What is the Best Supplement For High Blood Pressure?

Hypertension, or high blood pressure, is becoming the number one cause of cardiovascular disease death, and it’s an epidemic that is truly out of control (60 percent of the population has elevated blood pressure). Prehypertension (above normal blood pressure but not quite hypertension) is also a risk for stroke, like hypertension.

There are a variety of drugs that can mean the difference between life and death, so attempting to use mostly unproven supplements is very dangerous in this category. There are a few supplements that stand out—where the benefit may exceed the risk— but overall the most impressive research in this area has been on how comprehensive lifestyle changes (not just sodium and alcohol reduction) could profoundly lower blood pressure and reduce the need for low-dose blood pressure medications.

Clinical trials such as DASH (Dietary Approaches to Stop Hypertension), which our tax dollars helped fund, could finally help people realize that they have the power to reduce their risk of this disease. Just a 2 mm Hg (millimeters of mercury) drop in blood pressure can reduce the risk of death from stroke, heart disease, and all causes!

One more thing: If you’re worried about hypertension, then you should buy a home blood pressure monitoring device (my favorite company is Omron), which you can use whenever you want. (I recommend taking your blood pressure once or twice every 3 months from both arms and giving the results to your doctor.) One of the most important health indicators ever discovered is blood pressure, and we take it only once a year! Come on, folks! (Having your own blood pressure device also helps you avoid “white coat syndrome,” where your blood pressure shoots up at the doctor’s office because you’re stressed.)

What is High Blood Pressure?

When the arteries are damaged, they are less elastic, less compliant, taking more force to get blood to flow through them. That’s high blood pressure. A consistent reading of 140/90 mm Hg is considered high, but if it’s between 120 to 139/80 to 89 mm Hg, you have prehypertension, which increases your risk of developing full-blown hypertension. I think of this as a wake-up call. (The number on top is the systolic pressure and the number on the bottom is the diastolic pressure, both of which measure pressure in your arteries.)

Hypertension can be caused by stress, heart disease, tobacco, alcohol, family history, genetics, and more. Sometimes, there is no easy-to-pinpoint cause. Regardless, it needs to be treated ASAP, starting with lifestyle changes.

What are the Best Supplements For TreatingHigh Blood Pressure?

1. L-arginine 4 to 8 grams a day or L-citrulline 2 to 4 grams a day

L-arginine and L-citrulline increase blood levels of nitric oxide, which can dilate blood vessels and reduce blood pressure (see the Erectile Dysfunction section). It really is that simple. More than 10 randomized trials have shown that L-arginine can reduce systolic blood pressure an average of 5 to 6 mm Hg and diastolic by 2 to 3 mm Hg (some subjects were on blood pressure meds, while others weren’t). The problem is knowing what dosage works, and this is not easy to predict. In studies, doses have ranged from 4,000 milligrams to more than 20 grams (much of L-arginine is inactivated soon after ingesting it). Based on three of the most credible trials, though, the average dose per day was 4 to 8 grams, and the most common side effect was diarrhea.

I believe L-citrulline would be a wiser and safer choice initially, but unfortunately it does not have enough clinical trials yet. My experience is that it can usually do what L-arginine can, but at half the dosage. If L-citrulline doesn’t work in a month, then you can take more L-arginine.

2. Omega-3 fatty acids 2,000 milligrams or more a day   

A review of 70 randomized trials (yes, I said 70), published in the American Journal of Hypertension, found that the active ingredients in marine omega-3s (EPA and DHA) could reduce blood pressure by an average of 1.5 mm Hg systolic and 1 mm Hg diastolic. Dosages as low as 1,000 to 2,000 milligrams per day could help, but many studies used 2,000 milligrams or more.

Untreated hypertensive subjects (taking no meds) had average reductions of 4.5 mm Hg systolic and 3 mm Hg diastolic. Even subjects with normal blood pressure had an average reduction of 1.2 and 0.6 mm Hg. These effects may be as powerful overall as reducing sodium or alcohol intake or increasing exercise. Changing multiple lifestyle habits produces greater decreases than fish oil. Still, fish oil has been proven to reduce triglycerides (a measure of fat in the blood), and perhaps it has some role in blood pressure improvement by reducing blood vessel resistance and boosting function.

