Life Extension Blood Test Super Sale

Life Extension Magazine

Life Extension Magazine March 2010
Reports

Reduce Blood Pressure—Naturally
What Americans Can Learn from Traditional Cultures about Managing Hypertension


By William Davis, MD

French Maritime Bark Extract

Numerous studies point to the efficacy of a novel antioxidant compound of proanthocyanidins and bioflavonoids isolated from bark of the French maritime pine that grows along the southern coast of France.

An Everyday Dietary Danger

A University of Arizona study documented 50% reduced need for blood pressure medication in diabetic participants taking 125 mg of this compound per day.57 Interestingly, there was a 23.7 mg/dL drop in blood sugar and 0.8% reduction in hemoglobin A1c (a measure of long-term blood sugar control). Another study demonstrated reduced need for calcium blocker medication in participants given 100 mg per day.58

French maritime bark extract exerts its antihypertensive effects by blocking the angiotensin-converting enzyme (ACE)—similar to the mechanism of the prescription ACE inhibitors enalapril and lisinopril—enhancing endothelial (vessel lining) responsiveness, and blocking the effects of adrenaline (epinephrine).59

Anthocyanins

Anthocyanins are a class of plant flavonoids that confer the red, purple, and blue color to cranberries, blueberries, eggplant, grapes, red wine, pomegranate, and other similarly colored fruits and vegetables. Anthocyanins are proving to be powerful standouts for health effects among the many thousands of flavonoids and polyphenols identified to date.

A Finnish study of 72 middle-aged subjects examined the effects of consuming two servings of berries daily (alternating schedule of 100 g whole bilberries and a 50 g crushed lingonberry nectar; or black currant or strawberry purée and cold-pressed chokeberry and raspberry juice) compared to a non-berry containing calorie-matched control. Anthocyanins represented the dominant flavonoid at 275 mg of the total polyphenols of 837 mg per day. The berry group experienced a reduction in systolic blood pressure of 7.3 mmHg, along with 5.2% increase in HDL.60 A study of 50 mL (almost 2 oz) of anthocyanin-rich pomegranate juice reduced blood pressure by about 12%, in addition to reducing carotid intima-media thickness.61

Like French maritime bark extract and vitamin D, anthocyanins are natural inhibitors of the angiotensin-converting enzyme that increases blood pressure.62 The production of the natural and powerful artery-relaxing agent, nitric oxide, is also increased by anthocyanins.63

Some of the richest sources of anthocyanins are elderberries, chokeberries, and bilberries, which are difficult to find in the US, but may be obtained as nutritional supplements and extracts.

An Everyday Dietary Danger

What food can cause devastating inflammatory intestinal destruction that, if unrecognized, can lead to disability and death?18

Increase blood sugar higher and faster than table sugar?30

Trigger autoimmune inflammation in the thyroid?31

Create intestinal bloating, cramps, and alternating diarrhea and constipation, often labeled irritable bowel syndrome?32

Weaken the muscle controlling food exit from the esophagus to the stomach, resulting in reflux esophagitis (heartburn)?33

Worsen schizophrenia in susceptible individuals?34

Contribute to behavioral outbursts in children with autism?35,36

Increase the risk of or worsen various inflammatory diseases such as rheumatoid arthritis, ulcerative colitis, dermatitis herpetiformis, systemic lupus, pancreatitis, and increase measures of inflammation? 37-42

Cause unexplained anemia, mood swings, fatigue, fibromyalgia, eczema, and osteoporosis?38,43-45

That food is wheat. Yes, the ubiquitous grain we are urged to eat more and more by the USDA, the American Heart Association, the American Dietetic Association, and the American Diabetes Association. Wheat is among the most destructive ingredients in the modern diet, worse than sugar, worse than high-fructose corn syrup, worse than any fat. What other common food can result in such an extensive list of diseases, even death?

