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- by Dr. James Meschino, DC, MS, ROHP
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How To Lower Blood Pressure Naturally!
High blood pressure affects approximately twenty-five percent of the adult population in developed countries like the United States and Canada. In up to 75% of these cases hypertension manifests in a mild form, which is highly sensitive to nutrition, supplementation and lifestyle practices. (1,22) Even the most current medical literature stresses that all persons with documented hypertension should receive intensive non-pharmacologic therapies to improve control of their condition and reduce their risk of developing further cardiovascular disease. (2) Hypertension, along with hypercholesterolemia and cigarette smoking are considered to be the three cardinal risk factors for cardiovascular disease. Studies indicate that lowering a patient’s blood pressure from 160/90 to 140/80mmHg may decrease risk of heart disease by more than 30 percent. (3)
Although many pharmacologic agents are commonly prescribed to lower blood pressure, many patients neglect to take their medication due to side effects such as fatigue, impotence, elevated cholesterol levels and other undesirable symptoms and signs.4 For instance, in Canada 22 percent of adults have high blood pressure, but only 16 percent of this hypertensive population are treated and have their blood pressure under control. Thus, 84 percent of patients are either unaware of their high blood pressure problem or are not complying with recommendations to lower their blood pressure due to side effects from the medications, or for other reasons. 5,6 As a result, many patients and health practitioners are currently seeking a more natural approach to lowering blood pressure that eliminates the risk of side effects or can be used to help lower the dosage of blood pressure drugs (which also reduces risk of side effects) in order to achieve a normal blood pressure reading. The truth is that most cases of mild to moderate high blood pressure can be managed exclusively through dietary, exercise and supplementation interventions. 1,2
Lifestyle changes effective at reducing blood pressure include weight loss (4.5 kg or 10 lbs. Minimum) for those who are overweight. In fact, two-thirds of hypertensive patients who are overweight are able to reduce their blood pressure to normal by losing some of their excess (10-15 lbs.) weight. (They don’t need to lose all of their excess body fat.) 7,8 Regular physical activity (optimum 45 to 60 minutes of moderate activity [brisk walk] four to five times weekly), and low alcohol consumption (two or fewer drinks per day; fewer than 14 drinks weekly for men, nine for women) as well as limiting salt additives and foods with excessive added salt are all proven lifestyle practices that have been shown to lower blood pressure 7,8,9,1,2 and should be adhered to by hypertensive patients.
In addition to these well-known nutrition and exercise interventions, there is emerging evidence that specific dietary supplements can also assist in reducing high blood pressure. Here is a brief summary of the best-researched bioactive agents in this regard:
A number of well-designed human intervention trials reveal that calcium supplementation (1,000-1,500 mg calcium per day as calcium carbonate or citrate) can lower blood pressure, particularly in sodium-sensitive hypertensive patients. Calcium encourages sodium excretion by the kidneys and, in concert with magnesium, helps to relax the smooth muscle lining of arterioles, lowering diastolic pressure. 10 Calcium and magnesium supplements are best taken with meals for this purpose, and to enhance their absorption. 29
Supplementation with 600 mg per day of magnesium has been shown to lower blood pressure in some, but not all, studies. Presently, a greater body of evidence exists for calcium supplementation than for magnesium. However, there is no risk in including 600 mg of magnesium in the management of hypertension (unless severe kidney disease is present). 11
Omega-3 Fat Supplementation
Over sixty double-blind studies have demonstrated that either fish oil or flaxseed oil supplementation can be effective in lowering blood pressure. One tablespoon per day of flaxseed oil can lower systolic and diastolic blood pressure by up to 9 mm Hg. 12 I generally recommend 1,000 mg of flaxseed oil (in capsule form), twice per day with meals.
