Beyond Low Sodium and Weight Loss: Which Supplements Can Bring Blood Pressure Down

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While nutritional supplements are not a substitute for prescribed medication or a healthy lifestyle, certain supplements can help reduce blood pressure. This article explores various nutritional supplements known for their blood pressure-lowering effects. From well-known options like omega-3 fatty acids to lesser-known yet promising supplements like magnesium and Coenzyme Q10, we cover the research into how each can play a role in supporting cardiovascular health by keeping blood pressure in check. Read on for a comprehensive look at the research on these non-drug approaches to lowering blood pressure.

What Causes High Blood Pressure?

High blood pressure (hypertension) is known as the “silent killer” because it typically doesn’t cause noticeable symptoms unless it reaches very high levels. The exact causes of high blood pressure are complex and different for different people. In many cases, it develops over years and can be caused by a combination of factors.

High blood pressure is a common health condition where the force of the blood against your artery walls is consistently too high. According to data from the Centers for Disease Control and Prevention (CDC) and other health organizations:

• About 45% of adults in the U.S. have hypertension, defined as a blood pressure reading of 130/80 mmHg or higher. [PMID: 30969681]
• Prehypertension, now more commonly referred to as “elevated blood pressure,” is characterized by readings that are consistently just below the threshold for hypertension, typically in the range of 120-129/80 mmHg. A significant portion of the adult population falls into this category. [PMID: 17893682]

Major lifestyle contributors to high blood pressure include a diet high in salt, lack of regular physical activity, excessive alcohol intake, and tobacco use. These factors can lead to the hardening and narrowing of arteries, which increases blood pressure. Extra weight also contributes to elevated blood pressure, as the body requires more blood to supply oxygen and nutrients to its tissues, putting more pressure on the artery walls.

Genetic factors also play a role in the development of high blood pressure. If family members have been diagnosed with hypertension, the likelihood of developing it increases. Age is another factor; the risk of high blood pressure increases as you get older due to the natural hardening of arteries.

Other underlying health conditions can also cause high blood pressure. These include kidney disease, diabetes, and sleep apnea. Certain medications, such as birth control pills and decongestants, can also contribute to elevated blood pressure.

Even though high blood pressure might not cause immediate symptoms, long-term elevated pressure can lead to serious health complications like heart disease, stroke, and kidney damage, emphasizing the importance of regular blood pressure monitoring.

What Food and Lifestyle Factors Are Important For Managing High Blood Pressure?

Food Factors:

• Low Sodium Diet: High sodium intake is linked to increased blood pressure. Limiting salt in cooking and avoiding high-sodium processed and fast foods can lower blood pressure.
• Fruits and Vegetables: These are high in vitamins, minerals, and dietary fiber but low in calories. Eating a variety of fruits and vegetables can help lower blood pressure.
  • Nitrate-Rich Foods: Nitrates found in beets, garlic, and leafy greens improve blood flow by expanding blood vessels.
  • Potassium-Rich Foods: Potassium helps counteract the effects of sodium and eases tension in blood vessel walls. Foods like bananas, oranges, spinach, and sweet potatoes are rich in potassium.
• Lean Protein: Lean proteins, such as skinless poultry, fish, and plant-based sources like legumes, aid in reducing blood pressure by providing essential nutrients without the added saturated fats that can contribute to arterial plaque buildup and increased blood pressure.
• Dairy: Low-fat dairy provides calcium, which can help reduce blood pressure. Options include skim milk, low-fat yogurt, and cheese.
• Monounsaturated and polyunsaturated fats: Found in foods like avocados, nuts, seeds, and olive oil, can improve heart health when used in place of saturated fats. They do this by promoting healthy blood vessel function and reducing inflammation, which can help lower blood pressure.
• Food Sources of Omega-3: Sardines, Macarel, Anchovies, Salmon, and Herring are excellent food sources. [PMID: 12172309] Walnuts and flaxseed are plant sources of omega-3 which have also been shown to improve cardiovascular risk [PMC9526859] but do not have the EPA/DHA benefits of Fish Oil.
• Limit Alcohol and Caffeine: Excessive consumption of alcohol and caffeine can elevate blood pressure, so moderation is key.
• Dark Chocolate: Dark chocolate, in moderation, contains flavonoids that can help reduce blood pressure, but it should be high in cocoa content and low in sugar.
• Whole Grains: Full of fiber and nutrients, whole grains like brown rice, quinoa, and whole wheat help maintain healthy blood pressure.