Few foods occupy the exalted position that wheat has gained, earning over 20,000 research publications in the medical literature over the past 30 years, many studies detailing the destructive and sometimes fatal nature of this common dietary product. Celiac disease alone affects more than 2 million Americans.46 The medical literature is filled with case reports of deaths from this disease,47 often after years of struggle with incapacitating intestinal dysfunction and encephalopathy (brain inflammation).

What happens when you remove wheat from the diet? Experience at our clinic has shown that the majority of people quickly shed 20-30 lbs in the first few weeks, selectively lost from the abdomen (what I call “wheat belly”); blood sugar plummets; triglycerides drop up to several hundred milligrams, HDL increases, LDL drops (yes, wheat elimination is a means of achieving marked reduction in LDL, especially the small, heart disease-causing variety); and C-reactive protein plummets. In addition, intestinal complaints like pain, gas, and bloating improve or disappear; gastroesophageal reflux often disappears; rashes improve; inflammatory conditions like rheumatoid arthritis improve; diabetes (adult or type 2) is more easily controlled; and behavioral disorders and mood improve.

In people who have celiac disease, the meticulous avoidance of wheat gluten and gluten from other sources, including rye, spelt, and barley, will be necessary. But there are millions of Americans who are suffering wheat-intolerance in some form, from skin rashes to arthritis to depression, who are wheat-sensitive but remain unaware.

Beware of the food industry’s efforts to capitalize on wheat intolerance with products known as “gluten free.” These are generally foods that don’t trigger the inflammatory response of wheat, but still cause high blood sugar, weight gain, and other abnormalities.

Magnesium

In addition to magnesium’s capacity to help manage asthma attacks, migraine headaches, eclampsia and pre-eclampsia of pregnancy, heart rhythm disorders, and preserve kidney function,64,65 magnesium supplementation has been conclusively shown to reduce blood pressure.66 Magnesium deficiency contributes an even larger blood pressure-increasing effect in the setting of a modern American diet deficient in magnesium and rich in fructose—a situation that increases inflammation and the potential for metabolic syndrome.67

Omega-3 Fatty Acids

In one recent study, magnesium supplementation reduced systolic blood pressure by 5.6 mmHg and diastolic blood pressure by 2.8 mmHg.68 People with heart disease may derive even greater effects. A study of 50 participants with advanced heart disease demonstrated a 9.0 mmHg drop in systolic pressure with 500 mg elemental magnesium supplementation, despite serum magnesium levels in the normal range.69

The blood pressure-reducing effects of magnesium supplementation may be especially marked in those with low serum magnesium levels. A study of supplementation in diabetic participants starting with low serum magnesium levels demonstrated an astounding 20.4 mmHg drop in systolic blood pressure and an 8.7 mmHg drop in diastolic pressure with 450 mg of elemental magnesium daily.70

Omega-3 Fatty Acids

In addition to the triglyceride- and cardiovascular event-reducing effects of omega-3 fatty acids from fish oil, these fascinating oils also modestly reduce blood pressure. Daily intake of 1,000-3,000 mg of the omega-3 fatty acids EPA and DHA reduces systolic blood pressure by about 2.1 mmHg and diastolic pressure by about 1.6 mmHg.71 These blood pressure-reducing effects are accomplished via blocking the angiotensin system, promoting arterial relaxation (normalization of endothelial dysfunction), reduced production of inflammatory mediators, and reduced production of artery constricting factors.72

Resveratrol

Red wine in modest quantities has been demonstrated to reduce risk for cardiovascular disease.73 Much attention has focused on the polyphenol resveratrol, originating from red wine and grapes as a principal source of benefits, including potential life-extending effects due to activation of the sirtuin genes.74

Resveratrol

Resveratrol has been shown to inhibit the angiotensin-converting enzyme as a means to modestly reduce blood pressure,75 and also restores production of the natural artery-dilating agent, nitric oxide.76,77

Acetyl-L-carnitine

In a preliminary study, this amino acid reduced systolic blood pressure 9 mmHg in subjects taking 1,000 mg twice per day.78 In addition, acetyl-L-carnitine improved insulin responses and reduced blood sugar.

