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Hypertension

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Blood pressure is the force that blood has on blood vessel walls. When it is too high it can damage blood vessels. This can lead to stress on the heart, lungs, brain, and kidneys. High blood pressure itself does not cause symptoms. However, it can lead to heart attacks and stroke.

Health changes in diet, activity, and weight may reduce blood pressure. Others may need medicine to return to normal levels. Some natural treatments may help you lower blood pressure but should be used along with care plan made with your doctor. Do not replace standard treatments with natural ones.

Natural Therapies

Likely Effective

These supplements appear to lower blood pressure:

  • Beetroot juice B17,B25,B44
  • Berberine is a chemical found in certain plants.B26
  • Chitosan is a compound found in the shells of lobster, shrimp, and crab.D3
  • L-citrulline is an amino acid found in the body.D4, D5
  • Fiber is a substance in plants.A2,B34,B43
  • Flaxseed Oil comes from the tiny seeds of the flax plant D7, D8
  • Folate is a B vitamin that is found in foods and is also a supplement.B44
  • Garlic B1,B9,B14,B28
  • Ginseng is a plant that is often used in teas and sodas.D11, D12
  • Inorganic nitrates are found in leafy green foods, such as spinach and arugula.B25
  • Isoflavones are compounds found in many different plants.D9, D10
  • Lycopene is a compound found in tomato and grapefruit that is likely to lower blood pressure.D13
  • Magnesium is a mineral that helps steady blood pressure and other body tasks.B38,B44
  • Melatonin is a hormone that helps regulate sleep.B10,B44,D14
  • Nigella sativa (black seed) comes from a flowering plant in Asia.B39
  • Potassium is a mineral found in cells in the body. The body needs it to steady blood pressure.B16,B33
  • Quercetin is a compound that gives plants and foods their color.D16
  • Red yeast rice is a Chinese medicine from the product of yeast grown on white rice.B40,B42
  • Reserveratol is a compound found in grapes, peanuts, and wine.D17
  • Sea buckthorn is a tall plant with orange berries.D15
  • Sour tea (hibiscus sabdariffa L. tea) B7,B32
  • Vitamin C is found in foods and is also a supplement. It helps the body stay healthy.B15,B44

Other therapies that appear to help include:

  • Baduanjin/qigong is a Chinese workout used to aid health.C2,C5, C6,C9
  • Meditation C1,C8, C9
  • Tai Chi uses controlled, slow movements to aid physical and mental health.C3,C7
  • Yoga uses breath control, meditation, and poses to aid physical and mental health.C4,C9

These therapies appear helpful but by a small amount:

  • Chocolate A1,A4
  • Green and Black Tea B22
  • Omega-3 Fatty Acids are found mainly in fish oils.B21,B44
  • Soy B2,B12

May Be Effective

These therapies may possibly lower blood pressure:

  • Acupuncture may lower blood pressure when used with standard medicine.D1
  • B vitamins and L-arginine B45
  • Calcium helps aid bone health.B30
  • Chlorella is a type of algae.B4
  • Flaxseed is the seed of the flax plant.B29,B37,D6,D20, D21
  • French maritime pine bark B8,B13
  • Grape seed extract B35
  • Jiangya is a Chinese medicine.B7
  • Olive Leaf extract B11,B23,B40
  • Vitamin B2 D18, D19

May Not Be Effective

Pomegranate is a fruit that may not lower blood pressure.A3,A5, A6

Unlikely to Be Effective

These therapies were not linked to lower blood pressure:

  • Coenzyme Q10 is an antioxidant.B5,B36
  • Conjugated linoleic acid (CLA) is a fatty acid in the milk and meat of cows, sheep, and goats.B26
  • Vitamin D with or without calcium helps aid bone health.B3,B18,B20,B24,B31,B41,B44

Not Enough Data to Assess

  • Chiropractic D2

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse, such as:

  • Red yeast rice can lower cholesterol. It may cause problems in people who also take cholesterol-lowering medicine.B46
 

References►

Functional Foods

A1. Ried K, Sullivan T, et al. Does chocolate reduce blood pressure? A meta-analysis. BMC Med. 2010 Jun 28;8:39.

