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It’s called the “silent killer” because it has no overt symptoms, which leaves many people unaware they have it. Hypertension—high blood pressure—is a serious and common condition, with recent data reporting that nearly half of U.S. adults have it.1 Hypertension is also becoming increasingly common among young adults and can predict a major cardiovascular event later in life.2 3
Hypertension is a major risk factor for stroke and heart disease, including heart failure and heart attack. Left untreated, it can also damage delicate blood vessels throughout the body, leading to kidney disease, dementia, vision loss, and sexual dysfunction.4
The good news is that high blood pressure is modifiable—it can be controlled—and death from the condition is preventable. The key is knowing your numbers (normal blood pressure is below 120/80 mm Hg) and staying proactive to keep your numbers in check.
When you get a blood pressure reading, what do those numbers mean? The first number is your systolic pressure, or the pressure that occurs as blood pumps out of the heart and into your blood vessels. The second, or diastolic pressure, is when your heart rests between beats. High blood pressure is when the force of your blood pushing against the walls of your blood vessels is consistently too high. Elevated blood pressure (pre-hypertensive) is 120-129/80 mm Hg, while high blood pressure is 130-139/80-89 mm Hg.5
Some of the common risk factors for developing hypertension include excess weight, lack of physical activity, a diet heavy in processed foods and sugar (especially fructose), excessive alcohol consumption, smoking, and low levels of nitric oxide, which naturally fall with age, but are also linked to the use of mouthwash. Research published in 2020 found that “frequent regular use of over-the-counter mouthwash was associated with increased risk of hypertension, independent of [other] major risk factors…”6 One study also found that using mouthwash negated the blood-pressure lowering effects of exercise.7 Clinical trials have shown that antibacterial mouthwash depletes the oral bacteria that help the body produce nitric oxide, decreasing overall nitric oxide availability in the body. Nitric oxide is critical for regulating blood pressure.
African Americans are also at a higher risk. According to the American Heart Association, the prevalence of high blood pressure in African Americans is among the highest in the world and develops earlier in life.8 One observational study found that by the age of 25, hypertension among African American men and women was nearly twice that of their white counterparts.9 And recent research from Northwestern University found that over the course of one year, African American men had a 43 percent higher rate of death from heart failure, while African American women had a 54 percent higher death rate from heart failure compared to other racial groups.10
“This heart failure trend is another manifestation of the undertreatment of hypertension,” senior study author and cardiologist Sadiya Khan, MD said. “Know your blood pressure and make sure it’s being well managed and well-treated.”
Managing high blood pressure is possible—and you can do it with lifestyle interventions. Reduce your intake of processed foods and sugar, especially high-fructose corn syrup, which has been independently associated with higher blood pressure, even in adults with no previous history of hypertension.11 If you still drink soft drinks, make it a goal to significantly slash your intake—even one soda a day has been shown to increase blood pressure.12 Eat an abundance of potassium-rich vegetables and fruit to maintain a healthy sodium-potassium balance. Move your body regularly. This doesn’t have to mean rigorous workouts at the gym; something as simple as a daily walk is sufficient. If you are a heavy drinker, work to cut back your alcohol intake. And if you have high blood pressure and use antibacterial mouthwash, you may want to re-evaluate how you use it. Adopt small healthy habits and they will coalesce into big changes for your health!
In addition to healthy lifestyle habits, certain vitamins and nutrients are proven to support healthy blood pressure.
Nitric oxide (NO) is a molecule that is naturally produced by the body and is crucial for regulating blood pressure; diminished production is associated with hypertension, other cardiovascular dysfunction, and erectile dysfunction.13 NO has a number of important functions, including promoting blood vessel flexibility and vasodilation, both of which help maintain normal blood pressure, as well as reducing oxidative stress, another driver of hypertension. Beetroot is rich in dietary nitrate, which the body readily converts to NO. One recent review investigated 11 studies to examine the relationship between beetroot juice and blood pressure and concluded, “This easily found and cheap dietary intervention could significantly decrease the risk of suffering cardiovascular events and, in doing so, would help to diminish the mortality rate associated with this pathology. Hence, beetroot juice supplementation should be promoted as a key component of a healthy lifestyle to control blood pressure in healthy and hypertensive individuals.”
