D if you have hypercalcemia.
Consult your doctor before taking vitamin D if you are taking digoxin or any cardiac glycoside.
Only take large doses of vitamin D (2000 international units or 50 micrograms or more daily) if prescribed by your doctor.
See your doctor frequently if you take vitamin D and thiazides or if you take large doses of vitamin D. You may develop hypercalcemia.
Chronic large doses (95 micrograms or 3800 international units or more daily) of vitamin D can cause hypercalcemia.