Hypertension

NOTICE: This health information was not created by the University of Michigan Health System (UMHS) and may not necessarily reflect specific UMHS practices. For medical advice relating to your personal condition, please consult your doctor. Complete disclaimer

Hypertension

Need to Know

Hypertension

Related Topics

Beat hypertension-Lower your blood pressure with simple lifestyle changes to protect yourself from this hidden health problem. According to research or other evidence, the following self-care steps may be helpful.
  • Watch what you eat

    Choose a diet low in cholesterol and animal fat, and high in produce, whole grains, legumes, and low-fat dairy, with some nuts and seeds.

  • Get more soy

    Add 10 grams of soy protein or 16 ounces soy milk twice daily into your diet to help lower blood pressure.

  • Boost heart health with supplemental garlic

    600 to 900 mg a day of a standardized garlic extract can improve heart and blood vessel health, and also has a mild blood pressure-lowering effect.

  • Try CoQ10

    Taking 100 mg a day of this powerful antioxidant may have a significant impact on your blood pressure after one to several months.

  • Sidestep salt

    Avoid using too much table salt, limit salty fast foods, and read labels to find low-sodium foods (less than 140 mg per serving) in your grocery store.

  • Take minerals

    Supplements of calcium (800 to 1,500 mg a day) and magnesium (350 to 500 mg a day) may be helpful.

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.
  • Sidestep salt   

    Avoid using too much table salt, limit salty fast foods, and read labels to find low-sodium foods (less than 140 mg per serving) in your grocery store.

  • Watch what you eat

    Choose a diet low in cholesterol and animal fat, and high in produce, whole grains, legumes, and low-fat dairy, with some nuts and seeds.

  • Maintain a healthy weight

    Lose excess weight and keep it off with a long-term program of healthier eating and regular aerobic exercise for 30 to 60 minutes per day, four or more days per week.

  • Go vegetarian

    Vegetarians have lower blood pressure than meat eaters, partly because of the mineral potassium in fruits and vegetables, which helps blood pressure.

  • Limit alcohol

    Keep daily alcohol intake to two drinks or less per day, and fewer than 9 drinks per week for women to help prevent hypertension.

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.

About

About This Condition

Approximately 90% of people with high blood pressure have "essential" or "idiopathic" hypertension, for which the cause is poorly understood. The terms "hypertension" and "high blood pressure" as used here refer only to this most common form and not to pregnancy-induced hypertension or hypertension clearly linked to a known cause, such as Cushing's syndrome, pheochromocytoma, or kidney disease. Hypertension must always be evaluated by a healthcare professional. Extremely high blood pressure (malignant hypertension) or rapidly worsening hypertension (accelerated hypertension) almost always requires treatment with conventional medicine. People with mild to moderate high blood pressure should work with a doctor before attempting to use the information contained here, as blood pressure requires monitoring and in some cases the use of blood pressure-lowering drugs.

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 retain control of blood pressure. Left untreated, hypertension significantly increases the risk of stroke and heart disease.

Symptoms

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

Holistic Options

Anxiety in men (but not women) has been linked to development of hypertension.1 Several research groups have also shown a relationship between job strain and high blood pressure in men.2 , 3 , 4 Some researchers have tied blood pressure specifically to suppressed aggression.5

Although some kind of relationship between stress and high blood pressure appears to exist, the effects of treatment for stress remain controversial. An analysis of 26 trials reported that reductions in blood pressure caused by biofeedback or meditation were no greater than those seen with placebo.6 Though some stress management interventions have not been helpful in reducing blood pressure,7 , 8 those trials that have reported promising effects have used combinations of yoga, biofeedback, and/or meditation.9 , 10 , 11 Some doctors continue to recommend a variety of stress-reducing measures, sometimes tailoring them to the needs and preferences of the person seeking help.

Preliminary laboratory studies in animals12 and humans13 , 14 , 15 suggest that acupuncture may help regulate blood pressure. Most,16 , 17 , 18 , 19 , 20 , 21 but not all,22 preliminary trials also suggest that acupuncture may be an effective way to lower blood pressure. Whether blood pressure goes back up after acupuncture is discontinued remains an unsettled question.

Auricular (ear) acupressure has been reported to be an effective treatment for hypertension,23 , 24 , 25 though in one case the improvement was not significantly better than use of traditional herbal medicines.26

Spinal manipulation may lower blood pressure (at least temporarily) in healthy people, according to most preliminary27 , 28 , 29 and controlled30 trials. However, some research suggests the effect is no better than the blood pressure-lowering effect of sham ("fake") manipulation.31 In hypertensive people, temporary decreases in blood pressure have also been reported after spinal manipulation.32 , 33 , 34 However, most,35 , 36 , 37 but not all,38 trials suggest that manipulation produces only short-term decreases in blood pressure in hypertensive people.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation Why Get started
Add some fiber Several studies have shown that adding around 7 grams of fiber per day to the diet reduces blood pressure, although other studies have not shown a benefit.

Add some fiber

Several double-blind trials have shown that adding 6.5-7 grams of fiber per day to the diet for several months leads to reductions in blood pressure.39 , 40 , 41 However, other trials have not found fiber helpful in reducing blood pressure.42 , 43 The reason for these discrepant findings is not clear.
Fry with good oils Frying with more stable oils (such as olive oil) does not appear to increase high blood pressure risk, unlike cooking with unstable oils such as sunflower, corn, canola, and flaxseed.

Fry with good oils

Reusing vegetable oils for frying, especially oils with high concentrations of unsaturated fatty acids (such as sunflower or safflower oil) has been associated with an increased risk of high blood pressure.44 Presumably, this increased risk is due to some of the degradation products (such as lipid peroxides or polymers) that result from the excessive heating of these oils. Frying with more stable oils, such as olive oil, is not associated with an increased risk of high blood pressure.
Limit sugar Some doctors recommend that people with high blood pressure eat less sugar, as it has been reported to increase blood pressure in short-term trials.

