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Alternative therapies for hypertension

Alternative therapies for hypertension

You can get calcium by htpertension dark leafy greens, tofu, and dairy Soluble fiber and cholesterol reduction. Muscle preservation for overall fitness Each time your hypertnesion beats, or contracts, it pumps Alternative therapies for hypertension into hypertensoon arteries. Alternativs Blood pressure is grouped according to how high it is. Regular physical activity can lower high blood pressure by about 5 to 8 mm Hg. Hypertension ; 5 : — A longer blood pressure monitoring test may be done to check blood pressure at regular times over six or 24 hours.

Alternative therapies for hypertension -

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.

Magnesium There is a fair amount of evidence showing diets high in magnesium may lower hypertension risk. 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. Coenzyme Q10 The supplement coenzyme Q10 Co-Q10 is also involved in the contraction of smooth muscle, specifically the efficiency of contraction.

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. 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, patients found folic acid supplements significantly reduced systolic blood pressure.

Dietary supplements aren't tested and regulated as strictly as prescription and over-the-counter medication. Most of the events considered possibly, probably, or definitely related to ephedra use were cardiovascular in nature. Similarly, in a 2-year period in Texas, some reports of adverse effects of dietary supplements containing ephedra were reported.

It makes good sense to specifically instruct patients with hypertension, diabetes mellitus, thyroid disease, cardiac rhythm disorders, and seizures not to take herbals with ephedra.

Drug interactions expected for ephedrine are also likely with ma huang. In normotensive subjects, the effects of ma huang on BP and heart rate appear unpredictable, 14 but it undoubtedly can precipitate a hypertensive crisis in certain individuals when combined with caffeine. An additional cause of concern for clinicians treating hypertension is the reported association of kidney stones with ephedra ingestion.

Renal calculi containing ephedrine have also been found in patients consuming large amounts of guaifenesin and ephedrine in over-the-counter preparations. This is a derivative of the plant Hypericum perforatum used for the treatment of mild depression. It can be obtained as a tea, capsule, or oil.

John's wort contains several active ingredients that have a variety of effects on neurochemical signals in the central nervous system. It has undergone significant scientific testing including double blind clinical trials and is widely used in Germany.

John's wort, it appears to show similar response rates in the treatment of depression as tricyclic antidepressants and was also better tolerated.

The main concern regarding St. John's wort of particular interest to the hypertension physician is the reported interaction with several medications including cyclosporin, protease inhibitors, and some cardiovascular drugs.

John's wort has been shown to induce both liver and intestinal CYP3A. John's wort. Other expected interactions based on the CYP3A induction would include with digoxin 24 and possibly calcium channel blockers. John's wort is taken with substrates of the CYP3A system.

Garlic is commonly used among hypertensive patients because of its reputed benefit in reducing cardiovascular disease and lowering BP. Other claims for the benefits of garlic have included cancer prevention and anti-inflammation.

Studies have suggested a multitude of physiologic effects including inhibition of platelet activity and increased levels of antioxidant enzymes. There are probably several active ingredients in garlic preparations.

Not surprisingly, several studies have been done to examine its utility in treating hypertension and hyperlipidemia. In its evidence report, on garlic, the Agency for Health Care Research and Quality reviewed 37 randomized trials and found that garlic preparations did indeed lower total cholesterol by small amounts in the short term but no reduction was observed at 6 months.

Various doses of garlic were used providing about 3 to 6 mg of allicin per day. The majority of these studies found that garlic did not reduce BP compared to placebo, but the studies were small.

Interestingly, in one cross-sectional observation study of older patients, garlic intake was found to reduce age-related increases in aortic stiffness. This is a prescription drug that has been available for about 30 years and has long been known to be present in the bark of a West African tree.

The bark product contains several alkaloids including yohimbine that may be present in varying amounts. Yohimbine is a presynaptic α 2 -adrenergic blocking agent and possibly a monoamine oxidase inhibitor. It also has other effects on the autonomic nervous system.

Although not available as an over-the-counter product, it can be found in herbal and supplement stores and is promoted as treatment for erectile dysfunction.

It has been fairly well documented that yohimbine can increase BP in humans and should be used with caution if at all in hypertensive patients. The drug should also not be used in patients taking tricyclic antidepressants.

Of course, physicians treating hypertension in the United States should be aware of licorice. It is marketed for the treatment of stomach disorders and is associated with a form of pseudoaldosteronism manifesting as weight gain, hypertension, hypokalemia, and metabolic alkalosis.

The implicated substance is glycyrrhizic acid that inhibits β-hydroxysteroid dehydrogenase 33 and hence increased levels of cortisol that combine with the mineralocorticoid receptor an acquired apparent mineralocorticoid excess.

The disorder reverses within a few days on cessation of intake of licorice but may be associated with hypertensive encephalopathy 34 and chronic refractory hypertension.

Many herbs can increase digoxin levels or potentiate the effects of digitalis. This is because many herbs contain digitalis-like glycosides. Indeed several case reports attest to this in patients taking certain supplements.

Some drugs that may increase warfarin anticoagulation include vitamin E, dan-shen, dong quai, and devils claw, whereas ginseng and coenzyme Q may reduce its effect. Grapefruit juice, although not an herbal in the way it is used in this article, is also of concern to the hypertension physician because of its effect on the metabolism of many cardiovascular drugs.