Garlic Extract Supplementation
Supplementation with a garlic extract product that yields 4,000 mcg of allicin (1/2 to 1 clove of garlic) may help to lower blood pressure. Reductions of 20-30 mm Hg systolic and 10-20 mm Hg diastolic pressure have been demonstrated. However, this effect varies greatly among hypertensive subjects. 13,2
Coenzyme Q10 Supplementation
In recent years, a number of randomized, double- blind trials have demonstrated that Coenzyme Q10 (CoQ10) supplementation can effectively and consistently lower blood pressure in hypertensive subjects. CoQ10 is directly involved in the bioenergetic pathways of ATP production in heart muscle (myocardium). Research reveals that 39 percent of patients with high blood pressure have a deficiency of CoQ10. Supplementation with CoQ10 appears to correct this deficiency, correcting the underlying metabolic abnormality that leads to high blood pressure development. Most experts in this field believe that CoQ10 is able to lower blood pressure through its favourable influence on heart bioenergetic mechanisms and possibly relaxing vascular smooth muscle. Because CoQ10 corrects an underlying metabolic defect that leads to high blood pressure, lowering of blood pressure usually requires 4 to 12 weeks of CoQ10 supplementation. 14,15,16,17
In a recent randomized, double blind trial among patients receiving antihypertensive medications, the addition of 60 mg of CoQ10, twice daily was shown to markedly reduce both systolic and diastolic blood pressure. CoQ10 supplementation also reduced other risk factors for cardiovascular disease including a lowering of fasting and 2-hr. plasma insulin, glucose, triglycerides, lipid peroxides and blood levels of malondialdehyde – a marker of free radical damage. The authors of the study conclude that CoQ10 decreases blood pressure possibly by decreasing oxidative stress (free radical generation) and insulin response in patients with known hypertension receiving conventional antihypertensive drugs. This study and others provide evidence that CoQ10 can be taken safely in conjunction with antihypertensive drugs to produce better blood pressure lowering outcomes, if necessary. 18,19,20
The daily dosage of CoQ10 to aid in blood pressure lowering is usually 60 mg, twice per day, 18 although 100 mg once per day has been tested 12 and in mild cases of hypertension 30-75 mg, once per day may be sufficient to normalize blood pressure. 19,20
Hawthorn Extract Supplementation
The hawthorn plant and its berries are a rich source of a unique strand of bioflavonoids, known as procyanidins. Like CoQ10, these procyanidins have been shown to reverse congestive heart failure by enhancing bioenergetic pathways within the heart muscle (myocardium). More recently, we have seen a number of intervention trials that demonstrate that hawthorn extract supplementation can also effectively reduce high blood pressure. The procyanidins in hawthorn act as cardiac glycoside agents that increase cyclic AMP and produce a vasodilation effect on arteries. The daily dosage required to lower blood pressure ranges from 100-250 mg, up to three times daily if taken as a sole antihypertensive agent. To ensure sufficient levels of its active constituents (procyanidins), the product must be standardized to 3-5 percent vitexin content. (Vitexin is a key bioflavonoid.) Usually two to four weeks is required in order to see a significant decline in blood pressure in hypertensive patients. 23 Hawthorn is contra-indicated in patients taking digitalis or digoxin. 30
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How To Lower Blood Pressure Naturally!
Dr. James Meschino,
DC, MS, ROHP
The World Health Organization has promoted lifestyle modification as an effective method of reducing high blood pressure and overall cardiovascular risk.(24) A summary of effective natural antihypertensive interventions include:
- Weight Loss – Usually, only 10-15 lbs. of weight loss (in overweight subjects) will produce a significant blood pressure reduction in hypertensive patients.
- Salt Intake – Limit to 2-3 gms per day.
- Limit alcohol consumption to less than two drinks per day and even less for women. (max. 9 drinks per week)
- Exercise – endurance exercise 30-60 minutes per session, a minimum of three times per week.
- Calcium Supplementation – 1,000-1,500 mg per day (calcium carbonate or citrate), taken in divided doses of 500 mg per dose (with food).
- Magnesium Supplementation – 600 mg per day (all at once or in divided doses, with food).
- Flaxseed Oil – 2,000 mg per day (two 1,000-mg capsules with meals).
- Cardio Essential (Nutra Therapeutics) – Take two capsules, twice per day to acquire a daily dosage of 120 mg of CoQ10 and 150 mg of hawthorn (std to 5% vitexin content).
- Garlic Extract Supplementation (optional) – yielding 4,000 mcg of allicin content.
- Increase fruit and vegetable intake to at least 5 servings per day.