A2. Priebe MG, McMonagle JR. Effects of Ready-to-Eat-Cereals on Key Nutritional and Health Outcomes: A Systematic Review. PLoS One. 2016 Oct 17;11(10):e0164931. doi: 10.1371/journal.pone.0164931. eCollection 2016. Review. PubMed PMID: 27749919; PubMed Central PMCID: PMC5066953.

A3. Sahebkar A, Ferri C, et al. Effects of pomegranate juice on blood pressure: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res. 2017 Jan;115:149-161.

A4. Ried K, Fakler P, et al. Effect of cocoa on blood pressure. Cochrane Database Syst Rev. 2017 Apr 25;4:CD008893.

A5. Moazzen H, Alizadeh M. Effects of Pomegranate Juice on Cardiovascular Risk Factors in Patients with Metabolic Syndrome: a Double-Blinded, Randomized Crossover Controlled Trial. Plant Foods Hum Nutr. 2017 Jun;72(2):126-133.

A6. Gbinigie OA, Onakpoya IJ, et al. Evidence for the effectiveness of pomegranate supplementation for blood pressure management is weak: A systematic review of randomized clinical trials. Nutr Res. 2017 Oct;46:38-48.

Herbs and Supplements

B1. Ried K, Frank OR, et al. Effect of garlic on blood pressure: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2008 Jun 16;8:13.

B2. Kim JY, Gum SN, et al. Effects of nattokinase on blood pressure: a randomized, controlled trial. Hypertens Res. 2008 Aug;31(8):1583-1588.

B3. Margolis KL, Ray RM, et al. Effect of calcium and vitamin D supplementation on blood pressure: The Women's Health Initiative Randomized Trial. Hypertension. 2008 Nov;52(5):847-855.

B4. Shimada M, Hasegawa T, et al. Anti-hypertensive effect of gamma-aminobutyric acid (GABA)-rich Chlorella on high-normal blood pressure and borderline hypertension in placebo-controlled double blind study. Clin Exp Hypertens. 2009 Jun;31(4):342-354.

B5. Ho MJ, Bellusci A, et al. Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD007435.

B6. McKay DL, Chen CY, et al. Hibiscus sabdariffa L. tea (tisane) lowers blood pressure in prehypertensive and mildly hypertensive adults. J Nutr. 2010 Feb;140(2):298-303.

B7. Li H, Liu LT, et al. Traditional Chinese versus integrative treatment in elderly patients with isolated systolic hypertension: a multicenter, randomized, double-blind controlled trial. Zhong Xi Yi Jie He Xue Bao. 2010 May;8(5):410-416.

B8. Drieling RL, Gardner CD, et al. No beneficial effects of pine bark extract on cardiovascular disease risk factors. Arch Intern Med. 2010 Sep 27;170(17):1541-1547.

B9. Ried K, Frank OR, et al. Aged garlic extract lowers blood pressure in patients with treated but uncontrolled hypertension: a randomised controlled trial. Maturitas. 2010 Oct;67(2):144-150.

B10. Grossman E, Laudon M, et al. Effect of melatonin on nocturnal blood pressure: meta-analysis of randomized controlled trials. Vasc Health Risk Manag. 2011;7:577-584.

B11. Susalit E, Agus N, et al. Olive (Olea europaea) leaf extract effective in patients with stage-1 hypertension: comparison with Captopril. Phytomedicine. 2011 Feb 15;18(4):251-258.

B12. Dong JY, Tong X, et al. Effect of soya protein on blood pressure: a meta-analysis of randomised controlled trials. Br J Nutr. 2011 Aug;106(3):317-326.

B13. Schoones A, Visser J, et al. Pycnogenol ® (extract of French maritime pine bark) for the treatment of chronic disorders. Cochrane Database Syst Rev. 2012 Apr 18;(4):CD008294.

B14. Juraschek SP, Guallar E, et al. Effects of vitamin C supplementation on blood pressure: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2012 May;95(5):1079-1088.