By inhibiting intestinal CYP3A, it can increase the bioavailability of many substrates of CYP3A, including immunosuppressive drugs, certain HMG-Co-A reductase inhibitors, and most dihydropyridine calcium channel blockers.

One glass of mL of juice can significantly inhibit intestinal CYP3A. The chemical content of grapefruit that causes this effect has been suggested to be flavonoids and nonflavonoids, although this is by no means certain.

The effect of grapefruit juice was first discovered with felodipine and other 1,4 dihydropyridine calcium antagonists are also targets for this interaction. The effect is much less pronounced in the highly bioavailable drugs amlodipine and nifedipine.

There is conflicting data regarding the non-dihydropyridine drugs, verapamil and diltiazem. A more serious problem was reported in which a manufacturing error resulted in a nephrotoxic and carcinogenic herb Aristolochia fangchi being ingested by patients who later developed interstitial fibrosis and rapid progression to end-stage renal failure.

Unfortunately, a substantial number of these patients developed urothelial carcinomas. This illustrates the serious and widespread problems that may arise in the manufacture, distribution, and toxicities of herbal preparations. It is essential for all physicians treating hypertension to obtain a history of any herbal, dietary, or supplement use from all patients.

Because of the potency of the effect of grapefruit juice on several drugs used in hypertensive patients, specific questioning is needed about this. The number and complexities of such substances and their possible interactions with cardiovascular drugs make it imperative that a written or electronic reference source be immediately available for consultation.

Serious consideration should be given to having all patients attending a hypertension clinic discuss use of any such products with their physician before intake. Case reports and case series of hypertensive emergencies and serious cardiovascular complications illustrate the serious adverse effects that may occur.

More vigilance is needed in monitoring the use of herbals, supplements, and other nontraditional medications in the hypertensive population. Winslow LC , Kroll DJ : Herbs as medicines. Arch Intern Med ; : — Google Scholar. Phillips AW , Osborne JA : Survey of alternative and nonprescription therapy use.

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Ann Emerg Med ; 35 : — Kaye AD , Clarke RC , Sabar R , Vig S , Dhawan KP , Hofbauer R , Kaye AM : Herbal medicines: Current trends in anesthesiology practice—a hospital survey.

J Clin Anesth ; 12 : — Cappuccio FP , Duneclift SM , Atkinson RW , Cook DG : Use of alternative medicines in a multi-ethnic population. Ethn Dis ; 11 : 11 — Joint National Committee: The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure.

Arch Intern Med 24 ; : — Bakris GL , Williams M , Dworkin L , Elliott WJ , Epstein M , Toto R , Tuttle K , Douglas J , Hsueh W , Sowers J : Preserving renal function in adults with hypertension and diabetes: a consensus approach.

National Kidney Foundation Hypertension and Diabetes Executive Committees Working Group. Am J Kidney Dis ; 36 : — Hathcock J : Dietary supplements: how they are used and regulated.

J Nutr ; : S — S. Food and Drug Administration: Economic characterization of the dietary supplement industry: Final report. Food and Drug Administration Center for Food Safety and Applied Nutrition.

Food and Drug Administration, Washington DC, March Gurley BJ , Gardner SF , Hubbard MA : Content versus label claims in ephedra-containing dietary supplements. Herbal roulette. Consumer Reports. November — Haller CA , Benowitz NL : Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids.

N Engl J Med ; : — Centers for Disease Control and Prevention : Adverse events associated with ephedrine-containing products—Texas, December —September JAMA ; : — White LM , Gardner SF , Gurley BJ , Marx MA , Wang PL , Estes M : Pharmacokinetics and cardiovascular effects of ma huang in normotensive adults.

J Clin Pharmacol ; 37 : — Zahn KA , Li RL , Purssell RA : Cardiovascular toxicity after ingestion of herbal ecstacy. J Emerg Med ; 17 : — Powell T , Hsu FF , Turk J , Hruska K : Ma-huang strikes again: ephedrine nephrolithiasis. Am J Kidney Dis ; 32 : — Assimos DG , Langenstroer P , Leinbach RF , Mandel NS , Stern JM , Holmes RP : Guaifenesin- and ephedrine-induced stones.

J Endourol ; 13 : — Jacobs KM , Hirsch KA : Psychiatric complications of Ma-huang. Psychosomatics ; 41 : 58 — National Center for Complementary and Integrative Health. Health Info Health Info Home. Topics A-Z What Is Complementary, Alternative, or Integrative Health?

Herbs at a Glance Know the Science Safety Information. Resources for Health Care Professionals Tips on Complementary Health Statistics on Use.

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I'm Alternatiev. Leslie Thomas, Alternativs nephrologist Muscle preservation for overall fitness Non-GMO condiments Clinic. And I'm here to answer some of the hyperetnsion questions you might Personal weight loss about hypertension. Measuring your blood pressure at home is a straightforward process. Many people have a slightly higher blood pressure in one arm versus the other. So it's important to measure the blood pressures in the arm with the higher readings. Alternative therapies for hypertension

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