Herbs and Supplements for Hypertension

One in five deaths in the United States each year are caused by cardiovascular disease, making it the leading cause of death. Hypertension, which affects roughly half of U.S. adults, plays an important role in cardiovascular disease by increasing the risk of life-threatening events like heart attacks and strokes.

While doctors write more and more prescriptions to treat the rising number of patients with high blood pressure, some people are also seeking alternative medicine to help manage this condition.

There’s nothing wrong with this approach, as long as people don’t try to use herbs and supplements to replace prescription medications, says Paul Kalnins, ND, assistant professor at the National University of Natural Medicine in Portland, Oregon. That’s because there aren’t any herbs or supplements that can directly treat hypertension, Kalnins says.

When someone asks what ‘natural products’ treat hypertension, they are often asking unconsciously what herbs or supplements can replace pharmaceutical medications,” Kalnins adds. “No herb or supplement is as good as existing pharmaceuticals.”

Instead, what alternative therapies can offer patients is a way to address some of the underlying processes in the body that can contribute to what’s known as essential, or primary, hypertension that isn’t caused by other diseases, Kalnins says.

There are a few herbs and supplements that show promise for reducing factors that contribute to hypertension like stiffness in the arteries and inflammation. However, it’s important to use caution when choosing them. Some may have ingredients that aren’t listed on the labels, or an alternative treatment for hypertension may interact with prescription or over-the-counter medication. To be on the safe side, always talk to your healthcare provider before starting any new treatments.

Alternative Medicine for Blood Pressure

The following herbs and supplements may be beneficial for addressing some of the underlying causes of high blood pressure:

Hawthorn This northern European plant has been used as a heart-disease remedy for centuries. Some small studies in humans have found hawthorn effective at reducing inflammation and arterial stiffness, with modest reductions in blood pressure as result. Other small studies have found hawthorn less effective, however.

“With hypertension, there is low-grade inflammation in the arterial walls, which means the blood vessels constrict and don’t dilate naturally,” explains Kalnins. “The compounds in hawthorn can help relax those arterial walls.” It's possible that hawthorn may interact with digoxin (Digitek, Lanoxin), a medication used to treat certain heart disorders, so do not use these two treatments together without guidance from your doctor.

Fish Oil Fish oil has been touted as a worthwhile dietary supplement because it's a good source of omega-3 fatty acids, which, among other things, has naturally occurring anti-inflammatory properties. Some research has found fish oil particularly effective at reducing what’s known as systolic blood pressure, the “top number” that shows the pressure blood exerts on artery walls when the heart beats. Fish oil also has the added benefit of driving down triglycerides, a type of fat in the body that can be dangerous at high levels.

Numerous studies show that diet is the most effective way of getting the benefits of omega-3 sources like fish oil. Due to the high cost of wild fish and concerns over mercury levels of cheaper, farm-raised fish, dietary supplements from reputable sources are recommended as well. “Supplements should come from a source that checks the mercury levels in fish oil,” Kalnins says.

Garlic The compounds found in garlic help regulate the immune response involved in the inflammatory process and have been shown to lower lipid levels. Supplements made from kyolic aged garlic extract — which comes from organically grown garlic bulbs aged over 20 months at room temperature — may be particularly beneficial. A recent meta-analysis of 12 clinical trials found kyolic aged garlic extract significantly reduced both systolic blood pressure and what’s known as diastolic blood pressure, the “bottom number” that shows the pressure blood exerts on artery walls when the heart rests between beats.

Magnesium There is a fair amount of evidence showing diets high in magnesium may lower hypertension risk. Magnesium’s role as an alternative treatment for hypertension is intimately related to calcium. Arterial smooth muscle requires calcium for contraction, but people with high blood pressure tend to accumulate calcium in these muscles — hence, the widespread use of calcium channel blocker medication. Magnesium is thought to be a natural calcium channel blocker: It opposes the effects of calcium by relaxing the arterial muscle. Some healthcare professionals haven't seen much success with magnesium as a hypertension treatment specifically.

A recent research review suggests the effectiveness of magnesium may depend on who is taking it. This review examined data from 49 trials testing the impact of magnesium on people with normal blood pressure, individuals with untreated hypertension, patients with blood pressure that’s not well controlled by medication, and patients whose medicines do keep their blood pressure in check. While magnesium didn’t always help people with previously untreated hypertension, this supplement did appear to help improve blood pressure in patients whose hypertension wasn’t well controlled with prescription drugs.

Coenzyme Q10 The supplement coenzyme Q10 (Co-Q10) is also involved in the contraction of smooth muscle, specifically the efficiency of contraction. “Co-Q10 increases the activity of mitochondria, which is where energy is made, so it essentially gives more energy to the heart muscle,” says Kalnins. Scientists are still working to pinpoint exactly which people might benefit most from taking this supplement as a way to help manage the underlying causes of high blood pressure.

One recent meta-analysis of data from 17 clinical trials found Co-Q10 helped lower systolic blood pressure in people with metabolic diseases such as diabetes, for example. However, an earlier meta-analysis found moderate-quality evidence that Co-Q10 doesn’t have a clinically meaningful impact on people with primary hypertension.

Folic Acid Folic acid is sometimes given as an alternative treatment for hypertension because of its effects on the arterial walls. There is some evidence that accumulation of the amino acid homocysteine in the blood can damage these walls. Folic acid, typically given in combination with vitamins B6 or B12, reduces homocysteine levels. A recent meta-analysis of 22 studies with more than 40,000 patients found folic acid supplements significantly reduced systolic blood pressure.

The Bottom Line

Dietary supplements aren't tested and regulated as strictly as prescription and over-the-counter medication. In fact, manufacturers can market a supplement without having to prove safety or effectiveness.

Beyond this, a lot of what we know about the potential benefits of herbs and supplements for managing the underlying causes of hypertension is based on lab tests, animal studies, or small human trials, Kalnins says.

That's why you should research supplements and talk with your regular doctor about potential interactions and side effects before using an alternative treatment for hypertension.