B15. Stabler SN, Tejani AM, et al. Garlic for the prevention of cardiovascular morbidity and mortality in hypertensive patients. Cochrane Database Syst Rev. 2012 Aug 15;(8):CD007653.

B16. Aburto NJ, Hanson S, et al. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analysis. BMJ. 2013 Apr 3;346:f1378.

B17. Siervo M, Lara J, et al. Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. J Nutr. 2013 Jun;143(6):818-826.

B18. Witham MD, Price RJ, et al. Cholecalciferol treatment to reduce blood pressure in older patients with isolated systolic hypertension: the VitDISH randomized controlled trial. JAMA Intern Med. 2013 Oct 14;173(18):1672-1679.

B19. Ras RT, Zock PL, et al. Effect of polyphenol-rich grape seed extract on ambulatory blood pressure in subjects with pre- and stage 1 hypertension. Br J Nutr. 2013 Dec;110(12):2234-2241.

B20. Witham MD, Ireland S, et al. Vitamin D therapy to reduce blood pressure and left ventricular hypertrophy in resistant hypertension: randomized, controlled trial. Hypertension. 2014 Apr;63(4):706-712.

B21. Miller PE, Van Elswyk M, et al. Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: a meta-analysis of randomized controlled trials. Am J Hypertens. 2014 Jul;27(7):885-896.

B22. Liu G, Mi XN, et al. Effects of tea intake on blood pressure: a meta-analysis of randomised controlled trials. Br J Nutr. 2014 Oct 14;112(7):1043-1054.

B23. Wong RH, Garg ML, Wood LG, Howe PR. Antihypertensive potential of combined extracts of olive leaf, green coffee bean and beetroot: a randomized, double-blind, placebo-controlled crossover trial. Nutrients. 2014 Nov 5;6(11):4881-4894.

B24. Arora P, Song Y, et al. Vitamin D therapy in individuals with prehypertension or hypertension: the DAYLIGHT trial. Circulation. 2015 Jan 20;131(3):254-262.

B25. Kapil V, Khambata RS, et al. Dietary nitrate provides sustained blood pressure lowering in hypertensive patients: a randomized, phase 2, double-blind, placebo-controlled study. Hypertension. 2015 Feb;65(2):320-327.

B26. Lan J, Zhao Y, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015 Feb 23;161:69-81.

B27. Yang J, Wang HP, et al. Effect of conjugated linoleic acid on blood pressure: a meta-analysis of randomized, double-blind placebo-controlled trials. Lipids Health Dis. 2015 Feb 18;14:11.

B28. Xiong XJ, Wang PQ, et al. Garlic for hypertension: A systematic review and meta-analysis of randomized controlled trials. Phytomedicine. 2015 Mar 15;22(3):352-361.

B29. Khalesi S, Irwin C, et al. Flaxseed consumption may reduce blood pressure: a systematic review and meta-analysis of controlled trials. J Nutr. 2015 Apr;145(4):758-765.

B30. Cormick G, Ciapponi A, et al. Calcium supplementation for prevention of primary hypertension. Cochrane Database Syst Rev. 2015 Jun 30;(6):CD010037.

B31. Pilz S, Gaksch M, et al. Effects of vitamin D on blood pressure and cardiovascular risk factors: a randomized controlled trial. Hypertension. 2015 Jun;65(6):1195-1201.

B32. Serban C, Sahebkar A, et al. Effect of sour tea (hibiscus sabdariffa L.) on arterial hypertension: a systematic review and meta-analysis of randomized controlled trials. J Hypertens. 2015 Jun;33(6):1119-1127.

B33. Binia A, Jaeger J, et al. Daily potassium intake and sodium-to-potassium ratio in the reduction of blood pressure: a meta-analysis of randomized controlled trials. J Hypertens. 2015 Aug;33(8):1509-1520.

B34. Hartley L, May MD, et al. Dietary fibre for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2016 Jan 7;(1):CD011472.

B35. Park E, Edirisinghe I, et al. Effects of grape seed extract beverage on blood pressure and metabolic indices in individuals with pre-hypertension: a randomised, double-blinded, two-arm, parallel, placebo-controlled trial. Br J Nutr. 2016 Jan 28;115(2):226-238.