Limit sugar

Sugar has been reported to increase blood pressure in animals45 and humans in short-term trials.46 Though the real importance of this experimental effect remains unclear,47 some doctors recommend that people with high blood pressure cut back on their intake of sugar.
Try a vegetarian diet Vegetarians have lower blood pressure than meat eaters, partly because fruits and vegetables contain potassium-a known blood pressure-lowering mineral.

Try a vegetarian diet

Vegetarians have lower blood pressure than do people who eat meat.48 This occurs partly because fruits and vegetables contain potassium-a known blood pressure-lowering mineral.49 The best way to supplement potassium is with fruit, which contains more of the mineral than do potassium supplements. However, fruit contains so much potassium that people taking "potassium-sparing"diuretics can consume too much potassium simply by eating several pieces of fruit per day. Therefore, people taking potassium-sparing diuretics should consult the prescribing doctor before increasing fruit intake. In the Dietary Approaches to Stop Hypertension (DASH) trial, increasing intake of fruits and vegetables (and therefore fiber) and reducing cholesterol and dairy fat led to large reductions in blood pressure (in medical terms, 11.4 systolic and 5.5 diastolic) in just eight weeks.50 Even though it did not employ a vegetarian diet itself, the outcome of the DASH trial supports the usefulness of vegetarian diets because diets employed by DASH researchers were related to what many vegetarians eat. The DASH trial also showed that blood pressure can be significantly reduced in hypertensive people (most dramatically in African Americans) with diet alone, without weight loss or even restriction of salt.51 Nonetheless, restricting salt while consuming the DASH diet has lowered blood pressure even more effectively than the use of the DASH diet alone.52
Try some tomato In one study, supplementing with a tomato extract significantly lowered blood pressure in people with hypertension.

Try some tomato

In a double-blind trial, supplementation with a tomato extract significantly lowered both systolic and diastolic blood pressure, compared with a placebo, in people with hypertension.53 The amount of extract used was 250 mg per day (providing 15 mg per day of lycopene plus other carotenoids) for eight weeks.
Cut back on coffee In some studies, coffee drinking has led to small increases in blood pressure. Many doctors tell people with high blood pressure to avoid caffeinated products.

Cut back on coffee

Right after consuming caffeine from coffee or tea, blood pressure increases briefly.54 , 55 In trials lasting almost two months on average, coffee drinking has led to small increases in blood pressure.56 The effects of long-term avoidance of caffeine (from coffee, tea, chocolate, cola drinks, and some medications) on blood pressure remain unclear. A few reports have even claimed that long-term coffee drinkers tend to have lower blood pressure than those who avoid coffee.57 Despite the lack of clarity in published research, many doctors tell people with high blood pressure to avoid consumption of caffeine.
Sidestep salt Avoid using too much table salt, limit salty fast foods, and read labels to find low-sodium foods in your grocery store.

Sidestep salt

Primitive societies exposed to very little salt suffer from little or no hypertension.58 Salt (sodium chloride) intake has also been definitively linked to hypertension in western societies.59Reducing salt intake in the diet lowers blood pressure in most people.60 The more salt is restricted, the greater the blood pressure-lowering effect.61 Individual studies sometimes come to differing conclusions about the relationship between salt intake and blood pressure, in part because blood pressure-lowering effects of salt restriction vary from person to person, and small to moderate reductions in salt intake often have minimal effects on blood pressure-particularly in young people and in those who do not have hypertension. Nonetheless, dramatic reductions in salt intake are generally effective for many people with hypertension.

With the prevalence of salted processed and restaurant food, simply avoiding the salt shaker no longer leads to large decreases in salt intake for most people. Totally eliminating salt is more effective, but is quite difficult to achieve. Moreover, while an overview of the research found "There is no evidence that sodium reduction presents any safety hazards,"62 reports of short-term paradoxical increases in blood pressure in response to salt restriction have occasionally appeared.63 Therefore, people wishing to use salt reduction to lower their blood pressure should consult with a doctor.
Try a hypoallergenic diet In one study, people with migraines who also had high blood pressure experienced a significant drop in blood pressure when put on a hypoallergenic diet.

Try a hypoallergenic diet

Food allergy was reported to contribute to high blood pressure in a study of people who had migraine headaches.64 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. People who suffer migraine headaches and have hypertension should discuss the issue of allergy diagnosis and elimination with a doctor.

Supplements

What Are "Star" Ratings?

a7_3star   Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star   Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star   For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary "Star-Rating" system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.


Supplement Amount Why
Coenzyme Q10
 100 mg twice per day 3 stars   Taking coenzyme Q10 may have a significant impact on blood pressure.


3 stars  Coenzyme Q10

100 mg twice per day

Both preliminary65 , 66 , 67 and double-blind68 , 69 trials have reported that supplementation with coenzyme Q10 (CoQ10) leads to a significant decrease in blood pressure in people with hypertension. Much of this research has used 100 mg of CoQ10 per day for at least ten weeks.


Supplement Amount Why
Fish Oil
 3 to 15 grams daily omega-3 fatty acids 3 stars   EPA and DHA, the omega-3 fatty acids found in fish oil, have been repeatedly shown to lower blood pressure.


3 stars  Fish Oil

3 to 15 grams daily omega-3 fatty acids

EPA and DHA, the omega-3 fatty acids found in fish oil, lower blood pressure, according to an analysis of 31 trials.70 The effect was dependent on the amount of omega-3 fatty acids used, with the best results occurring in trials using unsustainably high levels: 15 grams per day-the amount often found in 50 grams of fish oil. Although results with lower intakes were not as impressive, trials using over 3 grams per day of omega-3 (as typically found in ten 1,000 mg pills of fish oil) also reported significant reductions in blood pressure. One double-blind trial reported that DHA had greater effects on blood pressure than EPA or mixed fish oil supplements.71 DHA is now available as a supplement separate from EPA.


