High blood pressure, or hypertension, is often referred to as “the silent killer” because you may not know that you have it until it’s too late. In fact, nearly one-third of people who have high blood pressure don’t know it. If your blood pressure is extremely high, however, certain obvious symptoms may manifest themselves:
• Severe headache
• Fatigue or confusion
• Vision problems
• Chest pain
• Difficulty breathing
• Irregular heartbeat
• Blood in the urine
• Pounding in your chest, neck or ears
In these situations, you should see a doctor immediately since you could be having a hypertensive crisis that could lead to a heart attack or stroke.1
Blood Pressure Ranges
Blood pressure readings are usually given as two numbers: systolic (the top number) and diastolic (the bottom number). An example is 120 over 80 (written as 120/80 mmHg). One or both of these numbers can be too high. Depending upon the measurement, your blood pressure may be classified as normal, high (hypertension) or pre-hypertension. Blood pressure may also be low, but that is not the topic of this article. In any case, here are the ranges for classifying your blood pressure:
• Normal blood pressure—lower than 120/80 mmHg most of the time.
• High blood pressure (hypertension)—140/90 mmHg or above most of the time.
• Pre-hypertension—120/80 or higher, but below 140/90
Treating High Blood Pressure
The treatment of high blood pressure should start with eating a heart-healthy diet and getting regular exercise (at least 30 minutes of aerobic exercise a day). If you smoke, you need to find a program to help you quit, and if you drink alcohol you should limit it to one drink a day for women, two a day for men. You should also limit the amount of sodium (salt) you eat (less than 1,500 mg per day), and try to avoid things that cause you stress. Staying at a healthy body weight can also make a big difference.
When these measures are insufficient or unsuccessful, physicians may also opt to prescribe medications to lower blood pressure. These may include diuretics (which reduce water weight), beta-blockers (which make the heart beat at a slower rate and with less force), angiotensin-converting enzyme or ACE inhibitors (which relax blood vessels), or calcium channel blockers (which also relax blood vessels). Unfortunately, these medications are associated with a range of side effects.
Another option for individuals with mild to moderate hypertension is to consider the use of certain nutraceuticals shown in human clinical research to be effective for lowering blood pressure. While there are many such nutraceuticals from which to choose, the ones highlighted in this article are chocolate/cocoa, potassium, nattokinase and coenzyme Q10.
A number of clinical studies have demonstrated that both dark and milk chocolate 46-105 grams/day was effective in modestly lowering systolic blood pressure by 4.7 mmHg and diastolic blood pressure by 2.8 mmHg in normotensive and hypertensive people.2,3 This beneficial effect was seen when the chocolate provided 213-500 mg of cocoa polyphenols. Additional research has shown that as little as 6.3 grams/day dark chocolate (providing 30 mg of polyphenols) also decreased systolic blood pressure by 2.9 mmHg and diastolic blood pressure by 1.9 mmHg in patients with prehypertension or mild hypertension.4 Another study5 found that that consuming 100 grams/day of cocoa (containing 500 mg of polyphenols) modestly reduce systolic and diastolic blood pressure in elderly patients with isolated systolic hypertension. At the end of the 14-day study, systolic BP had declined by 5.1 mmHg and diastolic BP declined by by 1.8 mmHg.6 Now if this isn’t a good enough excuse for eating chocolate, I don’t know what is.
Potassium is a vital mineral that is necessary to help maintain normal osmotic pressure of body fluids and the acid-base balance of the body. It also functions in the transmission of nerve impulses and muscle contraction. Taking potassium orally seems to reduce systolic blood pressure by about 2-4 mmHg and diastolic blood pressure by about 0.5-3.5 mmHg.7 Potassium seems to be most effective for people with low potassium levels, high daily sodium intake, and for African Americans.8-10 Consuming potassium from dietary sources also seems to decrease the risk of developing hypertension. Foods that provide at least 350 mg of potassium per serving and that are low in sodium, saturated fat, and cholesterol might help reduce the risk of developing high blood pressure.11,12 Likewise, consuming potassium from dietary sources seems to decrease the risk of stroke. There is some evidence that foods providing at least 350 mg of potassium per serving and that are low in sodium, saturated fat, and cholesterol might help reduce the risk of stroke.13,14
Nattokinase is a fibrinolytic (i.e., fibrin degrading) enzyme derived from a Japanese food called natto. Nattokinase is produced during the very fermentation process, which creates natto, involving boiled soybeans fermented with the bacteria Bacillus natto.15,16 In a randomized, double-blind, placebo-controlled trial,17 86 participants ranging from 20 to 80 years of age with an initial untreated systolic blood pressure of 130 to 159 mmHg received nattokinase (2,000 FU/capsule) or a placebo capsule for eight weeks. The objective of this study was to examine the effects of nattokinase supplementation on blood pressure in subjects with pre-hypertension or stage one hypertension. Seventy-three subjects completed the protocol. Compared with the control group, the statistically significant changes in SBP and diastolic blood pressure were -5.55 mmHg and -2.84 mmHg, respectively, after the eight-week intervention. The corresponding net change in renin activity was -1.17 ng/mL/h for the nattokinase group compared with the control group. In conclusion, nattokinase supplementation resulted in a reduction in systolic and diastolic blood pressure. These findings suggest that increased intake of nattokinase may play an important role in preventing and treating hypertension.