Lifestyle Factors:

• Weight Management: Being overweight can strain the heart and increase blood pressure. Losing even a small amount of weight can make a significant difference.
• Regular Physical Activity: Regular exercise strengthens the heart, allowing it to pump blood with less effort, thus lowering blood pressure. Aim for at least 150 minutes of moderate exercise per week.
• Stress Management: Chronic stress may contribute to high blood pressure. Techniques like deep breathing, meditation, and engaging in hobbies can help manage stress.
• Adequate Sleep: Poor sleep quality can affect blood pressure. Aim for 7-8 hours of quality sleep per night. Ask someone to listen to your breathing at night to make sure that you don’t stop breathing. This is a sign of sleep apnea which is a major risk for high blood pressure and heart disease.
• Smoking: Smoking increases blood pressure and damages blood vessels. Quitting smoking can improve overall heart health.
• Alcohol Intake: Drinking too much alcohol can raise blood pressure.
• Regular Health Checkups: Regular monitoring of blood pressure can help detect any changes early, allowing for timely management.

A decrease in body weight by 1 kg [2.2 pounds] resulted in a reduction of systolic [blood pressure by 1.2 points and diastolic pressure by 1.0 point]. Blood pressure generally decreased before normal weight was achieved and remained reduced as long as there was no marked regain in body weight. 

The relationship between body weight and blood pressure [PMID: 3070038]

What Nutritional Supplements Are Recommended For High Blood Pressure?

Each of the nutritional supplements recommended for managing blood pressure works through specific physiological mechanisms:

• Garlic: Garlic contains allicin, which is thought to have vasodilator properties, helping to relax blood vessels and lower blood pressure. Several studies have shown that garlic supplements can have a beneficial effect on blood pressure, especially in individuals with high blood pressure. [PMC4734812]
• Magnesium: Magnesium plays a key role in vascular tone and reactivity, as well as sodium-potassium balance. It helps in the relaxation of blood vessels, which can lower blood pressure. Studies show that magnesium supplementation may have a modest effect on reducing blood pressure, particularly in people with magnesium deficiency. [PMC5573024]
• Omega-3 Fatty Acids (Fish Oil): Omega-3 fatty acids, especially EPA and DHA found in fish oil, have anti-inflammatory effects and can improve cardiovascular health. They help in reducing artery stiffness and improving endothelial function, leading to lower blood pressure. Clinical trials have demonstrated the benefits of omega-3 fatty acids in reducing heart disease risk factors, including blood pressure. [PMID: 24610882][PMID: 12172309]
• Vitamin D: Some studies suggest that Vitamin D supplementation can help in reducing blood pressure in individuals with low Vitamin D levels who have high blood pressure. This nutrient regulates calcium and phosphate levels. It is believed to influence blood pressure by affecting renin production (an enzyme that plays a critical role in the body’s renin-angiotensin system, which regulates blood pressure). A deficiency in Vitamin D has been associated with an increased risk of hypertension. Vitamin D deficiency is very common. [PMC8968037] [PMID: 33234810] Vitamin D Labs are available at your local lab.
• Melatonin: Melatonin, a hormone produced by the pineal gland, is primarily known for regulating sleep-wake cycles. It also has properties that may affect blood pressure. Melatonin can improve endothelial function, reduce oxidative stress, and has a vasodilatory effect, which can help in lowering blood pressure. Some studies suggest that melatonin supplementation, especially in individuals with nocturnal hypertension, can have a beneficial effect on blood pressure regulation. [PMC1395802, PMID: 12019357]
• Nattokinase: Nattokinase is an enzyme extracted from natto, a traditional Japanese fermented soybean dish. It is known for its fibrinolytic activity, meaning it can help break down blood clots. Nattokinase may also aid in reducing blood pressure by acting on the body’s natural clotting mechanisms and potentially reducing arterial stiffness. Some research has shown that nattokinase supplementation can lead to modest reductions in blood pressure readings. [PMID: 18971533]
• Berberine: Berberine is a compound found in several plants like goldenseal and barberry. It has been traditionally used in Chinese medicine and is known for its cardiovascular benefits. Berberine may help lower blood pressure by improving arterial health, enhancing vasodilation, and exhibiting anti-inflammatory properties. Studies indicate that berberine can effectively reduce blood pressure, particularly in individuals with metabolic syndrome or type 2 diabetes. [PMID: 25498346]
• Calcium: Calcium plays a critical role in vascular contraction and dilation, muscle function, nerve transmission, and intracellular signaling. Proper calcium levels can help maintain the health of blood vessels and reduce the risk of hypertension. [PMC8748265] Research has shown mixed results, but calcium supplementation might be beneficial in reducing blood pressure in certain populations.
• Potassium: Potassium helps to balance the amount of sodium in cells, a critical factor for blood pressure regulation. Increased potassium intake can help relax blood vessel walls and excrete sodium, leading to lower blood pressure. Research has shown that diets rich in potassium are associated with lower blood pressure levels but potassium supplements may not provide the same benefit. [PMC7429027]