Supplement Amount Why
Pycnogenol
 100 to 200 mg per day 3 stars   Pycnogenol has been shown to reduce systolic blood pressure in people with mild hypertension.


3 stars  Pycnogenol

100 to 200 mg per day

In a small double-blind trial, 200 mg per day of Pycnogenol lowered systolic blood pressure by about 5 mmHg in a group of people with mild hypertension.72 Another double-blind trial found that 100 mg per day of Pycnogenol made it possible to significantly reduce the amount of blood pressure medication necessary to normalize blood pressure.73 In a controlled study, hypertensive patients with signs of early kidney dysfunction were treated with blood pressure medication and either 150 mg of Pycnogenol or placebo.74 After six months, the group receiving Pycnogenol had a greater reduction in diastolic blood pressure and improved in some measures of kidney function.

Supplement Amount Why
Soy
 10 grams soy protein or 16 ounces soy milk twice per day 3 stars   Supplementing with soy protein may significantly lower blood pressure.

3 stars  Soy

10 grams soy protein or 16 ounces soy milk twice per day

In a double-blind study of postmenopausal women, supplementing with 10 grams of soy protein twice a day for six weeks significantly reduced diastolic blood pressure by an average of 5 mm Hg, compared with a diet not containing soy protein.75 In another study, men and women with mild to moderate hypertension consumed 500 ml (approximately 16 ounces) of soy milk or cow's milk twice a day for three months. After three months, the average systolic blood pressure had decreased by 18.4 mm Hg in the soy group, compared with 1.4 mm Hg in the cow's milk group. The reductions in diastolic blood pressure were 15.9 mm Hg with soy milk and 3.7 mm Hg with cow's milk.76 In another study of people with hypertension who were consuming a low-protein, low-fiber diet, supplementing with a combination of soy protein and psyllium (a fiber source) lowered systolic blood pressure by an average of 5.9 mm Hg.77 The blood pressure reduction with soy protein alone or with fiber alone was less pronounced than that with combination treatment. Other research has also shown a blood pressure-lowering effect of soy protein.78 , 79

Supplement Amount Why
Asteraceae
 15 to 20 drops of an herbal tincture twice per day 2 stars   In one trial, people with mild hypertension who took a tincture of Achillea wilhelmsii experienced significant reductions in both systolic and diastolic blood pressure.

2 stars  Asteraceae

15 to 20 drops of an herbal tincture twice per day

In a double-blind trial, people with mild hypertension took a tincture of Achillea wilhelmsii, an herb used in traditional Persian medicine.80 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.


Supplement Amount Why
Calcium
 800 to 1,500 mg daily 2 stars   Calcium supplementation has been shown to lower blood pressure in people with hypertension.


2 stars  Calcium

800 to 1,500 mg daily

Caution: Calcium supplements should be avoided by prostate cancer patients.

Calcium supplementation-typically 800-1,500 mg per day-may lower blood pressure. However, while an analysis of 42 trials reported that calcium supplementation led to an average drop in blood pressure that was statistically significant, the actual decrease was small (in medical terms, a drop of 1.4 systolic over 0.8 diastolic pressure).81 Results might have been improved had the analysis been limited to studies of people with hypertension, since calcium has almost no effect on the blood pressure of healthy people. In the analysis of 42 trials, effects were seen both with dietary calcium and with use of calcium supplements. A 12-week trial of 1,000 mg per day of calcium accompanied by blood pressure monitoring is a reasonable way to assess efficacy in a given person.


Supplement Amount Why
Garlic
 600 to 900 mg of a daily herbal extract 2 stars   Taking garlic may improve heart and blood vessel health and may help lower blood pressure.

2 stars  Garlic

600 to 900 mg of a daily herbal extract

Garlic has a mild blood pressure-lowering effect, according to an analysis of ten double-blind trials.82 All of these trials administered garlic for at least four weeks, typically using 600-900 mg of garlic extract per day. Onion-closely related to garlic-may also have a mild blood pressure-lowering effect, according to preliminary research.83

Supplement Amount Why
Hawthorn
 1,200 mg per day of an herbal extract standardized to 2.2% flavonoids 2 stars   Hawthorn leaf and flower extracts have been reported to have a mild blood pressure-lowering effect.


2 stars  Hawthorn

1,200 mg per day of an herbal extract standardized to 2.2% flavonoids

Hawthorn leaf and flower extracts have been reported to have a mild blood pressure-lowering effect in people with early stage congestive heart failure.84 In a double-blind study, supplementation with a hawthorn extract significantly decreased diastolic blood pressure in people with type 2 diabetes. The amount used was 1,200 mg per day of an extract standardized to 2.2% flavonoids corresponding to 6 grams per day of dried flowering tops.85

Supplement Amount Why
Hibiscus
 2 tsp (5 to 6 grams) dried flowers brewed as tea, taken two to three times per day 2 stars   Two clinical trials have shown that hibiscus can lower blood pressure. The trials have suggested that Hibiscus sabdariffa tea may be as potent as some blood pressure medications.


2 stars  Hibiscus

2 tsp (5 to 6 grams) dried flowers brewed as tea, taken two to three times per day

Controlled clinical trials have shown that hibiscus can lower blood pressure.86 In one, people with high blood pressure who went off their medications were given either 2 teaspoons (5 to 6 grams) Hibiscus sabdariffa infused in 1 cup (250 ml) water or black tea three times per day.87 After 12 days the hibiscus group had significantly lower blood pressure than the black tea group. In another trial 10 grams of Hibiscus sabdariffa tea was compared to the drug captopril for four weeks in people with high blood pressure.88 Blood pressures fell an equal amount in both groups, suggesting this herbal tea may be as potent as some blood pressure medications.


Supplement Amount Why
Magnesium
 350 to 500 mg daily 2 stars   Taking magnesium may lower blood pressure, especially in people who are taking potassium-depleting diuretics.


