Managing Hypertension by Polyphenols

Abstract

!Hypertension is the most important risk factor in the development of cardiovascular diseases (CV) but its pathophysiology remains incompletely understood. Hypertension is clinically defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg. Taking an antihypertensive medication is also used as an alternative description. The publication of multiple hypertension guidelines reflects a continuous debate and an unsolved issue. The upper levels of normal ranges of blood pressure (BP) are based on, firstly, epidemiological findings relating BP levels to risks for adverse outcomes and, secondly, clinical trials demonstrating a reduced risk of adverse outcomes with antihypertensive therapies. Recently, members appointed to the Eighth Joint National Committee, independent of any sponsoring agency, have updated the management of high BP [1]. The recommendation to change the treatment goal for individuals aged 60 years or older with hypertension has raised some concerns in scientific associations with an interest in hypertension. The new guideline sets goals for SBP and diastolic DBP at less than 150/90 mmHg (previously 140/90 mmHg) in these patients. The diastolic goal of less than 90 mmHg is also recommended for hypertensive persons 30 through 59 years of age. They did not find evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, and recommend a BP of less than 140/90 mmHg for those groups. It is generally accepted that among patients with hypertension, those with an elevated SBP carry the highest risk for cardiovascular events but once the SBP is below 140 mmHg, the risk of incident CV does not change [2]. Relevant to our discussion, the diagAbstract ! Some polyphenols, obtained from plants of broad use, induce a favorable endothelial response in hypertension and beneficial effects in the management of other metabolic cardiovascular risks. Previous studies in our laboratories using the calyces of Hibiscus sabdariffa as a source of polyphenols show that significant effects on hypertension are noticeable in humans only when provided in high amounts. Available data are suggestive in animal models and ex vivo experiments, but data in humans are difficult to acquire. Additionally, and despite the low bioavailability of polyphenols, intervention studies provide evidence for the protective effects of secondary plant metabolites. Assumptions on public health benefits are limited by the lack of scientific knowledge, robust data derived from large randomized clinical trials, and an accurate assessment of the bioactive components provided by common foodstuff. Because it is likely that clinical effects are the result of multiple interactions among different polyphenols rather than the isolated action of unique compounds, to provide polyphenol-rich botanical extracts as dietary supplements is a suggestive option. Unfortunately, the lack of patent perspectives for the pharmaceutical industries and the high cost of...

Beneficial Effects of Chlorogenic Acids on Essential Hypertension

“…There are several studies that related CGAs properties with an improvement of glucose and insulin metabolism [20] . Knowing that hypertension is the most important risk factor in the development of cardiovascular diseases (CV) [21] , it could represent a relevant target of reducing the cardiovascular risk; in agreement with several studies showing that the use of green coffee extracts (GCEs)causes decreased values of blood pressure in humans [22] . Those effects have been attributed to the polyphenols present in the GCEs.…”

A comparative cross-sectional study of some hematological parameters of hypertensive and normotensive individuals at the university of Gondar hospital, Northwest Ethiopia

“…Systolic pressure is occurring during contraction of the left ventricle of the heart while diastolic pressure is occurring before the next contraction. Normally at rest the systolic pressure is within 100–140 mm mercury (mmHg) and diastolic pressure is within 60–90 mmHg [ 2 , 3 ]. Based on the seventh Joint National Committee (7 JNC) report in 2008, normal HTN was defined as systolic blood pressure (SBP) < 120 mmHg and diastolic blood pressure (DBP) < 80 mmHg, pre-HTN with SBP of 120-139 mmHg or DBP 80–89 mmHg, stage I HTN with SBP of 140–159 mmHg or DBP 90–99 mmHg and stage II HTN with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg [ 1 , 4 ].…”

Dietary intake of total polyphenols and the risk of all-cause and specific-cause mortality in Japanese adults: the Takayama study

“…The results of many studies support the beneficial effects of polyphenols on the major risk factors for CVD such as hypertension [30,31] and diabetes [32,33]. The most persuasive concept regarding the mechanism of lowering blood pressure is an increase in nitric oxide production plus an improvement of endothelial function [34].…”