3. L-theanine (100 to 200 milligrams a day) and GABA (50 to 100 milligrams a day)

L-theanine (100 to 200 milligrams a day) and GABA (50 to 100 milligrams a day) are stress-reducing supplements that could help stabilize blood pressure or lower it by several points (see the Stress and Anxiety section). In fact, one of the most commonly used drugs for stress or anxiety caused by public speaking is a blood pressure–lowering drug, a beta-blocker, which also controls or lowers your heart rate!

4. CoQ10

CoQ10 appears to provide some small benefit at dosages of 100 to 300 milligrams per day, but I’m skeptical based on the quality of the studies and my experience with patients. Stay tuned, though, because while I think it’s overrated, I cannot deny that the preliminary research is looking good! It apparently reduces chronic inflammation and relaxes arteries. My prediction is that CoQ10 will not live up to the hype, but we will see.

What Supplements Are Useless For High Blood Pressure?

Garlic and vitamin C

These have some minimal blood pressure–lowering effects but not large enough and consistent enough to recommend them or give a dosage.

Calcium and vitamin D

They just don’t work. The VitDISH randomized trial looked at elderly people with isolated systolic hypertension (systolic is higher than 140 mm Hg but diastolic is normal). Participants received 100,000 IU of vitamin D3 or a placebo every 3 months for 1 year, but there was no significant change in blood pressure.

There is some preliminary data that African Americans may get a modest decrease in blood pressure when supplementing with vitamin D at 2,000 to 4,000 IU per day (a potential 3- to 4-point drop in systolic blood pressure). Still, this data is not consistent enough to rely on vitamin D to lower blood pressure.

In the largest and best calcium supplement clinical trials in the world, the mineral has shown no impact—good or bad—on blood pressure at normal doses. But recent evidence suggests excess amounts (two to three times the 1,200- milligram Recommended Dietary Allowance) could increase calcification (hardening) of the arteries and the risk of cardiovascular disease. While this is controversial, there still isn’t any good reason to take calcium supplements for blood pressure.

Miscellaneous

Bitter orange and licorice supplements can raise blood pressure. Some people claim ginseng can raise blood pressure, too, but this has generally been due to stimulants that have been added to the ginseng. Supplements with caffeine can cause increases in blood pressure in some cases.

What Lifestyle Changes Can Help With High Blood Pressure?

Heart healthy = blood pressure healthy

Nuff said.

Exercise and drop pounds

At least once a week I hear how losing weight and exercising (both cardio and resistance training) has allowed someone to lower the dose of or stop taking blood pressure medication. So, yes, it works, people! Plus, when combined with a healthy diet, exercise can make losing weight easier.

Cut back on sodium and alcohol

Lowering your consumption of these while upping your intake of potassium and magnesium from dietary sources could have a substantial blood pressure– lowering effect.

Control your breath

Learning to slow your breathing can help reduce stress and blood pressure. In fact, any stress-busting activity—such as gardening, tai chi, or any hobby you find relaxing—can have a profound impact on high blood pressure. Google “Resperate”— a device that helps you control your breathing and can help lower blood pressure.   

Follow the DASH diet

There are many books about it or just google it. The DASH diet includes lots of fruits, veggies, nuts, whole grains, healthy fats, lean meat and poultry, and low- or nonfat dairy. It’s been shown to dramatically lower blood pressure.

What Else to Know About Treating High Blood Pressure?

Never just pop an over-the-counter blood thinner, such as aspirin, if you have uncontrolled hypertension. This is because the higher your blood pressure, the greater the chance that very thin blood can seep into spaces in the body where it doesn’t belong. This is known as internal bleeding, and last I checked, this is not a good thing!

Cold and flu remedies are notorious for containing the drug phenylephrine. It’s a decongestant that impacts a receptor in the body that can also increase blood pressure in some people. Based on the largest research reviews, these effects (both positive and negative) are questionable, so avoid products that contain this ingredient.

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