Melatonin

Because nocturnal hypertension has been associated with increased risk for cardiovascular events,79 the effect of melatonin on nighttime hypertension has been studied.

In addition to its sleep-enhancing effects, melatonin taken at or before bedtime reduces blood pressure during sleep. One study examined the effects of nightly dosing of 2.5 mg in 16 men; melatonin reduced systolic and diastolic blood pressure during sleep by 6 and 4 mmHg, respectively.80 Another study of 38 men demonstrated that 2 mg of a controlled-release melatonin preparation reduced systolic pressure by 6 mmHg and diastolic pressure by 3 mmHg during sleep.81

Summary

The virtual absence of hypertension in traditional cultures suggests that high blood pressure is, for most of us, a situation we create with modern diet and lifestyle. Reverting back to basic foods, especially reducing or eliminating wheat grains, cornstarch, and sugars, can reduce blood pressure substantially. Select nutrients, many of which restore nutrients that were more readily obtained by traditional eating habits but are lacking in the modern day diet, can also reduce blood pressure. While not everyone starting such a program during adulthood can hope to entirely avoid hypertension, these steps might help minimize the potential of developing this dangerous condition.

If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.

Dr. William Davis campaigns for the cause of heart disease reversal. He practices cardiology in Milwaukee, Wisconsin and is author of the book, Track Your Plaque (iUniverse, Inc., 2004). Dr. Davis can be contacted through www.trackyourplaque.com.

Editor’s Note

In this article, Dr. Davis has provided us with an abundance of natural methods to lower blood pressure.

As Dr. Davis noted in the introduction, even modest blood pressure readings above 115/75 sharply increase cardiovascular disease risk. Yet conventional doctors are allowing their aging patient’s blood pressure to reach dangerous levels of 140/90 before initiating anti-hypertensive therapy.

In fact, the home page of a pharmaceutical company’s web site (www.diovan.com) defines high blood pressure as 140/90 or higher.

This drug company is acting against its own economic interest by limiting the number of people who are candidates for its anti-hypertensive drug, while disseminating erroneous lethal information to the public.

We urge most Life Extension members to maintain their blood pressure at 115/75 (or lower) using natural methods first. If blood pressure remains stubbornly high, we suggest a safe and effective class of anti-hypertensive drugs be used called angiotensin II receptor antagonists. One of these drugs we have recommended for over a decade is called Cozaar® and it should be taken twice a day to maintain 24-hour control over blood pressure. Another drug in this class called Benicar® claims 24-hour blood pressure control with once a day dosing.

You should not trust any medication to provide 24-hour blood pressure control. If you are prescribed Benicar® or any other anti-hypertensive, use an at-home blood pressure monitoring device to make sure the drug is providing all-day control of blood pressure at the optimal range of 115/75 or lower. A major error in using anti-hypertensive drugs is that they wear off later in the day allowing blood pressure to spike to dangerously high levels.

You can obtain reliable at-home blood pressure monitors at your local pharmacy, or you can order one by phone by calling 1-800-544-4440.

References

1. Carvalho JJ, Baruzzi RG, Howard PF, et al. Blood pressure in four remote populations in the INTERSALT Study. Hypertension. 1989 Sep;14(3):238-46.

2. Ahmed MI, Pisoni R, Calhoun DA. Current options for the treatment of resistant hypertension. Expert Rev Cardiovasc Ther. 2009 Nov;7(11):1385-93.

3. Geleijnse JM, Witteman JC, Bak AA, den Breeijen JH, Grobbee DE. Reduction in blood pressure with a low sodium, high potassium, high magnesium salt in older subjects with mild to moderate hypertension. BMJ. 1994 Aug 13;309(6952):436-40.

4. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA. 2003 May 21;289(1):2560-75.