2 stars  Magnesium

350 to 500 mg daily

Some,89 but not all,90 trials show that magnesium supplements-typically 350-500 mg per day-lower blood pressure. Magnesium appears to be particularly effective in people who are taking potassium-depleting diuretics.91 Potassium-depleting diuretics also deplete magnesium. Therefore, the drop in blood pressure resulting from magnesium supplementation in people taking these drugs may result from overcoming a mild magnesium deficiency.

Supplement Amount Why
Melatonin
 Take under medical supervision: 2 mg daily of sustained-released supplment at night 2 stars   For people with nighttime hypertension, supplementing with melatonin may reduce nighttime systolic blood pressure.


2 stars  Melatonin

Take under medical supervision: 2 mg daily of sustained-released supplment at night

In a double-blind study, supplementation with 2 mg of sustained-release melatonin each night for four weeks significantly reduced nighttime systolic blood pressure, compared with a placebo, in people with nocturnal hypertension.92 Normally, blood pressure declines at night. People with hypertension who do not have this nighttime blood pressure decline are at increased risk of developing and dying from heart disease. Melatonin supplementation may therefore be beneficial for this subgroup of people with hypertension.

Supplement Amount Why
Vitamin D
(Vitamin D Deficiency)
 800 IU daily 2 stars   In one trial, women with low blood levels of vitamin D who were given calcium supplement plus vitamin D experienced significantly reduced systolic blood pressure.


2 stars  Vitamin D

800 IU daily

In a double-blind trial, women with low blood levels of vitamin D (measured as 25-hydroxyvitamin D3) were given a calcium supplement, plus either 800 IU of vitamin D per day or a placebo for eight weeks. Compared with the placebo, vitamin D significantly reduced systolic blood pressure by an average of 9.3%, but did not affect diastolic blood pressure.93

Supplement Amount Why
Vitamin E
 200 IU daily 2 stars   In a study of people with high blood pressure, vitamin E was significantly more effective than placebo at reducing both systolic and diastolic blood pressure.

2 stars  Vitamin E

200 IU daily

In a double-blind study of people with high blood pressure, 200 IU of vitamin E per day taken for 27 weeks was significantly more effective than a placebo at reducing both systolic and diastolic blood pressure.94 This study was done in Iran, and it is not clear whether the results would apply to individuals consuming a Western diet.

Supplement Amount Why
Arginine
 Refer to label instructions 1 star   The amino acid arginine is needed by the body to make nitric oxide, a substance that allows blood vessels to dilate, thus reducing blood pressure. Arginine given orally and intravenously has been reported to help reduce blood pressure.


1 star  Arginine

The amino acid arginine is needed by the body to make nitric oxide, a substance that allows blood vessels to dilate, thus leading to reduced blood pressure. Intravenous administration of arginine has reduced blood pressure in humans in some reports.95 In one controlled trial, people not responding to conventional medication for their hypertension were found to respond to a combination of conventional medication and oral arginine (2 grams taken three times per day.)96

Supplement Amount Why
Coleus
 Refer to label instructions 1 star   Forskolin, the active ingredient in Coleus forskohlii, has lowered blood pressure in a trial with people suffering from cardiomyopathy.


1 star  Coleus

Human trials investigating the use of Coleus forskohlii in blood pressure reduction have yet to be conducted. However, forskolin, the active ingredient in Coleus forskohlii, has lowered blood pressure in a small, preliminary trial with people suffering from cardiomyopathy.97 Extracts of coleus standardized to contain 15-20% forskolin are available, but further trials are needed to determine effective levels for treating people with hypertension.

Supplement Amount Why
Indian Snakeroot
 Refer to label instructions 1 star   Indian snakeroot contains powerful alkaloids that affect blood pressure. It has been used traditionally to treat hypertension, especially when associated with stress and anxiety.

1 star  Indian Snakeroot

Indian snakeroot (Rauwolfia serpentina) contains powerful alkaloids, including reserpine, that affect blood pressure and heart function. Indian snakeroot has been used traditionally to treat hypertension, especially when associated with stress and anxiety.98 Due to possible serious side effects, Indian snakeroot should only be taken under the careful supervision of a physician trained in its use.


Supplement Amount Why
L-Tryptophan
 Refer to label instructions 1 star   The brain chemical serotonin may affect blood pressure regulation, and animal research suggests its precursur L-tryptophan may help prevent and manage hypertension.


1 star  L-Tryptophan

The brain chemical serotonin may play a role in blood pressure regulation,99 and animal research suggests L-tryptophan, a precursor of serotonin, might be helpful in the prevention and treatment of hypertension.100 , 101 , 102 Preliminary human studies suggest that 3 to 4 grams per day of L-tryptophan can lower blood pressure in people with hypertension.103 , 104 Double blind trials are needed to confirm these promising reports.

Supplement Amount Why
Mistletoe
 Refer to label instructions 1 star   European mistletoe has reduced headaches and dizziness associated with high blood pressure, according to preliminary research, and has a small blood pressure-lowering effect.


1 star  Mistletoe

European mistletoe  (Viscum album) has reduced headaches and dizziness associated with high blood pressure, according to preliminary research.105 Mistletoe may be taken as 0.5 ml tincture three times per day.106 The blood pressure-lowering effect of mistletoe is small and may take weeks to become evident. Due to possible serious side effects, European mistletoe should only be taken under the careful supervision of a physician trained in its use.


Supplement Amount Why
Olive Leaf
 Refer to label instructions 1 star   Olive leaf has been used traditionally to treat people with hypertension. In animal studies a constituent of olive leaf has decreased blood pressure and dilated arteries surrounding the heart when given by injection.


1 star  Olive Leaf

In animal studies oleuropein, one of the constituents of olive leaf, has decreased blood pressure and dilated arteries surrounding the heart, when given by injection or intravenously.107 Olive leaf has been used traditionally to treat people with hypertension,108 but controlled human trials are needed before a blood pressure-lowering effect can be established.

Supplement Amount Why
Onion
 Refer to label instructions 1 star   Onion may have a mild blood pressure-lowering effect, according to preliminary research.