B36. Ho MJ, Li EC, et al. Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension. Cochrane Database Syst Rev. 2016 Mar 3;3:CD007435.

B37. Ursoniu S, Sahebkar A, et al. Effects of flaxseed supplements on blood pressure: A systematic review and meta-analysis of controlled clinical trial. Clin Nutr. 2016 Jun;35(3):615-625.

B38. Zhang X, Li Y, et al. Effects of magnesium supplementation on blood pressure: a meta-analysis of randomized double-blind placebo-controlled trials. Hypertension. 2016 Aug;68(2):324-333.

B39. Sahebkar A, Soranna D, et al. A systematic review and meta-analysis of randomized controlled trials investigating the effects of supplementation with Nigella sativa (black seed) on blood pressure. J Hypertens. 2016 Nov;34(11):2127-2135.

B40. Lockyer S, Rowland I, et al. Impact of phenolic-rich olive leaf extract on blood pressure, plasma lipids and inflammatory markers: a randomized controlled trial. Eur J Nutr. 2017;56(4):1421-1432.

B41. Qi D, Nie X, et al. The effect of vitamin D supplementation on hypertension in non-CKD populations: A systemic review and meta-analysis. Int J Cardiol. 2017 Jan 15;227:177-186.

B42. Xiong X, Wang P, et al. The effects of red yeast rice dietary supplement on blood pressure, lipid profile, and C-reactive protein in hypertension: A systematic review. Crit Rev Food Sci Nutr. 2017 Jun 13;57(9):1831-1851.

B43. Khan K, Jovanovski E, et al. The effect of viscous soluble fiber on blood pressure: A systematic review and meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2018 Jan;28(1):3-13.

B44. Wong AP, Kassab YW, et al. Review: Beyond conventional therapies: Complementary and alternative medicine in the management of hypertension: An evidence-based review. Pak J Pharm Sci. 2018 Jan;31(1):237-244.

B45. Menzel D, Haller H, et al. L-Arginine and B vitamins improve endothelial function in subjects with mild to moderate blood pressure elevation. Eur J Nutr. 2018 Mar;57(2):557-568.

B46. Raschi E, Girardi A, et al. Adverse Events to Food Supplements Containing Red Yeast Rice: Comparative Analysis of FAERS and CAERS Reporting Systems. Drug Saf. 2018 Aug;41(8):745-752.

Mind/Body Therapies

C1. Dickinson HO, Campbell F, et al. Relaxation therapies for the management of primary hypertension in adults. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD004935.

C2. Guo X, Zhou B, et al. Clinical effect of qijong practice on essential hypertension: a meta-analysis or randomized controlled trials. J Altern Complement Med. 2008 Jan-Feb;14(1):27-37.

C3. Wang J, Feng B, et al. Tai chi for essential hypertension. Evid Based Complement Alternat Med. 2013;2013:215254.

C4. Tyagi A, Cohen M. Yoga and hypertension: a systematic review. Altern Ther Health Med. 2014 Mar-Apr;20(2):32-59.

C5. Xiong X, Wang P, et al. Effect of Baduanjin exercise for hypertension: a systematic review and meta-analysis of randomized controlled trials. Maturitas. 2015 Apr;80(4):370-378.

C6. Hartley L, Lee, MS, et al. Qigong for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2015 Jun 11;(6):CD010390.

C7. Sun J, Buys N. Community-based mind-body meditative Tai Chi program and its effects on improvement of blood pressure, weight, renal function, serum lipoprotein, and quality of life in Chinese adults with hypertension. Am J Cardiol. 2015 Oct 1;116(7):1076-1081.

C8. Shi L, Zhang D, et al. Meditation and blood pressure: a meta-analysis of randomized clinical trials. J Hypertens. 2017 Apr;35(4):696-706.

D9. Wong AP, Kassab YW, et al. Review: Beyond conventional therapies: Complementary and alternative medicine in the management of hypertension: An evidence-based review. Pak J Pharm Sci. 2018 Jan;31(1):237-244.