5. Appel L J, Moore T J, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997 Apr 17;336(16):1117–24.

6. Szinnai G, Schachinger H, Arnaud MJ, Linder L, Keller U Effect of water deprivation on cognitive-motor performance in healthy men and women. Am J Physiol Regul Integ Comp Physiol. 2005 Jul;289(1):R275-80.

7. Colussi G, De Ferrari ME, Brunati C, Civati G. Medical prevention and treatment of urinary stones. J Nephrol. 2000 Nov-Dec;13 Suppl 3:S65-70.

8. Pastorova VE, Esartiia DT. Status of the coagulant and anticoagulant systems of the blood in experimental acute intestinal dehydration of the body. Biull Eksp Biol Med. 1981 Sep;92(9):287-9.

9. Bagdade JD, Buchanan WF, Pollare T, Lithell H. Effects of hydrochlorothiazide and captopril on lipoprotein lipid composition in patients with essential hypertension. Eur J Clin Pharmacol. 1996;49(5):355-9.

10. Nandeesha H, Pavithran P, Madanmohan T. Effect of antihypertensive therapy on serum lipids in newly diagnosed essential hypertensive men. Angiology. 2009 Apr-May;60(2):217-20.

11. Haffner SM. The prediabetic problem: development of non-insulin-dependent diabetes mellitus and related abnormalities. J Diabetes Complications. 1997 Mar-Apr;11(2):69-76.

12. Reungjui S, Pratipanawatr T, Johnson RJ, Nakagawa T. Do thiazides worsen metabolic syndrome and renal disease? The pivotal roles for hyperuricemia and hypokalemia. Curr Opin Nephrol Hypertens. 2008 Sep;17(5):470-6.

13. Zillich AJ, Garg J, Basu S, et al. Thiazide diuretics, potassium, and the development of diabetes: a quantitative review. Hypertension. 2006 Aug;48(2):219-24.

14. Black HR, Davis B, Barzilay J, et al. Metabolic and clinical outcomes in nondiabetic individuals with the metabolic syndrome assigned to chlorthalidone, amlodipine, or lisinopril as initial treatment for hypertension: a report from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Diabetes Care. 2008 Feb;31(2):353-60.

15. Hu FB, Manson JE, Willett WC. Types of dietary fat and risk of coronary heart disease: a critical review. J Am Coll Nutr. 2001 Feb;20(1):5-19.

16. Elliott SS, Keim NL, Stern JS, Teff K, Havel PJ. Fructose, weight gain, and the insulin resistance syndrome. Am J Clin Nutr. 2002 Nov;76(5):911-22.

17. Matía Martín P, Lecumberri Pascual E, Calle Pascual AL. Nutrition and metabolic syndrome. Rev Esp Salud Publica. 2007 Sep-Oct;81(5):489-505.

18. Bardella MT, Fredella C, Prampolini, L et al. Body composition and dietary intakes in adult celiac disease patients consuming a strict gluten-free diet. Am J Clin Nutr. 2000 Oct;72(4):937-39.

19. Cheng J, Brar PS, Lee AR, Green PH. Body mass index in celiac disease: beneficial effect of a gluten-free diet. J Clin Gastroenterol 2009 Sep 23.

20. Capristo E, Malandrino N, Farnetti S, et al. Increased serum high-density lipoprotein-cholesterol concentration in celiac disease after gluten-free diet treatment correlates with body fat stores. J Clin Gastroenterol. 2009 Nov-Dec;43(10):946-9.

21. Rizek RL, Friend B, Page L. Fat in today’s food supplylevel of use and sources. J Am Oil Chem Soc. 1974;51:244-50.

22. Astrup A, Dyerberg J, Selleck M, Stender S. Nutrition transition and its relationship to the development of obesity and related chronic diseases. Obes Rev. 2008 Mar;9 Suppl 1:48-52.

