Table 1.

Common dietary supplements used in the management of hypertension

S/no	Dietary supplement	Nutrients/ food sources	Form found	Target organ/cell	Health benefits	Limitations	Reference
1.	Cod liver oil	Vitamin A, D, and omega-3 fatty acids. Fish oils, flax seed, primrose, borage and flaxseed oils.	Herring haddock, Atlantic salmon, trout, tuna, cod and mackerel.	Cardiovascular system.	Reduces cardio metabolic risk factors, protects sudden cardiac death after myocardial infraction, reduces raised plasma triglycerides, reduces blood pressure and ameliorates atherogenic effects.	High doses required for reduction of blood pressure may have side effects.	Warner, 2000; Marchioli et al., 2002; Hooper et al., 2006; Apel et al., 2006; Abeywardena and Patten, 2011; Trofimiuk and Braszko, 2011.
2.	Garlic	Gamma glutamyl peptides, flavonol magnesium, ajoenes phosphorus, adenosine, allicin and sulphur	Allium sativum, aglio, ail, Da-suan, Knoblauch, La-juan, rustic treacle, stinking rose	Cardiovascular system.	Reduces cardiovascular diseases by lowering blood pressure and increases levels of antioxidant enzymes.	Inhibits platelet aggregation which may prolong bleeding time.	Mohamadi et al., 2000; Weiss, 2000; Mansoor, 2001.
3.	Coenzyme Q-10	B vitamins; B6, B12, niacin and folic acid. Fatty fish, organ meats and peanut.	Reduced or oxidized form of CoQ10 in dry powder capsules dispersed in oil, surfactants and emulsifiers such as lecithin and polysorbate 80 to improve absorption.	Heart, lung and liver	Strengthens heart muscle and improves a variety of heart conditions.	Low level compromises myocardial energy generation leading to “energy starvation” of the myocardium, considered to be a pathogenic mechanism of chronic heart failure (CHF).	Mohamadi et al., 2000; Weiss, 2000; Mansoor, 2001.
4.	Beta glucan	Sorghum, rye, maize, triticale, wheat, rice, seaweed and mushrooms.	Oat and barley bran.	Heart	Immune enhancer and cholesterol-lowering effect.	Delay stomach emptying.	Mohamadi et al., 2000; Weiss, 2000; Mansoor, 2001.
5.	Lipoic acid	Liver, spinach, broccoli and potato.	Lipoic acid in tablet and capsule.	Nerve cell, kidney, heart and liver.	Lowers blood pressure in persons with hypertension.	Pregnant women or nursing mothers should avoid lipoic acid supplements at pharmacologic doses.	Mohamadi et al., 2000; Weiss, 2000; Mansoor, 2001.
6.	Whole grains	Brown rice, wheat, barley, rye, maize.	Oat meal, polenta, wheat pasta, wheat bread, corn meal.	Heart and liver	Reduces systolic and diastolic pressures along with mean arterial pressure (MAP).	Intake of three servings a day must be ensured for positive result.	Anderson et al., 2000.
7.	(i) Potassium	Fruits and vegetables such as apricots, bananas, tomatoes and carrots.	Citrate and chloride.	Cell membranes.	Reduces blood pressure.	Potassium depletion in normal individuals causes sodium retention and increased blood pressure.	Kotchen and McCarron, 1998.
	(ii) Magnesium	Fat or fibre (from fruits, vegetables and cereal grains.	Citrate, stearate and sulphate forms.	Heart and kidney.	Inhibits platelet dependent thrombosis.	dequate levels may se loose stool in sitive individuals.	Touyz, 1991; Burgess et al., 1999.
	(iii) Sodium	Fat or fibre from fruits, vegetables and cereal grains.	Additive in commercial processed foods.	Heart and blood vessels.	Moderate intake reduces mean arterial pressure as well as morbidity and mortality.	Excess sodium in the diet can lead to or complicate high blood pressure.	McCarron, 1997 Burgess et al., 1999; Kotchen and McCarron, 1998.
8.	Vitamin E	Vegetable oil, sunflower nuts, avocado, carrot, peanut, almonds, hazelnuts.	Alpha - Tocopherol	Heart, brain, lung, and muscle	Reduces elevated blood pressure caused by excess endogenous aldehydes in insulin resistance hypertension.	Large doses of α-tocopherol inhibits normal blood coagulation.	Jiang et al., 2001; Vasdev et al., 2002.
9.	Vitamin B6	Brown rice, oats, wheat germ, molasses, cereals, potato, banana, plum and salmon fish.	Pyridoxine	Jejunum, ileum, heart.	Prevents heart attacks and nerve damage.	Excess doses over long period of time result into painful and ultimately irreversible neurological problem.	Schaumburg et al., 1983; Bendich and Cohen, 1990; McCormick, 2006.
10.	Vitamin C	Fruits and vegetables.	Ascorbic acid	Blood plasma, brain, spleen, lung, liver, kidney and pancreas.	Lowers blood pressure in persons with hypertension, helpful for long term health maintenance of arteries.	Causes diuretic effect which gets rid of fluids.	Ness et al., 1997; Vasdev et al., 2002.
11.	Polyphenol	Fruits and vegetables, nuts and their products.	Catechin and epicatechin.	Heart	Inhibits oxidation of low density lipoprotein (LDL), inhibits platelet aggregation and vascular relaxation through the production of nitric oxide.	Safety should be carefully tested in relation to the disease status of potential users.	Frankel et al., 1993; McCarron, 1997; Dubick and Omaye, 2001; Halsad, 2003; Carlson et al., 2008.
12.	Botanicals	Prickly pear, cactus, Coccinea indica, Aloe vera, fenugreek, bitter melon, Ginseng.	Herbs	Liver, bones, skin and heart.	Prevents hypertension and ulcerative colitis.	Lack of dose regimen and limited research on the efficacy of these botanicals.	Merchant and Andre, 2001; Van Breemen et al., 2007.
13.	Vanadium	Black pepper, mushroom, shell fish parsley, fresh fruits and vegetables.	Chelate and sulphates.	Muscles, liver, heart and body fluids.	Lowers blood pressure.	GI irritation and tissue accumulation, uncertain long term safety profile.	Bhanot et al., 1994a; Bhanot et al., 1994b Cohen et al., 1995; Goldfine et al., 1995; Boden et al., 1996;; Preuss et al., 1998.