Other Therapies

D1. Li DZ, Zhou Y, et al. Acupuncture for essential hypertension: a meta-analysis of randomized sham-controlled clinical trials. Evid Based Complement Altern Med. 2014;2014:279478.

D2. Wong AP, Kassab YW, et al. Review: Beyond conventional therapies: Complementary and alternative medicine in the management of hypertension: An evidence-based review. Pak J Pharm Sci. 2018 Jan;31(1):237-244.

D3. Huang H, Zou Y, et al. Quantitative assessment of the effects of chitosan intervention on blood pressure control. Drug Des Devel Ther. 2017;12:67-75.

D4. Mahboobi S, Tsang C, et al. Effect of L-citrulline supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Hum Hypertens. 2019;33(1):10-21.

D5. Barkhidarian B, Khorshidi M, et al. Effects of L-citrulline supplementation on blood pressure: A systematic review and meta-analysis. Aviencanna J Phytomed. 2019;9(1):10-20.

D6. Rodriguez-Leyva D, Weighell W, et al. Potent antihypertensive action of dietary flaxseed in hypertensive patients. Hypertension. 2013;62(6):1081-1089.

D7. Khalesi S, Irwin C, et al. Flaxseed consumption mat reduce blood pressure: a systematic review and meta-analysis of controlled trials. J Nutr. 2015;145(4):758-765.

D8. Ursoniu S, Sahebkar A, et al. Effects of flaxseed supplements on blood pressure: A systematic review and meta-analysis of controlled clinical trial. Clin Nutr. 2016;35(3):615-625.

D9. Taku K, Lin N, et al. Effects of soy isoflavone extract supplements on blood pressure in adult humans: systematic review and meta-analysis of randomized placebo-controlled trials. J Hypertens. 2010 Oct;28(10):1971-1982.

D10. Liu XX, Li SH, et al. Effect of soy isoflavones on blood pressure: a meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2012;22(6):463-470.

D11. Komishon AM, Shishtar E, et al. The effect of ginseng (genus Panax) on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials. J Hum Hypertens. 2016 Oct;30(10):619-626.

D12. Lee HW, Lim HJ, et al. Ginseng for Treating Hypertension: A Systematic Review and Meta-Analysis of Double Blind, Randomized, Placebo-Controlled Trials. Curr Vasc Pharmacol. 2017;15(6):549-556.

D13. Li X, Xu J. Lycopene supplement and blood pressure: an updated meta-analysis of intervention trials. Nutrients. 2013;5(9):3696-3712.

D14. Hadi A, Ghaedi E, et al. Effects of Melatonin Supplementation On Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Horm Metab Res. 2019 Mar;51(3):157-164.

D15. Vashishtha V, Barwhal K, et al. Effect of seabuckthorn seed oil in reducing cardiovascular risk factors: A longitudinal trial on hypertensive subjects. Clin Nut. 2017;36(5):1231-1238.

D16. Serban MC, Sahebkar A, et al. Effects of Quercetin on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 2016;5(7):e002713.

D17. Liu Y, Ma W, et al. Effect of resveratrol on blood pressure: meta-analysis of randomized controlled trials. Clin Nutr. 2015;34(1):27-34.

D18. Wilson CP, Ward M, et al. Riboflavin offers a targeted strategy for managing hypertension in patients with the MTHFR 677TT genotype: a 4-y follow-up. Am J Clin Nutr. 2012 Mar;95(3):766-772.

D19. Wilson CP, McNulty H, et al. Blood pressure in treated hypertensive individuals with the MTHFR 677TT genotype is responsive to intervention with riboflavin: findings of a targeted randomized trial. Hypertension. 2013;61(6):1302-1308.

D20. Pan A, Yu D, et al. Meta-analysis of the effects of flaxseed interventions on blood lipids. AM J Clin Nutr. 2009;90(2):288-297.

D21. Torkan M, Entezari MH, et al. Effect of flaxseed on blood lipid level in hyperlipidemic patients. Rec Recent Clin Trials. 2015;10(1):61-67.

Last reviewed February 2020 by EBSCO NAT Review Board Eric Hurwitz, DC  Last Updated: 11/16/2020