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Nature's Medicines: High Blood Pressure

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High Blood Pressure

If you have high blood pressure (consistently higher than 140/90) and see a conventional doctor, chances are pretty good that the doctor will tell you that you’ll have to take drugs, probably for the rest of your life.

If you’re willing to try some changes in your diet and lifestyle, though, there’s a good chance that you can bring your blood pressure into normal range—or at least reduce it somewhat. Losing just a little weight can work wonders. So can a modest cutback in salt. In one study, dropping about eight pounds and reducing sodium intake by 25 percent allowed half of the participants to lower their blood pressures enough to stop taking medication. Eating less saturated fat and more fiber can also reduce pressure, studies have shown.

There’s more. Doctors and practitioners who use alternative medicine have an arsenal of nutritional supplements—including herbs—that go hand in hand with dietary measures and weight loss. Some of these supplements help regulate blood volume and relax blood vessel muscles so that arteries can dilate, which reduces blood pressure. Others reduce your risk of developing atherosclerosis (hardening of the arteries), which eventually also causes high blood pressure. Still others, such as coenzyme Q₁₀ (coQ₁₀), help your heart pump more efficiently, which also reduces blood pressure, especially in people with damaged hearts. If you have high blood pressure, though, always check with your doctor before you take any supplements.

A Trio of Helpful Minerals

The people who are most susceptible to salt’s blood pressure–elevating effects may be low in other minerals, such as potassium, magnesium, and perhaps calcium, says David McCarron, M.D., professor of medicine and head of the division of nephrology, hypertension, and clinical pharmacology at Oregon Health Sciences University in Portland.

Potassium, magnesium, and calcium have a direct effect on blood volume or influence the ability of blood vessels to relax. Increasing blood volume is like opening up a faucet, and it increases blood pressure. If blood vessels are constricted, pressure also rises. When the vessels relax, blood pressure tends to go down.

"Each of these minerals has some effect separately, but all three interact and may have a better combined effect," Dr. McCarron says.

Potassium Power

Potassium affects blood volume because it helps you excrete sodium, says David B. Young, Ph.D., professor of physiology and biophysics at the University of Mississippi Medical Center in Jackson. When you excrete sodium, you also excrete water, which reduces blood volume and in turn reduces blood pressure.

How much should you get? The Daily Value (DV) is 3,500 milligrams, an amount provided by eight to nine servings of fruit and vegetables, and that much will help to reduce blood pressure. "More potassium will reduce it even more, however," says Dr. Young. "I’d like people to aim for twice that amount, 7,000 milligrams or more a day."

The safest way to get potassium is from foods, he says. In supplement form, a prescription is needed for dosages higher than 99 milligrams per tablet. If you are taking a non-potassium-sparing diuretic for high blood pressure, though, you may need supplemental potassium, Dr. Young says. In this case, your doctor will monitor your blood levels.

More Magnesium?

Magnesium helps to relax the smooth muscles in blood vessels, which allows them to dilate, says Decker Weiss, N.M.D., a naturopathic doctor at the Arizona Heart Institute in Phoenix. Supplemental magnesium has been effective in people who have high blood pressure due to kidney damage, pregnancy-induced high blood pressure, and the type of high blood pressure that’s caused by diuretics.

If you’re taking non-potassium-sparing diuretics such as thiazides to treat high blood pressure, they will begin to deplete your body of magnesium and potassium, the very minerals that you need to help regulate your pressure, notes Dr. Weiss. If your doctor has prescribed a diuretic for blood pressure control, it may stop working after six months or so because magnesium has been drained from your system. "Supplemental magnesium sometimes makes the diuretic more effective again," he says.

It’s safe for most people to use up to 350 milligrams a day of supplemental magnesium, Dr. Weiss says. The preferred forms are magnesium orotate and magnesium glycinate.

Calcium sometimes also helps to reduce blood pressure, although it has less effect than potassium or magnesium. It seems to work best in women who develop high blood pressure during pregnancy and in children who are calcium-deficient, says Matthew Gillman, M.D., assistant professor of ambulatory care and prevention at Boston University Medical School. In one study, pregnant women who took 2,000 milligrams a day of calcium reduced the incidence of high blood pressure by 54 percent.

The DV for calcium is 1,000 milligrams, an amount that many of us fail to consume in our daily diets. Even if you’re not getting the DV, though, if you already have high blood pressure, you should check with your doctor before taking supplemental calcium, Dr. Weiss says. "I don’t normally recommend it for high blood pressure unless I’m seeing an older woman who also has osteoporosis, because too much calcium can interfere with magnesium’s muscle-relaxing ability."

