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Dietary supplements are used extensively in
the general population and many are promoted for the natural treatment and
management of hypertension.
Coenzyme
Q10, Fish Oil, Garlic, and Vitamin C
In a review of the many dietary supplements
promoted for the management of hypertension, pharmacists in Atlanta and
Mississippi found coenzyme Q10, fish oil, garlic, and vitamin C with evidence
of possible benefits.
They also identified 4 products that were
consistently associated with increasing blood pressure (ephedra, Siberian
ginseng, bitter orange, licorice).
CoQ10
CoQ10 has been shown in two studies to
further reduce both systolic blood pressure (SBP) and diastolic blood pressure
(DBP) after 8 weeks when added to conventional antihypertensive agents. SBP was
reduced by 17.8 mm Hg in the treatment group and 1.7 mm Hg in the placebo
group.
Another study showed when CoQ10 was
administered to patients with essential hypertension for 10 weeks, a
statistically significant decrease in both SBP and DBP was noted.
In the fourth study CoQ10 doses were
adjusted to achieve a serum concentration of ≥2.0 μg/mL. Participants were
followed for 1 year or longer, with dose adjustments made on a monthly basis if
needed. Statistically significant decreases in both SBP and DBP were noted.
Fish
Oil
In a parallel designed trial of
normotensive and hypertensive men, participants were randomized to receive
either fish oil (eicosapentaenoic acid, docosahexaenoic acid) or placebo for 4
months followed by a 2-month washout period and reassessment. No significant BP
change was noted in either group of normotensive participants. In the fish oil
hypertensive group, average SBP decreased by 6 mm Hg and DBP by 5 mm Hg during
the treatment period and then returned to baseline after the 2-month washout.15
Another team of researchers examined the
effects of fish oil in obese, hypertensive, and dyslipidemic participants with
and without diabetes over 13 weeks. Participants also started the American
Heart Association Step I diet. Both groups had statistically significant
reductions in both SBP and DBP.16
Garlic
In a 12-week trial, researchers
demonstrated statistically significant reductions in both supine and standing
SBP and DBP with garlic supplementation. However, despite a long history of
use, the efficacy of garlic in hypertension is still debated.
Many of the concerns are the same as with
other DSs: product inconsistencies, lack of standardization, variable formulations,
and questionable study design and quality. Given the wide variation of products
used and other limitations of the existing evidence, it is difficult to make a
definitive recommendation for the use of garlic in the treatment of
hypertension.
Vitamin
C
A one-time loading dose of 2 g of ascorbic
acid followed by 500 mg daily for 1 month achieved a significant 13-mm Hg
reduction in SBP, but not DBP in participants.
After receiving 200 mg of ascorbic acid 3
times daily for 6 months, a statistically significant reduction (approx. 20mm
Hg) in SBP was demonstrated in elderly patients (65 years and older) with drug
refractory hypertension compared with younger adults (younger than 65 years)
who failed to show a significant BP reduction.
These findings are of interest, although
the limited data, product inconsistencies, lack of standardization, variable
formulations prevent global recommendations on the efficacy of these DS in the
treatment of hypertension.
Consumers must be reminded that they should
not consume DS without the supervision of a medical doctor or pharmacist.
###
Reference:
Rasmussen CB, Glisson JK, Minor DS.
Dietary supplements and hypertension: potential benefits and precautions. J Clin Hypertens (Greenwich). 2012 Jul;14(7):467-71. 2012;
14:467-471.
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