INTRODUCTION
Blood pressure, or blood pressure, is the force exerted by blood against the walls of vessels (arteries, veins and capillaries); the unit of measurement with which the values ​​are expressed is the millimeter of mercury, initialed mmHg, while the instruments that evaluate it are: the sphygmomanometer, the catheterization for endovascular pressure and the Holter ElectroCardiogram (ECG).
Blood pressure is NOT uniform throughout the cardiovascular system and is divided into:
- Systemic arterial pressure: based on the cardiac cycle, it oscillates between the two values ​​of maximum (systolic) and minimum (diastolic); excess systemic blood pressure is called hypertension
- Distal vascular pressure: it is lower than arterial pressure since it represents the inversion of the circulation between arterial and venous; the greatest loss is at the level of the arterioles, then further decreases in the venules and stabilizes in the veins
- Central venous pressure: measurable at the jugular level, it is the result of the balance between the cardiac cycle and the respiratory cycle
- Portal pressure: it is measured with catheterization and is used to determine the presence of any abnormalities (hypertension) of the portal circulation that can cause rupture and bleeding of esophageal varices (typical complications of cirrhosis with liver failure)
- Pulmonary pressure: it is proportionally lower than that of the systemic circulation but has the same flow system.
Hypertension
Essential arterial hypertension is a disease with multiple aetiology; it affects those who are genetically predisposed but also those who have certain risk factors, such as obesity, other metabolic diseases (such as diabetes and dyslipidemia), sedentary lifestyle, chronic nervousness, etc.
"Hypertension" is defined as an impairment of the arterial pressure balance that results in a CONSTANT increase in the diastolic (minimum)> 90mmHg, or in the systolic (maximum)> 140mmHg, with respect to a range of NORMALITY which is below 85mmHg for diastolic and below 135mmHg for systolic.
There is a form of secondary hypertension, which barely affects 5-10% of cases, caused by the complication of other diseases, for example: parenchymal nephropathy, hyperthyroidism and coarctation of the aorta. Furthermore, some drugs can negatively affect blood pressure balance, such as NSAIDs, cortisone and cyclosporine.
NB. The hypertension associated with Diabetes Mellitus EXPONENTLY increases the risk of cardiovascular complications, therefore of a negative prognosis.
Causes of hypertension
The causes of hypertension are not well defined and it would be more correct to speak of "predisposing factors"; among these we recognize: increased tone of the sympathetic nervous system, decreased ability of the kidney to eliminate sodium, genetic and dietary factors (diet rich in sodium and low in potassium), conditions of social stress, sedentary lifestyle and aging.
Treating hypertension
To treat hypertension, or even just improve blood pressure parameters, a series of lifestyle changes need to be made:
- In case of overweight or obesity, restore the normal weight (especially if the adipose deposit is android and visceral)
- Starting a diet against hypertension and its complications which includes: ZERO added sodium, increase in dietary potassium (fruit and vegetables), drastic reduction of saturated fats and cholesterol, increase of essential fatty acids, drastic reduction of alcohol ( if abused) and simple sugars (resulting in a drop in glycemic peaks)
- Begin physical activity and improve cardio-circulatory fitness
- Eliminate, if present, the habit of smoking.
Medicines for the treatment of hypertension, appropriately chosen and dosed by the doctor, are: diuretics, sympatholytics / adrenergic inhibitors, calcium antagonists, inhibitors of the renin-angiotensin system, direct-acting vasodilators and drugs for hypertensive emergency.
Useful supplements against hypertension
Some supplements can facilitate the reduction of blood pressure, consequently decreasing the risk of hypertension, especially when combined with diet and sports; these products are not recommended for those with normal blood pressure values ​​(below 85mmHg for diastolic and below 135mmHg for systolic) or for those who follow a drug treatment sufficient to compensate for any hypertensive form. On the other hand, in this last category of subjects, after checking and medical advice, it is possible to review the pharmacological approach (especially following the improvement of weight and overall cardiovascular risk) leaving more space for some useful supplements to lower the pressure.