1 star  Onion

Garlic has a mild blood pressure-lowering effect, according to an analysis of ten double-blind trials.109 All of these trials administered garlic for at least four weeks, typically using 600-900 mg of garlic extract per day. Onion-closely related to garlic-may also have a mild blood pressure-lowering effect, according to preliminary research.110

Supplement Amount Why
Reishi
 Refer to label instructions 1 star   One trial reported that reishi mushrooms significantly lowered blood pressure.

1 star  Reishi

A double-blind trial reported that reishi mushrooms significantly lowered blood pressure in humans.111 The trial used a concentrated extract of reishi (25:1) in the amount of 55 mg three times per day for four weeks. It is unclear from the clinical report how long it takes for the blood pressure-lowering effects of reishi to be measured.

Hawthorn leaf and flower extracts have been reported to have a mild blood pressure-lowering effect in people with early stage congestive heart failure.112 In a double-blind study, supplementation with a hawthorn extract significantly decreased diastolic blood pressure in people with type 2 diabetes. The amount used was 1,200 mg per day of an extract standardized to 2.2% flavonoids corresponding to 6 per day of dried flowering tops.113

Supplement Amount Why
Taurine
 Refer to label instructions 1 star   Research has found that supplementing with taurine lowers blood pressure in people, possibly by reducing levels of the hormone epinephrine (adrenaline).

1 star  Taurine

A deficiency of the amino acid taurine, is thought by some researchers to play an important role in elevating blood pressure in people with hypertension.114 Limited research has found that supplementation with taurine lowers blood pressure in animals115 and in people (at 6 grams per day),116 possibly by reducing levels of the hormone epinephrine (adrenaline).

Supplement Amount Why
Vitamin C
 Refer to label instructions 1 star   Some doctors recommend that people with hypertenstion supplement with vitamin C, which has been found to have a blood pressure-lowering effect.

1 star  Vitamin C

Five double-blind trials have found that vitamin C supplementation reduces blood pressure, but the reduction was statistically significant in only three of the five, and in most cases reductions were modest.117 , 118 Some doctors recommend that people with elevated blood pressure supplement with 1,000 mg vitamin C per day.

References

1. Markovitz JH, Matthews KA, Kannel WB, et al. Psychological predictors of hypertension in the Framingham Study. Is there tension in hypertension?JAMA 1993;270:2439-43.

2. Schnall PL, Schwartz JE, Landesbergis PA, et al. Relation between job strain, alcohol, and ambulatory blood pressure. Hypertension 1992;19:488-94.

3. Matthews KA, Cottington EM, Talbott E, et al. Stressful work conditions and diastolic blood pressure among blue collar factory workers. Am J Epidemiol 1987;126:280-91.

4. Pickering TG. Does psychological stress contribute to the development of hypertension and coronary heart disease? Eur J Clin Pharmacol 1990;39(Suppl 1):S1-S7.

5. Perini C, Müller FB, Bühler FR. Suppressed aggression accelerates early development of essential hypertension. J Hypertens 1991;9:499-503.

6. Eisenberg DM, Delbanco TL, Berkey CS, et al. Cognitive behavioral techniques for hypertension: are they effective? Ann Intern Med 1993;118:964-72.

7. Irvine MJ, Logan AG. Relaxation behavior therapy as sole treatment for mild hypertension. Psychosomatic Med 1991;53:587-97.

8. Johnston DW, Gold A, Kentish J, et al. Effect of stress management on blood pressure in mild primary hypertension. BMJ 1993;306:963-6.

9. Patel CH. Yoga and bio-feedback in the management of hypertension. Lancet 1973;2:1973-5.

10. Schneider RH, Staggers F, Alexander C, et al. A randomized controlled trial of stress reduction for hypertension in older African Americans. Hypertension 1995;26:820-9.

11. Patel C, Marmot MG, Terry DJ, et al. Trial of relaxation in reducing coronary risk: four year follow up. BMJ 1985;290:1103-6.

12. Lee HS, Kim JY. Effects of acupuncture on blood pressure and plasma renin activity in two-kidney one clip goldblatt hypertensive rats. Am J Chin Med 1994;22:215-9.

13. Chiu YJ, Chi A, Reid IA. Cardiovascular and endocrine effects of acupuncture in hypertensive patients. Clin Exper Hypertens 1997;19:1047-63.

14. Peng L, Feng-yen S, An-zhong Z. The effect of acupuncture on blood pressure: the interrelation of sympathetic activity and endogenous opioid peptides. Acupunct Electrother Res 1983;8:45-56.

15. Zhou Y, Wang Y, Fang Z, et al. Influence of acupuncture on blood pressure, contents of NE, DA and 5-HT of SHR and the interrelation between blood pressure and whole blood viscosity. Chen Tzu Yen Chiu 1995;20:55-61 [in Chinese].

16. Radzievsky SA, Lebedeva OD, Fisenko LA, Majskaja SA. Function of myocardial contraction and relaxation in essential hypertension in dynamics of acupuncture therapy. Am J Chin Med 1989;17:111-7.

17. Williams T, Mueller K, Cornwall MW. Effect of acupuncture-point stimulation on diastolic blood pressure in hypertensive subjects: a preliminary study. Phys Ther 1991;71:523-9.

18. Weihai Y, Hongxu L. Clinical observation on the immediate hypotensive effect of zanzhu point. J Tradit Chin Med 1996;16:273-4.

19. Utsunomiya N, Shigematsu Y, Ikeda K, et al. Fall in high blood pressure after applying acupuncture to SHR. Jpn Heart J 1978;19:594.

20. Yiping Z, Qiong C, Zhengming H, Yinong C. Experimental research on treatment of hypertension with acupuncture. J Tradit Chin Med 1993;13:277-80.