Coenzyme Q10 is a nutraceutical which has been extensively studied for its role in cardiovascular health, including blood pressure. In a published review,18 researchers examined the results of three double-blind, randomized, placebo-controlled human clinical trials suggesting that coenzyme Q10 supplementation can effectively lower blood pressure (BP) in hypertensive individuals. After careful examination of the data, the researchers concluded that treatment with 100-120 mg coenzyme Q10 daily in subjects with systolic BP greater than 140 mmHg or diastolic BP (DBP) greater than 90 mmHg resulted in mean decreases of 11 mmHg and 7 mmHg, respectively. Another study19 was undertaken to clarify the mechanism of the antihypertensive effect of 100 mg/day coenzyme Q10 (CoQ10) in hypertensive patients. At the end of the treatment, systolic blood pressure decreased from 164.5 to 146.7 mmHg and diastolic blood pressure decreased from 98.1 to 86.1 mmHg. Plasma CoQ10 values increased from 0.64 +/- 0.1 microgram/ml to 1.61 +/- 0.3 micrograms/ml. In addition, serum total cholesterol decreased from 222.9 mg/dl to 213.3 mg/dl and serum HDL cholesterol (the “good cholesterol”) increased from 41.1 to 43.1 +/- 1.5 mg/dl. The researchers also found that the antihypertensive effect of CoQ10 is probably based on its ability to reduce peripheral resistance. Peripheral resistance is the resistance of the arteries to blood flow. As the arteries constrict, the resistance increases and as they dilate, resistance decreases.
Chocolate/cocoa, potassium, nattokinase and coenzyme Q10 are not the only nutraceuticals with value for lowering blood pressure, but supplementation with one or more of these is a good place to start for individuals with mild-to-moderate hypertension. However, supplementation is only one spoke on the wheel of hypertension treatment, with the other spokes including diet, exercise and stress control. When each of these is incorporated into a comprehensive program, the results will likely be significantly better.
2 Grassi D, Necozione S, Lippi C, et al. Cocoa reduces blood pressure and insulin resistance and improves endothelium-dependent vasodilation in hypertensives. Hypertension 2005;46:398-405.
3 Taubert D, Roesen R, Schomig E. Effect of cocoa and tea intake on blood pressure: a meta-analysis. Arch Intern Med 2007;167:626-34.
4 Taubert D, Roesen R, Lehmann C, et al. Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial. JAMA 2007;298:49-60.
5 Taubert D, Berkels R, Roesen R, Klaus W. Chocolate and blood pressure in elderly individuals with isolated systolic hypertension. JAMA 2003;290:1029-30.
6 Taubert D, Berkels R, Roesen R, Klaus W. Chocolate and blood pressure in elderly individuals with isolated systolic hypertension. JAMA 2003;290:1029-30.
7 Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 1997;277:1624-32.
8 Davis BR, Oberman A, Blaufox MD, et al. Lack of effectiveness of a low-sodium/high-potassium diet in reducing antihypertensive medication requirements in overweight persons with mild hypertension. Am J Hypertens 1994;7:926-32.
9 Whelton PK, He J, Cutler JA, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 1997;277:1624-32.
10 Whelton PK, Buring J, Borhani NO, et al. The effect of potassium supplementation in persons with a high-normal blood pressure. Results from phase 1 of the trials of hypertension prevention (TOHP). Ann Epidemiol 1995;5:85-95.
11 FDA, CFSAN. FDA-approved potassium health claim notification for potassium containing foods. 2000. Available at: www.cfsan.fda.gov/~dms/hclm-k.html.
12 Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm 13 FDA, CFSAN. FDA-approved potassium health claim notification for potassium containing foods. 2000. Available at: www.cfsan.fda.gov/~dms/hclm-k.html.
14 Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
15 Sumi H, Hamada H, Tsushima H, et al. A novel fibrinolytic enzyme (nattokinase) in the vegetable cheese Natto; a typical and popular soybean food in the Japanese diet. Experientia 1987;43:1110-1.
16 Fujita M, Nomura K, Hong K, et al. Purification and characterization of a strong fibrinolytic enzyme (nattokinase) in the vegetable cheese natto, a popular soybean fermented food in Japan. Biochem Biophys Res Commun 1993;197:1340-7.
17 Kim JY, Gum SN, Paik JK, Lim HH, Kim KC, Ogasawara K, Inoue K, Park S, Jang Y, Lee JH. Effects of nattokinase on blood pressure: a randomized, controlled trial. Hypertens Res 2008;31(8):1583-8.
18 Ho MJ, Bellusci A, Wright JM. Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension (review). Cochrane Database Syst Rev 2009;(4):CD007435.
19 Digiesi V, Cantini F, Oradei A, Bisi G, Guarino GC, Brocchi A, Bellandi F, Mancini M, Littarru GP. Coenzyme Q10 in essential hypertension. Mol Aspects Med. 1994;15 Suppl:s257-63.
Gene Bruno, MS, MHS, the dean of academics for Huntington College of Health Sciences, is a nutritionist, herbalist, writer and educator. For more than 30 years he has educated and trained natural product retailers and health care professionals, has researched and formulated natural products for dozens of dietary supplement companies, and has written articles on nutrition, herbal medicine, nutraceuticals and integrative health issues for trade, consumer magazines and peer-reviewed publications. He can be reached at firstname.lastname@example.org.