Categories of supplements for lowering blood pressure
The main categories of blood pressure lowering supplements are:
Plants and plant extracts
- Diuretics: Diuretics are blood pressure lowering supplements that contain molecules (or extracts) that promote kidney filtration. However, it should be noted that some boast considerable concentrations of molecules which, although diuretic, also have a stimulating and hypertensive effect; for this reason these products do NOT facilitate the lowering of blood pressure (eg caffeine and theina).
Other diuretic blood pressure lowering supplements contain plant extracts with "more or less" recognized and relatively effective characteristics; they are: pineapple, birch, artichoke, cucumber, walnut leaves, onion, horsetail, fennel, apple, nettle, elderflower, corn stigmas and dandelions.
Some diuretic molecules, in addition to composing the classic food supplements, can be combined and infused to obtain draining herbal teas.
NB. It is also important to specify that blood pressure lowering supplements based on drainage molecules or extracts are NOT diuretic drugs! The latter, in addition to being much more effective, are equally dangerous in case of abuse or incorrect dosage.
- Hypotensive medicinal plant extracts: There are plants, fruits, seeds and flowers capable of lowering (relatively effectively) blood pressure regardless of renal filtration; these products are generically defined "supplements based on hypotensive medicinal plants". Among the most effective varieties we mention: garlic, onion, rauwolfia, birch, hawthorn, heart, ginkgo biloba, blueberry, orthosiphon, mistletoe, red vine, olive, periwinkle, uncaria, lily of the valley, ligustic, carcadè (hibiscus), evodia and Iranian yarrow . These plants contain active ingredients useful for lowering pressure that can also be used in combination within the same food supplement.
Supplements based on essential molecules such as mineral salts, fatty acids (AGE) and amino acids
- Potassium: potassium is the main intracellular cation and, as such, participates in the acid-base balance and in the control of osmotic pressure; however, the remaining extracellular concentration also seems to perform very important functions, including the regulation of blood pressure. Some studies suggest that increased potassium lowers blood pressure and increases urinary sodium excretion, with a reflex effect of reducing systolic blood pressure and (theoretically) hypertension-related deaths (Rose, 1986). The average recommended intake ranges from 800 to 3100 mg / day, but using potassium-based blood pressure-lowering supplements that deliver up to 2500-4000mg / day can be effective in lowering blood pressure by up to 4mmHg.
- Magnesium: magnesium is a mainly intracellular mineral, but the small portion present in the extracellular fluid is responsible for the membrane potential of nerves and muscles; even if the mechanism is not yet clear, like potassium, magnesium also helps lower blood pressure. Some recent studies show that doses between 120 and 973mg of magnesium per day (where the requirement is approximately 150-500mg / day) effectively contribute to reducing blood pressure levels; Ultimately, taking magnesium-based blood pressure-lowering supplements can be a useful factor but only in dosages that can exceed 200% of the recommended ration.
- Essential Fatty Acid (AGE) omega3 (ω3): ω3 is an essential polyunsaturated fat (PUFA) which must be present in the diet in quantities equal to or greater than 0,5% of the total kcal and (possibly) have a ratio with the other AGE (ω6) of approximately 1: 4. Ω3 has numerous beneficial functions for the organism; to name but a few we remember: the constitution of membranes, the precursion of anti-inflammatory molecules, the improvement of the blood lipid balance and the reduction of blood pressure as well as cardiovascular risk.
In case of using supplements to lower the pressure based on ω3 we point out that for the moment there are NO known side effects related to the abuse of ω3 fatty acids, therefore (even if it is NEVER appropriate to exceed) it is advisable to use sustained dosages that almost 100% of the daily requirement, therefore pearls, drops or capsules for at least 1g / day.
NB. The most "pure" and qualitatively best omega3 (rich in EPA and DHA) is krill oil, followed by blue fish oil and cod liver oil (both liquid and pearls). WARNING! Ω3-based blood pressure supplements are highly perishable and should be stored in the refrigerator.
- Arginine: arginine is a semi-essential amino acid to which numerous functions are attributed; among others, recently discovered but of great interest, we mention the precursion of nitric oxide (NOS); the latter is essential for the maintenance of vascular endothelial function and determines the reduction of arterial pressure thanks to the improvement of the vascular capacity to dilate and constrict itself in an elastic manner. When supplementing with arginine-based products to lower blood pressure, it is advisable to use tablets for a total of about 8g / day.