21. Tam K-C, Yiu H-H. The effect of acupuncture on essential hypertension. Am J Chin Med 1975;3:369-75.

22. Kraft K, Coulon S. Effect of a standardized acupuncture treatment on complains, blood pressure and serum lipids of hypertensive, postmenopausal women. A randomized, controlled clinical study. Forsch Komplementarmed 1999;6:74-9 [in German].

23. Rongxing Z, Yanhua Z, Lu Y. Hypotensive effect of ototherapy in relation to symptomatic and dispositional types of patients. J Tradit Chin Med 1992;12:124-8.

24. Kangmei C, Shulian Z, Ying Z. Clinical application of traditional auriculoacupoint therapy (continued). J Tradit Chin Med 1993;13:152-4.

25. Rongxing Z, Yanhua Z, Jialiang W, et al. Anti-hypertensive effect of auriculo-acupoint pressing therapy-clinical analysis of 274 cases. J Tradit Chin Med 1991;11:189-92.

26. Peng Y, Fenglan L, Xin W. Treatment of essential hypertension with auriculopressure. J Tradit Chin Med 1991;1117-21.

27. Tran T, Kirby J. Effects of upper cervical adjustments upon the normal physiology of the heart. ACA J Chiro 1977;XI:S58-62.

28. McGuiness J, Vicenzino B, Wright A. The influence of a cervical mobilization technique on respiratory and cardiovascular function. Manual Therapy 1997;(2):216-20.

29. Vicenzino B, Cartwright T, Collins D. Cardiovascular and respiratory changes produced by lateral glide mobilization of the cervical spine Manual Therapy 1998;3(2):67-71.

30. Dulgar G, Hill D, Sirucek A, et al. Evidence for possible anti-hypertensive effect of basic technique apex contact adjusting. J Chiro 1980;14:S97-S102.

31. Nansel D, Jansen R, Cremata E, et al. Effects of cervical adjustments on lateral-flexion passive end-range asymmetry and on blood pressure, heart rate and plasma catecholamine levels. J Manipulative Physiol Ther 1991;14:450-6.

32. Fichera AP, Celander DR. Effect of osteopathic manipulative therapy on autonomic tone as evidenced by blood pressure change and activity of the fibrinolytic system. J Am Osteopath Assoc 1969;68:1036-8.

33. McKnight M, DeBoer KD. Preliminary study of blood pressure changes in normotensive patients under chiropractic care. J Manipulative Physiol Ther 1988;11:261-6.

34. Yates RG, Lamping DL, Nancy LA, Wright C. Effects of chiropractic treatment on blood pressure and anxiety: a randomized, controlled trial. J Manipulative Physiol Ther 1988;11:484-8.

35. Morgan JP, Dickey JL, Hunt HH, Hudgins PM. A controlled trial of spinal manipulation in the management of hypertension. J Am Osteopath Assoc 1985;85(5):308-12.

36. Mannino J. The application of neurologic reflexes to the treatment of hypertension. J Am Osteopath Assoc 1979;79:225-31.

37. Wagnon RJ, Sandefur RM, Ratliff CR. Serum aldosterone changes after specific chiropractic manipulation. Am J Chiropr Med 1988;1(2):66-70.

38. Goodman R. Hypertension and the atlas subluxation complex. Chiropractic: J Chiropractic Res Clin Invest 1992;8(2)30-2.

39. Rossner S, Andersson IL, Ryttig K. Effects of a dietary fibre supplement to a weight reduction programme on blood pressure. A randomized, double-blind, placebo-controlled study. Acta Med Scand 1988;223:353-7.

40. Eliasson K, Ryttig KR, Hylander B, Rossner S. A dietary fibre supplement in the treatment of mild hypertension. A randomized, double-blind, placebo-controlled trial. J Hypertens 1992;10:195-9.

41. Schlamowitz P, Halberg T, Warnoe O, et al. Treatment of mild to moderate hypertension with dietary fibre. Lancet 1987;2:622-3.

42. Fehily AM, Burr ML, Butland BK, Eastham RD. A randomised controlled trial to investigate the effect of a high fibre diet on blood pressure and plasma fibrinogen. J Epidemiol Community Health 1986;40:334-7.

43. Swain JF, Rouse IL, Curley CB, Sacks FM. Comparison of the effects of oat bran and low-fiber wheat on serum lipoprotein levels and blood pressure. N Engl J Med 1990;322:147-52.

44. Soriguer F, Rojo-Martinez G, Dobarganes MC, et al. Hypertension is related to the degradation of dietary frying oils. Am J Clin Nutr 2003;78:1092-7.

45. Zein M, Areas JL, Breuss GH. Effects of excess sucrose ingestion on the lifespan of SHR. J Am Coll Nutr 1989;8:435 [abstract #42].

46. Rebello T, Hodges RE, Smith JL. Short-term effects of various sugars on antinatriuresis and blood pressure changes in normotensive young men. Am J Clin Nutr 1983;38(1):84-94.

47. Preuss HG, Fournier RD. Effects of sucrose ingestion on blood pressure. Life Sci 1982;30:879-86.

48. Margetts BM, Beilin LJ, Vandongen R, Armstrong BK. Vegetarian diet in mild hypertension: a randomised controlled trial. BMJ 1986;293:1468-71.

49. Cappuccio FP, MacGregor GA. Does potassium supplementation lower blood pressure? A meta-analysis of published trials. J Hypertens 1991;9:465-73.

50. Appel LJ, Moore TJ, Boarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med 1997;336:1117-24.

51. Svetkey LP, Simons-Morton D, Vollmer WM, et al. Effects of dietary patterns on blood pressure: a subgroup analysis of the Dietary Approaches to Stop Hypertension (DASH) randomized clinical trial. Arch Intern Med 1999;159:285-93.

52. Sachs FM, Svetkey LP, Vollmer WM, et al. Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med 2001;344:3-10.

53. Engelhard YN, Gazer B, Paran E. Natural antioxidants from tomato extract reduce blood pressure in patients with grade-1 hypertension: a double-blind, placebo-controlled pilot study. Am Heart J 2006;151:100.

