High blood pressure, or hypertension, is a significant global health concern. Studies indicate that approximately 31.1% of the adult population worldwide had hypertension as of 2010, with a higher prevalence in low- and middle-income countries (31.5%) compared to high-income countries (28.5%)​​. More recent data from 2019 shows that the prevalence of hypertension in adults aged 30–79 years was around 32% in women and 34% in men, mirroring the levels from 1990​​. The World Health Organization estimates that 1.28 billion adults aged 30–79 years have hypertension, most living in low- and middle-income countries, with a large portion (46%) being unaware of their condition​​.

Addressing hypertension involves several strategies. Dietary approaches include reducing sodium intake, limiting alcohol consumption, increasing potassium intake, and adopting dietary patterns like the DASH (Dietary Approaches to Stop Hypertension) or Mediterranean diets​​. Lifestyle modifications such as regular physical activity, weight control, smoking cessation, and reducing dietary fat and cholesterol are also recommended. Adequate intake of dietary potassium, calcium, and magnesium, along with moderation in alcohol intake, is advised​​​​. Population-based strategies focus on interventions for small reductions in blood pressure across the entire population, optimizing treatment adherence and minimizing therapeutic inertia​​.

In addition to these methods, certain supplements have shown promise in helping to reduce high blood pressure. These include potassium, omega-3 fatty acids, probiotics, Hibiscus sabdariffa, calcium, aged garlic extract, berberine, niacin, vitamin B6, vitamin B12, and vitamin C​​. Specifically, garlic supplements have been confirmed to lower systolic and diastolic blood pressure, similar to standard anti-hypertensive medications, based on a meta-analysis of 12 trials involving 553 hypertensive participants​​. Furthermore, dietary potassium intake has been shown to lower blood pressure in both hypertensive and nonhypertensive patients significantly​​.

However, it's important to note that while these supplements may aid in blood pressure reduction, official organizations generally recommend prioritizing lifestyle changes and medication over supplements for managing hypertension.

Potassium

Potassium is an essential dietary mineral and electrolyte that plays a vital role in maintaining proper heart function and regulating blood pressure.

Potassium helps to balance the effects of sodium and aids in relaxing blood vessel walls, thereby reducing blood pressure. It also manages the body’s fluid balance, which is crucial for maintaining healthy blood pressure levels.

A dose-response meta-analysis exploring the relationship between potassium supplementation and blood pressure found that higher potassium intake is associated with lower blood pressure, especially in patients with high blood pressure. The blood pressure lowering effect was found to be greater in hypertensive patients and more pronounced with longer supplementation duration​​​​​​.

Omega-3 Fatty Acids

Omega-3 fatty acids are a type of polyunsaturated fat found in fish and plant oils. They are considered essential fats, meaning they must be obtained through diet or supplements.

Omega-3 fatty acids can improve heart health by reducing inflammation and decreasing triglycerides. They also help to dilate blood vessels, which can lead to a reduction in blood pressure.

A dose-response meta-analysis indicates that the optimal combined intake of omega-3 fatty acids for blood pressure lowering is likely between 2 g/d and 3 g/d. Higher doses may provide additional benefits in lowering blood pressure, particularly among groups at high risk for cardiovascular diseases​​​​.

Probiotics

Probiotics are live microorganisms, usually bacteria, which are similar to beneficial microorganisms found in the human gut. They are often referred to as "good" or "healthy" bacteria.

Probiotics may improve blood pressure control by enhancing kidney function, reducing total cholesterol, and supporting healthy artery function.

A systematic review and meta-analysis of randomized controlled trials showed that probiotic consumption leads to a modest but significant reduction in both systolic and diastolic blood pressure. This effect was more pronounced in hypertensive patients, particularly those with diabetes mellitus, and was associated with the duration of treatment, dosage, and age of the subjects​​​​​​.

Hibiscus sabdariffa

Hibiscus sabdariffa, commonly known as hibiscus, is a plant whose extracts are often used in herbal teas and supplements.