In addition to the supplements already mentioned, there are several other natural remedies and supplements sometimes used for managing high blood pressure. Hawthorn, for instance, is an herbal supplement often used for heart health and may help lower blood pressure by dilating blood vessels. Beetroot juice, rich in dietary nitrates, can help improve blood flow and lower blood pressure. L-arginine, an amino acid, is thought to enhance nitric oxide production in the body, leading to vasodilation and reduced blood pressure. Cocoa flavonoids, found in dark chocolate, have been linked to modest blood pressure reduction due to their vasodilatory effects. Lastly, folic acid, a B vitamin, is sometimes recommended, particularly for pregnant women, to lower the risk of high blood pressure. While these supplements can be helpful, it’s important to use them under medical supervision, especially when combined with prescribed blood pressure medications.

Nitric Oxide and Blood Pressure

The relationship between nitric oxide (NO) and high blood pressure is a significant aspect of cardiovascular health. Nitric oxide, a molecule produced naturally in the body, plays a crucial role in regulating blood pressure by signaling blood vessels to relax and dilate, which improves blood flow and reduces blood pressure. However, when there’s a deficiency in nitric oxide production, blood vessels can become less flexible, leading to increased resistance in blood flow and, consequently, higher blood pressure.

Don’t use mouthwash. Frequent use of antibacterial mouthwash kills beneficial bacteria in the mouth that are involved in the conversion of dietary nitrates into nitric oxide. This can inadvertently lower the body’s nitric oxide levels, contributing to increased blood pressure. Therefore, avoiding mouthwash and focusing on a diet rich in nitrate sources, such as leafy greens, beets, and garlic, can help boost nitric oxide production, supporting better blood vessel health and blood pressure regulation. Check out our article on dental health: Dump the Mouthwash: How Oral Probiotics and Sonicare Improve Heart Health and Cut Dementia Risk.

Importance of Continuing Blood Pressure Medications

Blood pressure medication plays a vital role in maintaining blood pressure control. Abruptly stopping or changing the dosage without consulting a physician can lead to a sudden spike in blood pressure, potentially leading to severe health complications. As you make diet and lifestyle changes and add supplements to lower your blood pressure, it is important to work closely with your physician to effectively manage blood pressure. They will adjust medications as needed, and provide guidance on lifestyle changes that can further enhance blood pressure control.