54. Rachima-Maoz C, Peleg E, Rosenthal T. The effect of caffeine on ambulatory blood pressure in hypertensive patients. Am J Hypertens 1998;11:1426-32.

55. Hodgoson JM, Buddey IB, Burke V, et al. Effects on blood pressure of drinking green and black tea. J Hypertens 1999;17:457-63.

56. Jee SH, He J, Whelton PK, et al. The effect of chronic coffee drinking on blood pressure. A meta-analysis of controlled clinical trials. Hypertension 1999;33:647-52.

57. Wakabayashi K, Kono S, Shinchi K, et al. Habitual coffee consumption and blood pressure: a study of self-defense officials in Japan. Eur J Epidemiol 1998;14:669-73.

58. Page LB, Damon A, Moellering RC Jr. Antecedents of cardiovascular disease in six Solomon Islands Societies. Circulation 1974;44:1132-46.

59. Stamler J, Rose G, Elliott P, et al. Findings of the international cooperative INTERSALT study. Hypertension 1991;17(1 Suppl):I9-15.

60. MacGregor GA, Markandu ND, Sagnella GA, et al. Double-blind study of three sodium intakes and long-term effects of sodium restriction in essential hypertension. Lancet 1989;2:1244-7.

61. Cutler JA, Follmann D, Allender PS. Randomized trials of sodium reduction: an overview. Am J Clin Nutr 1997;65(Suppl):643S-51S.

62. Cutler JA, Follmann D, Allender PS. Randomized trials of sodium reduction: an overview. Am J Clin Nutr 1997;65(Suppl):643S-51S.

63. Egan BM, Stepniakowski KT. Adverse effects of short-term, very-low-salt diets in subjects with risk-factor clustering. Am J Clin Nutr 1997;65(Suppl):671S-7S.

64. Grant ECG. Food Allergies and migraine. Lancet 1979;1:966-9.

65. Folkers K, Drzewoski J, Richardson PC, et al. Bioenergetics in clinical medicine. XVI. Reduction of hypertension in patients by therapy with coenzyme Q10. Res Commun Chem Pathol Pharmacol 1981;31:129-40.

66. Langsjoen P, Langsjoen P, Willis R, Folkers K. Treatment of essential hypertension with coenzyme Q10. Mol Aspects Med 1994;15 Suppl:s265-72.

67. Digiesi V, Cantini F, Oradei A, et al. Coenzyme Q10 in essential hypertension. Molec Aspects Med 1994;15 Suppl:s257-63.

68. Digiesi V, Cantini F, Brodbeck B. Effect of coenzyme Q10 on essential arterial hypertension. Curr Ther Res 1990;47:841-5.

69. Singh RB, Niaz MA, Rastogi SS, et al. Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease. J Hum Hypertens 1999;13:203-8.

70. Morris MC, Sacks F, Rosner B. Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation 1993;88:523-33.

71. Mori TA, Bao DQ, Burke V, et al. Docosahexaenoic acid but not eicosapentaenoic acid lowers ambulatory blood pressure and heart rate in humans. Hypertension 1999;34:253-60.

72. Hosseini, S, Lee, J, Sepulveda RT, Fagan T, et al. A randomized, double blind, placebo-controlled, prospective 16 week crossover study to determine the role of Pycnogenol(R) in modifying blood pressure in mildly hypertensive patients. Nutr.Res 2001;21:67-76.

73. Liu X, Wei J, Tan F, et al.. Pycnogenol, French maritime pine bark extract, improves endothelial function of hypertensive patients. Life Sci 2004;74:855-62

74. Cesarone MR, Belcaro G, Stuard S, et al. Kidney flow and function in hypertension: protective effects of pycnogenol in hypertensive participants--a controlled study. J Cardiovasc Pharmacol Ther 2010;15:41-6.

75. Washburn S, Burke GL, Morgan T, Anthony M. Effect of soy protein supplementation on serum lipoproteins, blood pressure, and menopausal symptoms in perimenopausal women. Menopause1999;6:7-13.

76. Rivas M, Garay RP, Escanero JF, et al. Soy milk lowers blood pressure in men and women with mild to moderate essential hypertension. J Nutr 2002;132:1900-2.

77. Burke V, Hodgson JM, Beilin LJ, et al. Dietary protein and soluble fiber reduce ambulatory blood pressure in treated hypertensives. Hypertension2001;38:821-6.

78. He J, Gu D, Wu X, et al. Effect of soybean protein on blood pressure: a randomized, controlled trial. Ann Intern Med 2005;143:1-9.

79. Welty FK, Lee KS, Lew NS, Zhou JR. Effect of soy nuts on blood pressure and lipid levels in hypertensive, prehypertensive, and normotensive postmenopausal women. Arch Intern Med 2007;167:1060-7.

80. Asgary S, Naderi GH, Sarrafzadegan N, et al. Antihypertensive and antihyperlipidemic effects of Achillea wilhelmsii. Drugs Exp Clin Res 2000;26:89-93.

81. Griffith LE, Guyatt GH, Cook RJ, et al. The influence of dietary and nondietary calcium supplementation on blood pressure. An updated metaanalysis of randomized controlled trials. Am J Hypertens 1999;12:84-92.

82. Silagy C, Neil AW. A meta-analysis of the effect of garlic on blood pressure. J Hypertension 1994;12:463-8.

83. Louria DB, McAnally JF, Lasser N, et al. Onion extract in treatment of hypertension and hyperlipidemia: A preliminary communication. Curr Ther Res 1985;37:127-31.

84. Schmidt U, Kuhn U, Ploch M, Hübner W-D. Efficacy of the hawthorn (Crataegus) preparation LI 132 in 78 patients with chronic congestive heart failure defined as NYHA functional class II. Phytomed 1994;1(1):17-24.

85. Walker AF, Marakis G, Simpson E, et al. Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial. Br J Gen Pract 2006;56:437-43.