It helps lower blood pressure by affecting cardiovascular risk factors. Hibiscus has been found to modulate blood pressure, potentially due to its diuretic properties, its ability to inhibit angiotensin-converting enzyme (which is similar to how certain blood pressure medications work), and its rich content of anthocyanins and other antioxidants.

A systematic review and meta-analysis showed that Hibiscus sabdariffa significantly lowers systolic and diastolic blood pressure. However, the study emphasizes the need for further well-designed trials to validate these results​​​​​​.

Calcium

Calcium is an essential mineral for bone health and also plays a role in blood pressure regulation.

It helps lower blood pressure by aiding in the contraction and relaxation of blood vessels and by managing the balance of other minerals, such as sodium and potassium, which are involved in blood pressure regulation.

The meta-analysis of several trials showed that calcium supplementation reduced blood pressure, particularly in young adults. There was a statistically significant decrease in systolic blood pressure with calcium supplementation for hypertensive individuals and the overall sample​​​​​​.

Aged Garlic Extract

Aged garlic extract is derived from fresh garlic that has been aged, which alters its chemical composition and enhances its beneficial properties.

It lowers blood pressure through multiple mechanisms, including relaxing blood vessels, reducing inflammation, and possibly through mild diuretic effects.

Meta-analyses of studies involving hypertensive subjects have confirmed that garlic supplements significantly lower both systolic and diastolic blood pressure, showing reductions comparable to standard anti-hypertensive medications. The effect was more pronounced in hypertensive patients compared to normotensive patients​​​​.

Berberine

Berberine is a compound extracted from several different plants used in traditional Chinese medicine. It has been studied for various health benefits, including its potential impact on blood pressure.

Berberine may help lower blood pressure by improving insulin sensitivity, reducing inflammation, and possibly affecting blood vessel dilation. However, the evidence is mixed.

A systematic review found that berberine provided a statistically significant reduction in systolic blood pressure compared to metformin. Another study noted that berberine combined with lifestyle intervention or oral hypo-tensors tended to lower blood pressure more than lifestyle intervention alone or placebo​​​​​​.

Niacin (Nicotinic Acid)

Niacin, also known as nicotinic acid, is a form of vitamin B3 used to treat dyslipidemia, a risk factor for cardiovascular disease.

Its potential to lower blood pressure is thought to be due to its effects on lipid profiles, as well as other cardiovascular risk factors.

Data on niacin's effects on blood pressure is limited, and more research is needed to confirm its effectiveness in reducing blood pressure​​.

Vitamin B6 (Pyridoxine)

Vitamin B6, or pyridoxine, is a vitamin involved in several body functions, including neurotransmitter synthesis and amino acid metabolism.

Low levels of vitamin B6 are associated with hypertension. High doses of vitamin B6 have been found to lower blood pressure and serum catecholamine levels in hypertensive subjects.

In a study of hypertensive subjects administered 5 mg/kg/day of vitamin B6 for four weeks, blood pressure was significantly lowered by 14/10 mmHg​​.

Vitamin B12

Vitamin B12 plays an essential role in red blood cell formation, nerve function, and DNA synthesis.

It may help reduce blood pressure by improving endothelial function and reducing homocysteine levels, which are associated with cardiovascular risk.

A study involving folate supplementation alone or with vitamin B6 and/or vitamin B12 found reduced blood pressure, improved insulin resistance, and favorable outcomes on lipid metabolic profiles​​.

Vitamin C

Vitamin C, also known as ascorbic acid, is an essential nutrient and powerful antioxidant.

It helps in reducing blood pressure by improving endothelial function and reducing oxidative stress. It may also help relax blood vessels.

A meta-analysis of randomized controlled trials found that short-term vitamin C supplementation reduced both systolic and diastolic blood pressure. However, long-term effects need further investigation​​.

Takeaway

Supplements have shown potential antihypertensive effects. However, their use should be cautiously approached and consulted with a healthcare provider. Various supplements can lower systolic or diastolic blood pressure or both, but they do not replace medical treatment, especially in significantly elevated blood pressure cases.