Recent research suggests that another way beetroot juice supports cardiovascular health is by reducing over-stimulation of the sympathetic nervous system (SNS); activation of the SNS increases heart rate, blood pressure, and blood vessel constriction. Studies have shown that 250 mL to 500 mL of beetroot juice daily is effective in reducing blood pressure.14 15 16 17 18 19 Beetroot powder supplements are also an effective way to increase NO production.20
Studies have consistently shown that low blood levels of vitamin D are linked to hypertension. One study found that men and women with vitamin D levels of 15 ng/mL or less had a three to six times increased risk of developing hypertension over a four-year period compared to those with levels of 30 ng/mL or higher.21 Other research has found that increasing vitamin D levels with supplementation lowers blood pressure.22 A study investigating the effects of vitamin D supplementation on 250 African American men and women found that for each 1 ng/mL increase in blood levels of vitamin D, there was a drop in systolic blood pressure. Doses were given at 1,000; 2,000; or 4,000 IUs daily for three months, with the most significant decreases found in those taking 4,000 IUs.23 It is worth noting that African Americans are particularly at risk of developing a vitamin D deficiency because darker skin reduces natural vitamin D production.24 It’s important to have your levels checked and aim to maintain levels between 40-80 ng/mL.25
Celery seeds contain a unique compound called “L-3-n-butylphthalide” or 3nB, that has a relaxing effect on blood vessels, effectively lowering blood pressure (it is also what gives celery its unique taste and smell). Celery seed extract appears to work in the same way as calcium channel blockers, which are often prescribed as anti-hypertensive drugs, by blocking the flow of calcium into cells that line the blood vessel walls, helping them to relax.26 One trial of 30 mild to moderate hypertensive patients found that a standardized extract of celery seed extract at 75 mg twice daily lowered both systolic and diastolic blood pressure at three and six weeks of follow up. And while calcium channel blockers can reduce blood flow to the brain, in animal studies, celery seed extract has been shown to improve blood flow, prevent stroke, and enhance energy production in the brain.27 A recent study found that supplementation with celery seed not only lowered blood pressure, but also improved liver and kidney function, fasting blood sugar, and lipid levels.28
Drinking three cups of hibiscus tea every day can be an enjoyable and easy way to reduce blood pressure. A study including 65 pre- and mild hypertensive adults had the participants drink three eight-ounce servings of hibiscus tea or a placebo daily for six weeks. At the end of the study, there was an improvement in both systolic and diastolic pressure in those drinking the tea, compared to the placebo group. The most improvement was seen in systolic pressure and in those participants who had higher blood pressure to begin with.29 A recent analysis of five studies investigating the effect of hibiscus tea on blood pressure confirmed that the tea had a significant effect on lowering systolic and diastolic blood pressure.30
The amino acids L-arginine and L-citrulline have also been shown to be effective in reducing elevated blood pressure, in part by increasing NO production in the body.31 The B vitamins folic acid/folate, riboflavin (B2), and pyridoxine (B6) have been found to lower systolic blood pressure and homocysteine levels, and to reduce oxidative stress related to hypertension.32 A review on the flavonoid quercetin published in 2020 looking at 17 studies including 893 participants, found that quercetin significantly reduced both systolic and diastolic blood pressure. In participants who took quercetin for eight weeks or more, there was also significant positive changes in HDL cholesterol and triglycerides.33
And last, but certainly not least, is a fish oil supplement that contains the omega-3s EPA and DHA. A meta-analysis published in June 2022 in the Journal of the American Heart Association reviewed 71 clinical trials published between 1987 and 2020 examining the relationship between high blood pressure and EPA and DHA. Among nearly 5,000 participants, the people who consumed between 2-3 grams of combined EPA and DHA daily had reduced blood pressure compared to those who did not consume any; for those with hypertension, consuming 3 grams daily reduced systolic blood pressure by an average of 4.5 mm Hg.34
Although hypertension is a common and serious health issue, as you can see, there are myriad options to reduce blood pressure naturally and effectively, while also reducing your risk of developing even more serious cardiovascular issues down the road.