23. Chavarro JE, Stampfer MJ, Campos H, Kurth T, Willett WC, Ma J. A prospective study of trans-fatty acid levels in blood and risk of prostate cancer. Cancer Epidemiol Biomarkers Prev. 2008 Jan;17(1):95-101.

24. Rohr-Udilova NV, Stolze K, Sagmeister S, Nohl H, Schulte-Hermann R, Grasl-Kraupp B. Lipid hydroperoxides from processed dietary oils enhance growth of hepatocarcinoma cells. Mol Nutr Food Res. 2008 Mar;52(3):352-9.

25. Adam SK, Das S, Soelaiman IN, Umar NA, Jaarin K. Consumption of repeatedly heated soy oil increases the serum parameters related to atherosclerosis in ovariectomized rats. Tohoku J Exp Med. 2008 Jul;215(3):219-26.

26. Soriquer F, Rojo-Martínez G, Dobarganes MC, et al. Hypertension is related to the degradation of dietary frying oils. Am J Clin Nutr. 2003 Dec;78(6):1092-97.

27. Bozan B, Temelli F. Chemical composition and oxidative stability of flax, safflower and poppy seed and seed oils. Bioresour Technol. 2008 Sep;99(14):6354-9.

28. Brenes M, García A, Dobarganes MC, Velasco J, Romero C. Influence of thermal treatments simulating cooking processes on the polyphenol content in virgin olive oil. J Agric Food Chem. 2002 Oct 9;50(21):5962-7.

29. Babio N, Bulló M, Salas-Salvadó J. Mediterranean diet and metabolic syndrome: the evidence. Public Health Nutr. 2009 Sep;12(9A):1607-17.

30. Available at: http://lpi.oregonstate.edu/infocenter/foods/grains/gigl.html. Accessed December 9, 2009.

31. Rousset H. A great imitator for the allergologist: intolerance to gluten. Eur Ann Allergy Clin Immunol. 2004 Mar;36(3):96-100.

32. Verdu EF, Armstrong D, Murray JA, et al. Between celiac disease and irritable bowel syndrome: the “no man’s land” of gluten sensitivity. Am J Gastroenterol. 2009 Jun;104(6):1587-94.

33. Cuomo A, Romano M, Rocco A, et al. Reflux oesophagitis in adult coeliac disease: beneficial effect of a gluten free diet. Gut. 2003 Apr;52(4):514-17.

34. Kalaydjian AE, Eaton W, Cascella N, Fasano A. The gluten connection: the association between schizophrenia and celiac disease. Acta Psychiatr Scand. 2006 Feb;113(2):82-90.

35. Vojdani A, O’Bryan T, Green JA et al. Immune response to dietary proteins, gliadin and cerebellar peptides in children with autism. Nutr Neurosci. 2004 Jun;7(3):151-61.

36. Elder JH, Shankar M, Shuster J, Theriaque D, Burns S, Sherrill L. The gluten-free, casein-free diet in autism: results of a preliminary double blind clinical trial. J Autism Dev Disord. 2006 Apr;36(3):413-20.

37. Collin P, Reunala T, Pukkala E, et al. Coeliac disease--associated disorders and survival. Gut. 1994 Sep;35(9):1215-18.

38. Hernandez L, Green PH. Extraintestinal manifestations of celiac disease. Curr Gastroenterol Rep. 2006 Oct;8(5):383-89.

39. Volta U, De Angelis GL, Granito A, et al. Autoimmune enteropathy and rheumatoid arthritis: a new association in the field of autoimmunity. Dig Liver Dis. 2006 Dec;38(12):926-9.

40. Freeman HJ. Adult celiac disease followed by onset of systemic lupus erythematosus. J Clin Gastroenterol. 2008 Mar;42(3):252-5.

41. Rodrigo L, Alvarez N, Riestra S, et al. Relapsing acute pancreatitis associated with gluten enteropathy. Clinical, laboratory, and evolutive characteristics in thirty-four patients. Rev Esp Enferm Dig. 2008 Dec;100(12):746-51.