86. McKay DL, Chen CY, Saltzman E, Blumberg JB. Hibiscus sabdariffa L. tea (tisane) lowers blood pressure in prehypertensive and mildly hypertensive adults. J Nutr 2010;140:298-303.

87. Haji Faraji M, Haji Tarkhani AH. The effect of sour tea (Hibiscus sabdariffa) on essential hypertension. J Ethnopharmacol 1999;65:231-6.

88. Herrera-Arellano A, Flores-Romero S, Chavez-Soto MA, Tortoriello J. Effectiveness and tolerability of a standardized extract from Hibiscus sabdariffa in patients with mild to moderate hypertension: a controlled and randomized clinical trial. Phytomedicine 2004;11(5):375-82.

89. Motoyama T, Sano H, Fukuzaki H, et al. Oral magnesium supplementation in patients with essential hypertension. Hypertension 1989;13:227-32.

90. Patki PS, Singh J, Gokhale SV, et al. Efficacy of potassium and magnesium in essential hypertension: a double-blind, placebo controlled, crossover study. BMJ 1990;301:521-3.

91. Dyckner T, Wester PO. Effect of magnesium on blood pressure. BMJ 1983;286:1847-9.

92. Grossman E, Laudon M, Yalcin R, et al. Melatonin reduces night blood pressure in patients with nocturnal hypertension. Am J Med 2006;119:898-902.

93. Pfeifer M, Begerow B, Minne HW, et al. Effects of a short-term vitamin D3 and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women.J Clin Endocrinol Metab 2001;86:1633-7.

94. Boshtam M, Rafiei M, Sadeghi K, Sarraf-Zadegan N. Vitamin E can reduce blood pressure in mild hypertensives. Int J Vitam Nutr Res 2002;72:309-14.

95. Calver A, Collier J, Vallance P. Dilator actions of arginine in human peripheral vasculature. Clin Sci 1991;81:695-700.

96. Pezza V, Bernardini F, Pezza E, et al. Study of supplemental oral l-arginine in hypertensives treated with enalapril + hydrochlorothiazide. Am J Hypertens 1998;11:1267-70 [letter].

97. Kramer W, Thormann J, Kindler M, Schlepper M. Effects of forskolin on left ventricular function in dilated cardiomyopathy. Arzneimittelforschung 1987;37:364-7.

98. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council, Austin, TX. Integrative Medical Communications, Boston, MA: 1998, 152-3.

99. Lehnert H, Beyer J. Cardiovascular and endocrine properties of L-tryptophan in combination with various diets. Adv Exp Med Biol 1991;294:407-16 [review].

100. Fregly MJ, Lockley OE, Cade JR. Effect of chronic dietary treatment with L-tryptophan on the development of renal hypertension in rats. Pharmacology 1988;36:91-100.

101. Lark LA, Witt PA, Becker KB, et al. Effect of dietary tryptophan on the development of hypertension in the Dahl salt-sensitive rat. Clin Exp Hypertens A 1990;12:1-13.

102. Pop E, Anderson W, Prókai-Tátrai K, et al. Antihypertensive activity of redox derivatives of tryptophan. J Med Chem 1990;33:2216-21.

103. Cade JR, Fregly MJ, Privette M. Effect of tryptophan and 5-hydroxytryptophan on the blood pressure of patients with mild to moderate hypertension. Amino Acids 1992;2:133-42.

104. Lehnert H et al. [Note: Other authors' names not found.] Effects of L-tryptophan on blood pressure in essential hypertensives. Clin Exp Theory Pract 1987;A9:208 [abstract].

105. Bowman IA. The everlasting mistletoe and the cardiovascular system. Texas Heart Inst J 1990;17(4):310-4 [review].

106. British Herbal Medicine Association. British Herbal Pharmacopoeia. West Yorks, UK: BHMA, 1983.

107. Petkov V, Manolov P. Pharmacological analysis of the iridoid oleuropein. Arzneimittelforschung 1972;22:1476-86.

108. Weiss RF. Herbal Medicine. Gothenburg, Sweden: AB Arcancum, 1988, 160-1.

109. Silagy C, Neil AW. A meta-analysis of the effect of garlic on blood pressure. J Hypertension 1994;12:463-8.

110. Louria DB, McAnally JF, Lasser N, et al. Onion extract in treatment of hypertension and hyperlipidemia: A preliminary communication. Curr Ther Res 1985;37:127-31.

111. Jin H, Zhang G, Cao X, et al. Treatment of hypertension by ling zhi combined with hypotensor and its effects on arterial, arteriolar and capillary pressure and microcirculation. In: Nimmi H, Xiu RJ, Sawada T, Zheng C (eds). Microcirculatory Approach to Asian Traditional Medicine. New York: Elsevier Science, 1996, 131-8.

112. Schmidt U, Kuhn U, Ploch M, Hübner W-D. Efficacy of the hawthorn (Crataegus) preparation LI 132 in 78 patients with chronic congestive heart failure defined as NYHA functional class II. Phytomed 1994;1(1):17-24.

113. Walker AF, Marakis G, Simpson E, et al. Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial. Br J Gen Pract 2006;56:437-43.

114. Kohashi N, Katori R. Decrease of urinary taurine in essential hypertension. Jpn Heart J 1983;24:91-102.

115. Abe M, Shibata K, Matsuda T, Furukawa T. Inhibition of hypertension and salt intake by oral taurine treatment in hypertensive rats. Hypertension 1987;10:383-9.

116. Fujita T, Ando K, Noda H, et al. Effects of increased adrenomedullary activity and taurine in young patients with borderline hypertension. Circulation 1987;75:525-32.

117. Ness AR, Chee D, Elliott P. Vitamin C and blood pressure-an overview. J Human Hypertens 1997;11:343-50.

118. Fotherby MD, Williams JC, Forster LA, et al. Effect of vitamin C on ambulatory blood pressure and plasma lipids in older persons. J Hypertens 2000;18:411-5.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.