Herbs That Take the Pressure Off

Herbs can provide additional help in controlling blood pressure, Dr. Weiss says. Many different herbs are used for this purpose. With most you need medical supervision.

Among the safer and more popular herbs is dandelion, which acts as a natural potassium-sparing diuretic. "I will prescribe a tincture of dandelion for up to a few months if someone has excess fluid that needs to be reduced," Dr. Weiss says. How much you need to take depends on your blood pressure. If you have gallbladder disease, however, you should not use dandelion preparations without the approval of your doctor.

Fiber Fills the Bill

Dr. Weiss routinely prescribes a high-fiber diet for people concerned about heart disease, and there’s some evidence that fiber can also help reduce high blood pressure. In a large study of more than 40,000 nurses whose lifestyles and diet patterns were followed for four years, researchers discovered that those who got the highest amounts of fiber were least likely to develop high blood pressure. In another study, with animals whose blood pressures had been elevated by a high-fat diet, switching to a low-fat diet and fiber supplements reduced pressure by 10 to 15 points.

Of the two kinds of fiber—soluble and insoluble—it’s the soluble type that’s more important for lowering blood pressure, Dr. Weiss says. This fiber is found in fruits, beans, and oats. If you want additional fiber, look for a supplement that contains mixed soluble fibers such as psyllium, gums, and pectin, he says.

Fish Oil and Flaxseed Oil Smooth the Way

Doctors recommend that you do some serious fat-swapping if you have high blood pressure. Cut back on saturated fats, they say, including animal fat, butter, and the kind of fat that’s in many baked goods. As much as possible, avoid hydrogenated fats, the kind found in margarine and shortening, and polyunsaturated fats, such as corn oil.

Instead of these "unhealthy" fats, Dr. Weiss suggests that you get more of two essential fatty acids, omega-3’s and omega-6’s. Omega-3’s are found in fish oil and flaxseed oil. Borage oil supplies omega-6’s.

"I recommend 1,000 to 3,000 milligrams a day of a mixture of these two essential fatty acids," he says. The fatty acids change your body chemistry so that you produce fewer harmful prostaglandins, hormonelike substances that can jack up blood pressure.

Vitamins to the Rescue

High blood pressure can also develop over time from atherosclerosis, as arteries clogged with fatty deposits become narrow and hardened, like a pipe clogged with mineral deposits. Not everyone with high blood pressure has atherosclerosis, but if you have high cholesterol and high blood pressure, Dr. Weiss recommends adding nutrients that help prevent atherosclerosis. These include vitamins C and E, which help reduce the formation of fatty deposits and clots inside blood vessels.

Vitamin C may have additional blood pressure–lowering effects, Italian researchers report. They found that it helped blood vessels dilate normally. In some people with high blood pressure, the vitamin stopped the breakdown of nitric oxide, a blood vessel–dilating chemical that is secreted from the walls of the blood vessels.

"I routinely prescribe these to anyone who wants to prevent heart disease and related problems," Dr. Weiss says. He recommends 400 to 800 international units of vitamin E and suggests using the type labeled "mixed tocopherols." "And I recommend 1,000 to 2,000 milligrams a day of vita min C in divided doses," he says.

You’ll also want to make sure that you get about 400 micrograms of folic acid, 1,000 micrograms of vitamin B₁₂, and 100 to 250 milligrams of vitamin B₆, Dr. Weiss says. Doses of vitamin B₆ above 100 milligrams a day must be taken under medical supervision.

These three B vitamins are important because they help your body chew up homocysteine, a substance that you can easily do without. Homocysteine is an amino acid by-product that can damage arteries, says Dr. Weiss. It creates rough spots on artery walls, and those roughened areas can pick up fatty deposits that harden into artery-clogging plaque. Taking these B vitamins can help preserve smooth-walled arteries.

Coenzyme Q₁₀ Helps Your Heart Help You

This substance is made naturally in the body, but perhaps it’s in short supply. If high blood pressure is accompanied by heart damage or weakness, you might need coQ₁₀, Dr. Weiss says. It improves energy supplies to the heart muscle cells, so it helps your heart to pump more efficiently, with less effort. That in turn helps to lower blood pressure.

In one study of 109 people with high blood pressure, more than half were able to stop or reduce their medication after four months of treatment with coQ₁₀. Dr. Weiss recommends 30 milligrams three times a day. To improve absorption, he says, it’s best to take it at the same time you take fish oil or flaxseed oil.

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