42. Festen EA, Szperl AM, Weersma RK, Wijmenga C, Wapenaar MC. Inflammatory bowel disease and celiac disease: overlaps in the pathology and genetics, and their potential drug targets. Endocr Metab Immune Disord Drug Targets. 2009 Jun;9(2):199-218.

43. McGough N, Cummings JH. Coeliac disease: a diverse clinical syndrome caused by intolerance of wheat, barley and rye. Proc Nutr Soc. 2005 Nov;64(4):434-50.

44. Wallace DJ, Hallegua DS. Fibromyalgia: the gastrointestinal link. Curr Pain Headache Rep. 2004 Oct;8(5):364-8.

45. Prigent F, Civatte J. Atopy and associated diseases. Ann Dermatol Venereol. 1982;109(4):341-53.

46. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/. Accessed December 9, 2009.

47. Rubio-Tapia A, Kyle RA, Kaplan EL, et al. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology. 2009 Jul;137(1):88-93.

48. Lind L, Hanni A, Lithell H, et al. Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men. Am J Hypertens. 1995 Sep;8(9):894–901.

49. Forman JP, Curhan GC, Taylor EN. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension among young women. Hypertension. 2008 Nov;52(5):828-32.

50. Pfeifer M, Begerow B, Minne HW, et al. Effects of a short-term vitamin D3 and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endcrinol Metab. 2001;86:1633–37.

51. Witham MD, Nadir MA, Struthers AD. Effect of vitamin D on blood pressure: a systematic review and meta-analysis. J Hypertens. 2009 Oct;27(10):1948-54.

52. Giovannucci E. Vitamin D and cardiovascular disease. Curr Atheroscler Rep. 2009 Nov;11(6):456-61.

53. Rosenfeldt FL, Haas SJ, Krum H, et al. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum Hypertens. 2007 Apr;21(4):297-306.

54. Devereux RB, Wachtell K, Gerdts E, et al. Prognostic significance of left ventricular mass change during treatment of hypertension. JAMA. 2004;292:2350-56.

55. Langsjoen PH, Folkers. Isolated diastolic dysfunction of the myocardium and its response to CoQ10 treatment. Clin Investig. 1993;71:S140-44.

56. Langsjoen P, Willis R, Folkers K. Treatment of essential hypertension with coenzyme Q10. Mol Aspects Med. 1994;15:S265-72.

57. Zibadi S, Rohdewald PJ, Park D, Watson RR. Reduction of cardiovascular risk factors in subjects with type 2 diabetes by pycnogenol supplementation. Nutr Res. 2008 May;28(5):315-20.

58. Liu X, Wei J, Tan F, Zhou S, Würthwein G, Rohdewald P. Pycnogenol, French maritime pine bark extract, improves endothelial function of hypertensive patients. Life Sci. 2004 Jan 2;74(7):855-62.

59. Rohdewald P. A review of the French maritime pine bark extract (pycnogenol), a herbal medication with a diverse clinical pharmacology. Int J Clin Pharmacol Ther. 2002 Apr;40(4):158-68.

60. Erlund I Koli R, Alfthan G, et al. Favorable effects of berry consumption on platelet function, blood pressure, and HDL cholesterol. Am J Clin Nutr. 2008;87:323-31.

61. Aviram M, Rosenblat M, Gaitini D, et al. Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation. Clin Nutr. 2004 Jun;23(3):423-33.

62. Ojeda D, Jiménez-Ferrer E, Zamilpa A, et al. Inhibition of angiotensin converting enzyme (ACE) activity by the anthocyanins delphinidin- and cyanidin-3-O-sambubiosides from Hibiscus sabdariffa. J Ethnopharmacol. 2009 Oct 4.

63. Xu JW, Ikeda K, Yamori Y. Upregulation of endothelial nitric oxide synthase by cyanidin-3-glucoside, a typical anthocyanin pigment. Hypertension. 2004 Aug;44(2):217-22.