Hypertension Drug-Nutrient Interactions

ARB Drug-Nutrient Interactions:

ARBs include medications such as losartan, valsartan, irbesartan, telmisartan, candesartan, eprosartan, olmesartan, and azilsartan. Angiotensin II Receptor Blockers (ARBs) are used for managing high blood pressure and heart failure, can interact with certain nutrients and dietary supplements. Here are some drug-nutrient or supplement interactions involved with ARBs:

• Potassium and Potassium Supplements: ARB medications can reduce potassium clearance by the kidneys.  This can cause excessive potassium to build up in the blood and can lead to irregular heartbeat when very high levels of potassium are consumed. Don’t use potassium supplements (or electrolyte drinks) without your physician’s approval.  
  • DO NOT USE POTASSIUM-BASED SALT SUBSTITUTES: Many salt substitutes are high in potassium. Since ARBs can raise potassium levels, using these substitutes might further increase the risk of high potassium blood levels. [PMID: 31498767]
• Vitamin D Supplements: In some cases, vitamin D can increase the blood pressure-lowering effects of ARBs. This interaction isn’t always harmful but should be monitored.
• St. John’s Wort: This supplement can reduce the effectiveness of many medications, potentially including ARBs, by affecting how the body breaks down the drugs.
• Anti-Inflammatory Drugs (NSAIDs): NSAIDs can reduce the effectiveness of ARBs and increase the risk of kidney problems. This includes over-the-counter medications like ibuprofen and naproxen.
• Alcohol: While not a nutrient or supplement, alcohol can increase the blood pressure-lowering effects of ARBs, potentially leading to hypotension (low blood pressure).
• Antacids: Some antacids, especially those containing aluminum or magnesium, can affect the absorption of ARBs when taken at the same time.

ACE Inhibitor Drug-Induced Nutrient Depletions & Interactions

ACE inhibitors include drugs such as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril.

• Zinc: ACE inhibitors deplete zinc. [PMC5874849] If you take any of the ACE inhibitors, your multivitamin should include 11mg of Zinc.
• Potassium: DO NOT USE POTASSIUM-BASED SALT SUBSTITUTES. ACE inhibitors can reduce potassium clearance by the kidneys.  This can cause excessive potassium to build up in the blood and can lead to irregular heartbeat when very high levels of potassium are consumed. Don’t use potassium supplements (or electrolyte drinks) without your physician’s approval.  
• CoQ10 and Fish Oil can reduce blood pressure. If you are taking blood pressure medicines, be careful to monitor blood pressure when adding CoQ10 or Fish Oil.
• Garlic, Ginkgo biloba & St. John’s Wort: These have the potential to affect the metabolism or clearance of blood pressure medicines.

Beta Blocker Drug-Induced Nutrient Depletions & Interactions

Beta-blockers include medications such as atenolol, metoprolol, propranolol, bisoprolol, carvedilol, labetalol, nadolol, nebivolol, sotalol, timolol, acebutolol, and esmolol.

Drug-Induced Nutrient Depletion:

• Coenzyme Q10: Beta Blockers can deplete CoQ10. If you are taking a Beta Blocker such as Propranolol, Metoprolol, Atenolol, Bisoprolol, Carvedilol, Labetalol, or others, you may benefit from 100 mg CoQ10.  [PMID: 17892] [PMC4112525]

Drug-Nutrient Interactions: 

• CoQ10 and Fish Oil: These Supplements can reduce blood pressure. If you are taking blood pressure medicines, be careful to monitor blood pressure when adding CoQ10 and Fish Oil.
• Garlic, Ginkgo biloba & St. John’s Wort: These have the potential to affect the metabolism or clearance of blood pressure medicines.
• Potassium: Some beta-blockers can increase potassium levels in the blood, so potassium supplements or high-potassium foods might worsen this effect.
• Alcohol: Alcohol can increase the blood pressure-lowering effect of beta blockers, leading to hypotension (low blood pressure) and increased risk of dizziness or fainting.
• Caffeine: Beta blockers can sometimes exaggerate the effects of caffeine, leading to increased heart rate and blood pressure.
• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): NSAIDs can reduce the blood pressure-lowering effect of beta blockers.
• Antacids: Some antacids, particularly those containing aluminum or magnesium, can affect the absorption and effectiveness of beta blockers.

