Table 1.
Dietary supplements and nutraceuticals with a clinically relevant blood pressure‐lowering effect in humans
| Dietary supplement/nutraceutical | Level of evidence | Potential mechanisms involved in blood pressure regulation |
|---|---|---|
| Aged garlic extract | Meta‐analysis of randomized controlled trials | ↑ NO production; ↑ H2S; ↑ bradykinin; ↓ catecholamine sensitivity; ACE inhibition; calcium channel blocking |
| Beetroot juice | Meta‐analysis of randomized controlled trials | ↑ NO availability |
| Calcium (in pregnancy) | Meta‐analysis of randomized controlled trials | Unknown |
| Chelated magnesium | Meta‐analysis of randomized controlled trials | Calcium channel blocking; ↑ PGE; ↑ NO synthesis |
| Cocoa flavonoids | Meta‐analysis of randomized controlled trials | Antioxidation; free radical scavenging; ↑ NO production and endothelial function; ↓ inflammation; ↓ ROS production (NADPH oxidase inhibition) |
| Coenzyme Q10 (high dosage in hypertensive patients) | Meta‐analysis of randomized controlled trials | Antioxidation; free radical scavenging; ↑ vitamin and antioxidant regeneration; acts as a cofactor and coenzyme in mitochondrial oxidative phosphorylation; ↑ LDL and lipid oxidation |
| Controlled‐release melatonin (night hypertension) | Meta‐analysis of randomized controlled trials | ↑ NO production; protection of vessels from oxidation; regulation of circadian rhythms |
| Fish peptides | Various small randomized controlled trials | ACE inhibition |
| Isoflavones | Meta‐analysis of randomized controlled trials | ACE inhibition? |
| L‐arginine (high dosages) | Meta‐analysis of randomized controlled trials | ↑ NO availability |
| Lactotripeptides | Meta‐analysis of randomized controlled trials | ACE inhibition? |
| Lycopene | Meta‐analysis of randomized controlled trials | Antioxidation; free radical scavenging |
| Polyunsaturated fatty acids (high dosages) | Meta‐analysis of randomized controlled trials | ↓ TXA2 and inflammation; ↑ vasodilator PGs; ↑ NO synthase; ↓ insulin resistance; ↓ RAAS |
| Potassium | Different randomized controlled trials | ↑ Natriuresis; ↑ baroflex sensitivity modulation; ↑ Na+–K+‐ATPase; ↑ insulin sensitivity; ↓ ATII; ↓ catecholamine sensitivity; ↓ ADMA; ↓ oxidative stress; ↓ TGF‐ β production |
| Probiotics | Meta‐analysis of randomized controlled trials | ACE inhibition? |
| Pycnogenol | Meta‐analysis of randomized controlled trials | ↑ NO production; ↓ ACE; ↑ endothelial function; ↓ myeloperoxidase activity; ↓ urinary albumin excretion |
| Resveratrol | Meta‐analysis of randomized controlled trials | ↑ NO production; protection of vessels from oxidation; ↓ vascular inflammation; ↓ platelet aggregation |
| Vitamin C | Meta‐analysis of randomized controlled trials | ↓ adrenal steroid production and serum aldehydes; ↓ binding affinity of the AT1R for ATII; ↑ Na+–K+‐ATPase; ↑ natriuresis; ↑ superoxide dismutase; ↑ cyclic GMP; ↑ NO and PGI2 |
ACE, angiotensin‐converting enzyme; ADMA, asymmetric dimethylarginine; AT1R, angiotensin II type 1 receptor; ATII,, angiotensin II; H2S, hydrogen sulfide, LDL, low‐density lipoprotein; NO, nitric oxide; PG, prostaglandin, RAAS, renin–angiotensin–aldosterone system; ROS, reactive oxygen species; TGF‐β, transforming growth factor‐β; TX, thromboxane.