64. Guerrera MP, Volpe SL, Mao JJ. Therapeutic uses of magnesium.Am Fam Physician. 2009 Jul 15;80(2):157-62.

65. Pham PC, Pham PM, Pham PT, et al. The link between lower serum magnesium and kidney function in patients with diabetes mellitus Type 2 deserves a closer look. Clin Nephrol. 2009 Apr;71(4):375-9.

66. Kawano Y, Matsuoka H, Takishita S, Omae T. Effects of magnesium supplementation in hypertensive patients: assessment by office, home, and ambulatory blood pressures. Hypertension. 1998 Aug;32(2):260-5.

67. Rayssiguier Y, Gueux E, Nowacki W et al. High fructose consumption combined with low dietary magnesium intake may increase the incidence of the metabolic syndrome by inducing inflammation. Magnes Res. 2006 Dec;19(4):237-43.

68. Hatzistavri LS, Sarafidis PA, Georgianos PI, et al. Oral magnesium supplementation reduces ambulatory blood pressure in patients with mild hypertension. Am J Hypertens. 2009 Oct;22(10):1070-5.

69. Baker WL, Kluger J, White CM, et al. Effect of magnesium L-lactate on blood pressure in patients with an implantable cardioverter defibrillator. Ann Pharmacother. 2009 Apr;43(4):569-76.

70. Guerrero-Romero F, Rodríguez-Morán M. The effect of lowering blood pressure by magnesium supplementation in diabetic hypertensive adults with low serum magnesium levels: a randomized, double-blind, placebo-controlled clinical trial. J Hum Hypertens. 2009 Apr;23(4):245-51.

71. Geleijnse JM, Giltay EJ, Grobbee DE, et al. Blood pressure response to fish oil supplementation: metaregression analysis of randomized trials. J Hypertens. 2002 Aug;20(8):1493-9.

72. Cicero AF, Ertek S, Borghi C. Omega-3 polyunsaturated fatty acids: their potential role in blood pressure prevention and management. Curr Vasc Pharmacol. 2009 Jul;7(3):330-7.

73. da Luz PL, Coimbra SR. Wine, alcohol and atherosclerosis: clinical evidences and mechanisms. Braz J Med Biol Res. 2004 Sep;37(9):1275-95.

74. Guarente L. Sirtuins in aging and disease. Cold Spring Harb Symp Quant Biol. 2007;72:483-8.

75. Inanaga K, Ichiki T, Matsuura H et al. Resveratrol attenuates angiotensin II-induced interleukin-6 expression and perivascular fibrosis. Hypertens Res. 2009 Jun;32(6):466-71.

76. Labinskyy N, Csiszar A, Veress G, et al. Vascular dysfunction in aging: potential effects of resveratrol, an anti-inflammatory phytoestrogen. Curr Med Chem. 2006;13(9):989-96.

77. Takahashi S, Uchiyama T, Toda K. Differential effect of resveratrol on nitric oxide production in endothelial f-2 cells. Biol Pharm Bull. 2009 Nov;32(11):1840-3.

78. Ruggenenti P, Cattaneo D, Loriga G, et al. Ameliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: effects of acetyl-L-carnitine therapy. Hypertension. 2009 Sep;54(3):567-74.

79. Brotman DJ, Davidson MB, Boumitri M, Vidt DG. Impaired diurnal blood pressure variation and all-cause mortality. Am J Hypertens. 2008 Jan;21(1):92-7.

80. Scheer FA, Van Montfrans GA, van Someren EJ, et al. Daily nighttime melatonin reduces blood pressure in male patients with essential hypertension. Hypertension. 2004 Feb;43(2):192-7.

81. Grossman E, Laudon M, Yalcin R, et al. Melatonin reduces night blood pressure in patients with nocturnal hypertension. Am J Med. 2006 Oct;119(10):898-902.