Calcium Channel Blocker Drug-Nutrient Interactions

In the United States, the calcium channel blockers in use include Amlodipine (Norvasc), Diltiazem (Cardizem, Cartia XT, Dilt-XR), Nifedipine (Adalat CC, Procardia XL), Verapamil (Calan, Verelan), Felodipine (Plendil), Isradipine (DynaCirc), Nicardipine (Cardene, Cardene SR), and Nisoldipine (Sular).

Drug-Nutrient Interactions:

• Calcium Supplements: People taking Calcium Channel Blockers such as Amlodipine, Diltiazem, Nifedipine, Verapamil, or others should avoid calcium supplements because they interfere with the blood pressure lowering activity of these drugs.
• Vitamin D: When using verapamil for blood pressure, it’s vital to monitor levels while optimizing vitamin D under medical guidance. Vitamin D affects calcium absorption, potentially impacting verapamil’s effectiveness. Balanced vitamin D levels and regular blood pressure checks can help manage this interaction effectively.
• Melatonin: Melatonin may impair the effectiveness of some calcium channel blockers. Monitor for changes in effectiveness and adjust doses as necessary and/or avoid use of melatonin with Calcium Channel Blockers. 
• CoQ10 and Fish Oil: These can reduce blood pressure. If you are taking blood pressure medicines, be careful to monitor blood pressure when adding CoQ10 or Fish Oil.
• Garlic, Ginkgo Biloba & St. John’s Wort: These have the potential to affect the metabolism or clearance of blood pressure medicines.

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Supplement Safety Information

Potassium, Magnesium, Omega-3 Fatty Acids (Fish Oil), Coenzyme Q10 (CoQ10), Garlic Supplements, Calcium, Melatonin, Nattokinase, Berberine, and Vitamin D are generally regarded as safe for most individuals when taken in recommended dosages. These supplements, widely used for various health benefits, have also been associated with aiding in blood pressure management.

Medication Interactions:

• Garlic Supplements: Increases the risk of bleeding when taken with blood thinners, and can enhance the blood sugar-lowering effect of diabetes medications.
• Magnesium: Increases magnesium excretion with certain diuretics, leading to deficiency, and can interfere with the absorption of some antibiotics.
• Omega-3 Fatty Acids (Fish Oil): Can enhance the blood-thinning effect of anticoagulants, increasing bleeding risk, and may also enhance the effects of blood pressure medications.
• Coenzyme Q10 (CoQ10): May decrease the effectiveness of blood thinners and can lower blood pressure, enhancing the effect of blood pressure drugs.
• Nattokinase: Increases the risk of bleeding when used with blood thinners and enhances the blood-thinning effect of aspirin.
• Calcium: Affects the absorption of heart medications like beta-blockers and can interact with certain diuretics affecting calcium levels in the body.
• Melatonin: Melatonin can affect vascular reactivity, meaning it can influence how blood vessels constrict or dilate. This action can impact the effectiveness of blood pressure medications, especially those that work by managing vascular tone, such as calcium channel blockers or beta-blockers. It can also enhance the effects of sedative drugs.
• Berberine: Can enhance the blood sugar-lowering effect of diabetes medications and may interfere with the effectiveness of immune suppressants.
• Vitamin D: Steroids reduce calcium absorption, diminishing Vitamin Ds effectiveness. Orlistat (Xenical, Alli) are weight loss drugs that can reduce the absorption of Vitamin D.
• Potassium: Enhances the effects of blood pressure medications, possibly leading to low blood pressure. Potassium supplements can cause high potassium levels when taken with potassium-sparing diuretics.

