Nutrition and nutraceutical supplements in the treatment of hypertension

Abstract

Macronutrient and micronutrient deficiencies are very common in the general population, and may be even more common in patients with hypertension and cardiovascular disease due to genetic and environmental causes, and prescription drug use. Vascular biology assumes a pivotal role in the initiation and perpetuation of hypertension and target organ damage sequelae. Endothelial activation, oxidative stress and vascular smooth muscle dysfunction (hypertrophy, hyperplasia and remodeling) are initial events that initiate hypertension. Nutrient–gene interactions determine a broad array of phenotypic consequences such as vascular problems and hypertension. Optimal nutrition, nutraceuticals, vitamins, antioxidants, minerals, weight loss, exercise, smoking cessation, and moderate restriction of alcohol and caffeine, in addition to other lifestyle modifications, can prevent, delay the onset, reduce the severity, treat and control hypertension in many patients. An integrative approach combining these lifestyle suggestions with the correct pharmacologic treatment will best achieve new goal blood pressure levels, reduce cardiovascular risk factors, improve vascular health, reduce target organ damage, including coronary heart disease, stroke, congestive heart failure and renal disease, and reduce healthcare expenditure. The expanded scientific roles for nutraceutical supplements will be discussed in relation to the prevention and treatment of essential hypertension and cardiovascular diseases.

Keywords::

• antioxidants
• hypertension
• natural treatment
• nutrition
• vascular biology

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Notes

BP: Blood pressure; C: Cholesterol; NO: Nitric oxide; O₂^-: Oxide ion; ROS: Reactive oxygen species.

BP: Blood pressure; ED: Endothelial dysfunction; ROS: Reactive oxygen species; SVR: Systemic vascular resistance; VSM: Vascular smooth muscle.

BP: Blood pressure; Ca²⁺: Calcium; CHD: Coronary heart disease;

ED: Endothelial dysfunction; EDV: Endothelial vasodilation; HLP: Hyperlipidemia;

K⁺: Potassium; SVR: Systemic vascular resistance; TC: Total cholesterol;

TG: Triglyceride; TxA₂: Thromboxane A₂; VSM: Vascular smooth muscle.

ABPM: Ambulatory blood pressure monitor; BP: Blood pressure; CHD: Coronary heart disease; CHF: Congestive heart failure; CVA: Cerebrovascular accident;

DBP: Diastolic blood pressure; DM: Diabetes mellitus; ED: Endothelial dysfunction; oxLDL: Oxidized low-density lipoprotein; PAD: Peripherial arterial disease;

RVR: Renal vascular resistance; SBP: Systolic blood pressure; TC: Total cholesterol; TG: Triglyceride; TOD: Target organ damage.