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High blood pressure

MagazineApril 2009 (Vol. 20 Issue 1)High blood pressure

Q) I'm a 31-year-old man who doesn't smoke, eats reasonably healthily and exercises daily

Q) I'm a 31-year-old man who doesn't smoke, eats reasonably healthily and exercises daily. But on two occasions in the past few months, my GP has found my blood pressure to be higher than normal. Can you recommend any natural ways to lower my blood pressure?-I.G., via e-mail

A) High blood pressure (BP) should certainly not be ignored, but bear in mind that BP measurements can be unreliable. They can rise with physical exertion or stress of any kind, however minor. The time of day, room temperature, a full blad-der, eating or drinking within the previous hour, standing, sitting or lying down can all influence your reading. Even having a conversation can increase BP (WDDTY vol 14 no 8). This helps to explain the 'white-coat effect'-a rise in BP caused by the very act of having it measured.

To determine whether your BP is truly cause for concern, you may wish to try ambulatory BP monitoring, which measures BP over a 24-hour period as you carry on with your usual activities, or home monitoring, where you take your own readings. Studies consistently report that these measures are significantly more accurate than the manual BP readings taken in the office or clinic (Curr Hypertens Rep, 2008; 10: 355-8).

If, after careful monitoring, it turns out that your BP is indeed unhealthily high, there are a number of simple steps you can take to lower it, providing there's no specific cause such as kidney disease or a hormonal disorder. The following natural remedies and lifestyle changes have all proven successful for treating high BP (hypertension).

- Changing your diet. Simply increasing your intake of fruit and vegetables can dramatically lower BP (Lancet, 2002; 359: 1969-74), probably because they're a good source of potassium and fibre-both of which are known to lower BP (J Hypertens, 1991; 9: 465-73; J Hypertens, 1992; 10: 195-9). Even more effective is the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes fruit and vegetables as well as low fat and sodium levels (Can Fam Physician, 2004; 50: 375). It's also important to limit alcohol consumption to no more than 14 units a week (9 units for women) (Can J Cardiol, 2008; 24: 465-75).

- Coenzyme Q10. This powerful antioxidant is a promising alter-native to conventional drugs for managing hypertension. In one trial, 50-mg supplements twice a day dramatically reduced both systolic (the upper number) and diastolic (the lower number) BP in just 10 weeks (Mol Aspects Med, 1994; 15 Suppl: s257-63).

More recently, a review of the literature by the Cardiac Surgical Research Unit in Melbourne, Australia, concluded that "coen-zyme Q10 has the potential in hypertensive patients to lower systolic blood pressure by up to

17 mmHg and diastolic blood pressure by up to 10 mmHg without significant side-effects" (J Hum Hypertens, 2007; 21: 297-306).

- Fish oil. According to an analysis of 31 placebo-controlled trials, the omega-3 fatty acids found in fish oil have a dose-response effect on BP: the higher the dose, the better the results. BP decreased the most in trials using high doses of omega-3 (15 g/day), although lower doses (around 3 g/day) also resulted in significant reductions (Circulation, 1993; 88: 523-33).

One study suggests that docosa-hexaenoic (DHA) might be the main omega-3 responsible for the BP-lowering effect (Hypertension, 1999; 34: 253-60).

- Garlic. A meta-analysis of 11 studies found garlic preparations to be better than a placebo in improving hypertension (BMC Car-diovasc Disord, 2008; 8: 13). Try supple-menting with around 600-900 mg/day of garlic powder.

- Achillea wilhelmsii. This Iranian herb (a type of yarrow) signifi-cantly reduced both systolic and diastolic BP vs a placebo. Trial participants took 15-20 drops of a water-and-alcohol-based extract twice daily for six months-and reported no side-effects (Drugs Exp Clin Res, 2000; 26: 89-93).

- Chocolate. In an 18-week trial of otherwise healthy individuals with above-optimal BP, just 6.3 g/day of dark chocolate (containing 30 mg of polyphenols) significantly reduced BP readings-with no weight gain. Polyphenol-free white chocolate, on the other hand, had no such effect (JAMA, 2007; 298: 49-60).

- Tomato extract. Hypertensive patients given 250 mg/day of tomato extract (Lyc-O-Mato gel capsules, containing 15 mg of lycopene plus other carotenoids) achieved significant reductions in BP after eight weeks of treatment (Am Heart J, 2006; 151: 100).

- Mind/body exercise. It sounds like you already do enough physical activity, but it might be worth incorporating mind-body tech-niques such as yoga, tai chi and qigong into your daily routine, which have all been shown to lower BP (J Clin Hypertens [Greenwich], 2007; 9: 800-1; J Altern Complement Med, 2003; 9: 747-54; J Altern Complement Med, 2008; 14: 27-37). They likely work by reducing stress, which is linked to BP, especially in men (Curr Hypertens Rep, 2001; 3: 249-54).

What is hypertension?

High blood pressure (BP), or hypertension, is when there's a sustained BP reading of 140/90 mmHg or higher. It rarely has any overt symptoms, but can seriously cause damage to organs such as the heart, kidneys and brain, while increasing the risks of heart attack and stroke. In most cases, the cause is unknown, although obesity, a sedentary lifestyle, smoking, a high-salt diet, heavy drinking and stress are thought to play a role (Smith L et al. The Duke Encyclopedia of New Medicine. Emmaus, PA: Rodale Press, 2006).

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