Reviewed by Dietitian Karen Ansel, M.S., RDN
Credit: Photo: Getty Images. EatingWell design.
Key Points
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Certain supplements can be harmful for individuals with high blood pressure.
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Experts in heart health have identified the most concerning supplements for hypertension.
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It is advisable to steer clear of bitter orange, licorice root, caffeine, yohimbine, and ephedra.
High blood pressure, or hypertension, occurs when blood forcefully pushes against the walls of your arteries, making your heart work harder to circulate blood. Over time, this excessive strain can damage blood vessels and increase the likelihood of severe health issues such as heart attacks and strokes. In fact, approximately half of adults in the U.S. suffer from high blood pressure, often earning the title “the silent killer” due to its subtle onset. While managing this condition typically involves lifestyle adjustments and medication, many people seek out supplements for extra support. However, not all supplements are as safe or beneficial as they may appear. Consulting cardiovascular specialists, we identify which supplements should be avoided by those with high blood pressure.
1. Bitter Orange
Bitter orange extract, obtained from the dried peel of the bitter orange fruit, is frequently included in supplements targeting weight loss and athletic performance. However, for those with high blood pressure, this extract can be particularly hazardous.
“Bitter orange contains synephrine, which can increase blood pressure and cause irregular heart rhythms,” explains Columbus Batiste, M.D., a board-certified interventional cardiologist and co-founder of Healthy Heart Nation. Research shows that continued use of bitter orange may elevate systolic blood pressure by 6 mmHg and diastolic pressure by 4 mmHg, increasing the risk of severe complications like heart attacks and strokes. It’s also commonly combined with other ingredients, so scrutinizing labels is essential.
2. Licorice Root
Famous for its unique sweetness and medicinal properties, licorice root has long been utilized to alleviate digestive troubles and respiratory infections. However, “for those suffering from high blood pressure, it is advisable to forgo licorice supplements,” cautions Michelle Routhenstein, M.S., RD, CDCES, a cardiovascular dietitian and owner of Entirely Nourished. This is due to glycyrrhizic acid, which can lead to sodium retention, potentially causing an increase in blood pressure. A study indicated that even a low dose of 100 milligrams of glycyrrhizic acid can markedly raise blood pressure when used consistently.
Additionally, licorice root can lower potassium levels, resulting in muscle weakness and irregular heart rhythms, further stressing the heart. Some licorice supplements may claim to lack glycyrrhizic acid, but since supplements are not strictly regulated like food, you may not always get what is advertised. In fact, the aforementioned study found the glycyrrhizic acid content in one tested supplement was 50% higher than the label suggested.
3. Caffeine-Containing Supplements
Caffeine is not just limited to your morning brew or afternoon tea; it is also prevalent in many supplements aimed at enhancing energy, alertness, and athletic performance. However, this stimulant can cause temporary spikes in blood pressure, making it a risky option for those with hypertension, warns Routhenstein.
Research indicates that caffeine can elevate systolic and diastolic blood pressure by 2 mmHg. While this may appear insignificant, even a slight increase can adversely affect heart health, especially in vulnerable individuals. Caffeine affects everyone differently, as personal metabolism varies. Some may experience increased blood pressure with minimal caffeine intake, and consumption can lead to higher readings.
When checking supplement labels, also look for guarana, a caffeine-rich ingredient commonly found in energy drinks and supplements that raises both heart rate and blood pressure, according to Batiste.
4. Yohimbine
Yohimbine, sourced from the bark of the yohimbe tree, features in many supplements and teas promoted for weight loss, athletic performance, and enhanced sexual health. Ironically, it is also marketed for high blood pressure. However, Batiste contends that yohimbine is a stimulant that can dangerously raise both blood pressure and heart rate. Routhenstein concurs, noting that yohimbine increases blood pressure by escalating levels of norepinephrine, a hormone that narrows blood vessels, impeding blood flow.
5. Ephedra
Ephedra, a traditional herbal remedy used for ailments like colds and headaches, gained popularity in modern dietary supplements aimed at weight loss and energy enhancement. However, it is fraught with risks. “Ephedra contains ephedrine alkaloids, potent stimulants associated with severe complications like high blood pressure, heart attacks, strokes, and even sudden death,” notes Batiste. It can also interfere with blood pressure and heart medications, diminishing their effectiveness. As a result, the Food and Drug Administration has banned ephedra from dietary supplements. While its active ingredient, ephedrine, can still be found in some asthma and allergy medications, consulting a healthcare provider is crucial before using any product containing ephedra.
Nutrition and Lifestyle Strategies for Healthy Blood Pressure
Maintaining healthy blood pressure is not solely about avoiding harmful supplements; a healthy lifestyle plays a vital role. Here are expert-recommended strategies:
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Follow the DASH Diet: The DASH diet (Dietary Approaches to Stop Hypertension) has been proven to lower blood pressure. It emphasizes fruits, vegetables, whole grains, beans, nuts, seeds, fish, lean meats, and low-fat dairy, while limiting trans and saturated fats and added sugars.
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Exercise Regularly: The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic exercise weekly, along with muscle-strengthening exercises at least twice a week.
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Prioritize Sleep: Quality sleep impacts blood pressure. Aim for seven to nine hours each night. If you snore or stop breathing during sleep, you may have sleep apnea, a hidden contributor to high blood pressure that warrants a discussion with your doctor for effective treatment.
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Manage Stress: Chronic stress can elevate blood pressure. Implementing practices such as meditation, deep breathing, engaging in enjoyable hobbies, and spending quality time with loved ones can help alleviate stress.
The Bottom Line
A myriad of supplements vie for attention with claims of health benefits. While some may indeed offer support, others can raise blood pressure or interact negatively with hypertension medications. Cardiologists and dietitians agree that certain supplements, like bitter orange, licorice root, caffeine, yohimbine, and ephedra, should be avoided by individuals with high blood pressure. With many supplements containing multiple ingredients, it’s critical to read labels carefully. Before starting any new supplement, consult your healthcare provider to ensure it’s a safe and effective choice for your health needs.
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