The preceding recommendations can be used in conjunction with standard antihypertensive drugs if necessary. At present, there is sufficient evidence from well- designed medical intervention trials to show that lifestyle interventions are successful in reducing or eliminating the need for pharmacologic therapy in a high percentage of hypertensive patients. 25,26,27,28
1. Quick Reference to Clinical Nutrition, Halpern, S. (ed.); Nutrition and Cardiovascular Disease; J.B.Lippincott Company, Philadelphia, 1987: 139-153
2. Canadian Guidelines for Cardiac Rehabilitation and Cardiovascular Disease Prevention (Canadian Assoc. of Cardiac Rehab.) 1 st edition, 1999; 94-104
3. Fowler, F.E. Myocardial infarction in the 1990’s; Postgraduate Medicine, May 1995; 97, 5: 135-146
4. Complete Guide to Prescription and Non-Prescription Drugs (1999 edition) Griffith H.W. The Body Press, 1998: 168-169, 194-195, 54-55
5. Murray, C.J.L.M., et al. Evidence-based health policy – lessons from the global burden of disease study. Science 1996; 274: 740-743
6. Joffres, M.R., et al. Awareness, treatment, and control of hypertension in Canada. Am J Hypertens. 1997; 10, (Pt-1): 1097-1102
7. 2000 Canadian hypertension recommendations (summary of recommendations affecting family physicians) – the Canadian Hypertension Recommendations Working Group. Canadian Family Physician. April 2001; 47: 793-794
8. Modern Nutrition in Health and Disease (sixth edition) Goodhart, R., and Shils, M. Lea and Febiger: 733
9. Pate, R.R., et al. Physical Activity and Public Health. JAMA. Feb. 1, 1995; 272, 5: 402-407
10. Meese, R.B., et al. The inconsistent effects of calcium supplements upon blood pressure in primary hypertension. Am J Med Sci. 1987; 29: 4219-4224
11. Motoyama, T., et al. Oral magnesium supplementation in patients with essential hypertension. Hypertension, 1989; 13: 227-232
12. Murray, M., and Pizzorno, J. Encyclopedia of Natural Medicine (2 nd edit.) Prima Publishing, 1997; 425-535
13. Foushee, D.B., et al. Garlic as a natural agent for the treatment of hypertension. A preliminary report. Cytobios. 1982; 34: 145-162
14. Digiesi, V., et al. Mechanism of action of Coenzyme Q10 in essential hypertension. Curr Ther Res. 1992; Res 51: 668-672
15. Langsjoen, P., et al. Treatment of essential hypertension with Coenzyme Q10. Mol Aspects Med. 1994;Med 15 (suppl): 265-272
16. Digiesi, V., et al. Coenzyme Q10 in essential hypertension. Mol Aspects Med. 1994; Med 15 (suppl): 257-263
17. McCarty, M.F. Coenzyme Q versus hypertension: does CoQ decrease endothelial superoxide generation? Med Hypotheses. 1999; 53, 4: 300-304
18. Singh, R.B., et al. Effect of hydrosoluble Coenzyme Q10 on blood pressure and insulin resistance in hypertensive patients with coronary artery disease. J Hum Hypertens. 1999; 13, 3: 203-208
19. Yamagami, T., et al. Bioenergetics in Clinical Medicine. Studies on Coenzyme Q10 and Essential Hypertension. Research Comm in Chem. Path and Pharmacol 1975; 11, 2: 273-288
20. Yamagami, T., et al. Bioenergetics in Clinical Medicien, VIII. Administration of Coenzyme Q10 to patients with essential hypertension. Research Comm in Chem Path and Pharmacol. 1976; 14, 4: 721-727
21. Encyclopedia of Nutritional Supplements. Murray, M., PRIMA publishing, 1996: 300-301
22. Nutritional Influences on Illness. Werbach, M.R. Third Line Press., Inc. 1987: 227-240
23. Encyclopedia of Natural Medicine (2 nd edit) Murray, M. and Pizzorno, J. Prima Publishing 1997: 524-535
24. Petrella, R.J. Lifestyle approaches to managing high blood pressure. Can Family Phys. 1999; 45: 1750-1755
25. Elmer, J.P., et al. Lifestyle intervention: results of the Treatment of Mild Hypertension Study. (TOHMS). Prev Med 1995; 24: 378-388
26. Stamler, R., et al. Nutritional therapy for high blood pressure. Final report of a four-year randomized controlled trial – the hypertension control program. JAMA. 1987; 257: 1484-1491
27. Iso, H., et al. Community-based education classes for hypertension control: a 1.5-year randomized controlled trial. Hypertension. 1996; 27: 968-974
28. Appel, L.J., et al. A clinical trial of the effects of dietary patterns on blood pressure (DASH-study) N Engl J Med 1997; 336: 1117-1124
29. Levenson, D., et al. A review of calcium preparations. Nutr Reviews. 1994; 52, 7: 221-232
30. Shariff, S., et al. Herbal Fervor and Vitamin Vigor: Herbs and vitamins for cardiac disease. Perspective in Cardiology. 2000; 16, 1: 21-29
Global Integrative Medicine Academy
The Global Integrative Medicine Academy was created to satisfy a need, expressed by many health professionals, to establish credentials as experts in Nutritional Medicine. But, health professionals also needed to be able to complete the programme with a minimum impact on their career, family, and lifestyle. That is why the Advanced Nutritional Medicine and Sports Nutrition Certification Program was created.