As always, these interactions can vary, and it’s important to consult with a healthcare professional for advice tailored to individual health needs and medication regimens.

Supplement Interactions:

• Potassium: High-dose licorice root can interact with potassium, potentially leading to hyperkalemia.
• Magnesium: Taking magnesium in high doses at the same time as other mineral supplements like calcium and zinc may interfere with their absorption.
• Omega-3 Fatty Acids (Fish Oil): Supplements with blood-thinning effects, such as Ginkgo biloba or high-dose vitamin E, can increase the risk of bleeding when taken with omega-3 fatty acids.
• Coenzyme Q10 (CoQ10): Vitamin K supplements can interact with CoQ10, potentially affecting blood clotting.
• Garlic Supplements: Combining garlic supplements with other blood-thinning supplements like omega-3 fatty acids or turmeric can increase the risk of bleeding.
• Calcium: Taking calcium in high doses with other minerals like iron and magnesium at the same time can interfere with their absorption.
• Melatonin: Supplements with sedative properties, such as valerian root or St. John’s Wort, can enhance sedative effects when taken with melatonin.
• Nattokinase: Like garlic supplements, combining nattokinase with other blood-thinning supplements can increase the risk of bleeding.
• Berberine: Supplements that lower blood sugar, such as cinnamon or alpha-lipoic acid, can lead to hypoglycemia when combined with berberine.
• Vitamin D: Taking high doses of vitamin D can affect magnesium metabolism and may lead to adverse effects if not balanced properly.

Food First!

Although this article discusses supplements in detail, don’t forget that we are absolutely committed to the “Food First” approach to nutrition. When it comes to your health, the totality of your eating habits far surpasses the impact of individual nutrients or any single supplement you consume. Even though this article doesn’t delve into the broader picture of your overall diet, it’s crucial to keep this element at the forefront of our minds. Your food needs to provide all the vitamins, minerals, fiber, and phytochemicals to nourish your body systems down to the cellular level.

Food choices, rather than supplements, are the most critical factors for a healthy gut microbiome. These trillions of tiny inhabitants in your gut affect your brain waves; they orchestrate your immune system. They possess the power to create molecules that can switch genes on or off and are even capable of synthesizing neurotransmitters. Opting for organic foods and steering clear of plastic packaging (including those labeled BPA-free) is a smart move to limit toxin exposure. The sum of all these parts leads to a powerful conclusion: the ultimate key to your health lies in the quality and balance of the food you consume. Supplements are secondary.

To Sum It Up

Potassium, Magnesium, Omega-3 Fatty Acids, Coenzyme Q10, Garlic Supplements, Calcium, Melatonin, Nattokinase, Berberine, and Vitamin D stand out as valuable allies in the quest for maintaining healthy blood pressure levels. Each of these supplements offers unique benefits, from supporting vascular health to enhancing heart function and promoting overall cardiovascular wellness. They work in various ways to help manage and potentially reduce high blood pressure, making them a significant consideration for those looking to naturally support their heart health.

It’s important to remember that supplements should complement a balanced diet and healthy lifestyle choices. For personalized advice and to ensure these supplements align with your specific health needs, seeking further information and guidance from a Registered Dietitian can be incredibly beneficial. A dietitian can provide tailored recommendations based on your unique health profile, dietary habits, and any medications you may be taking, ensuring a holistic and effective approach to managing blood pressure and overall health.

This Article is Not a Substitute for Medical Advice

Dietary supplements are not designed to diagnose, treat, cure, or prevent any disease. The Supplement Sciences website seeks to provide comprehensive access to the most relevant supplement information along with convenient online ordering. We do not provide medical advice and cannot guarantee that every product suggested is completely without risk. Since each person is unique in their health history and medication use, it is important to discuss supplements with your personal physician. Specifically, pregnant women and individuals being treated for cancer or liver or kidney problems must consult their physician about every nutritional supplement they plan to take. People taking medications for the treatment of HIV or with a history of organ transplant must not take supplements without consulting with their physician.