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How to Treat Hypertension without Prescription Drugs

on May 16, 2018

by Chris Kresser

Two-thirds of Americans have either prehypertension or hypertension, both of which are major risk factors for cardiovascular disease (CVD), the leading cause of the death in the United States. However, prescription drugs may not be necessary to treat high blood pressure. Read on to learn what dietary changes, lifestyle strategies, and supplements can help lower blood pressure naturally.


Eighty million U.S. adults, or one in three, have hypertension (1). Another one in three have prehypertension, defined as blood pressure in the range of 120–139/80–89 mmHg. In addition to costing $48.6 billion annually, hypertension is a major risk factor for cardiovascular disease, congestive heart failure, chronic renal failure, and stroke (1). Even prehypertension increases the risk of death from CVD (2). Because of its severity, hypertension requires immediate treatment, but prescription drugs may not be the answer.

Risks of blood pressure-lowering medications

Blood pressure-lowering medications include diuretics, beta-blockers, ACE inhibitors, and calcium channel blockers. Often, more than one is needed to control hypertension.

Initially, these medications were only recommended for people whose blood pressure exceeded 160/100 mmHg, but they are now routinely prescribed when blood pressure approaches 140/90 mmHg, even in the absence of any previous cardiovascular event. Treating mild hypertension with drugs has not been shown to be effective, yet it is common practice (3, 4).

Some of the risks of blood pressure-lowering medications include headaches, dizziness, depression, sleep problems, erectile dysfunction, and renal or cardiac dysfunction. Often, these side effects lead to additional prescription drugs like testosterone or Viagra. The good news is that dietary changes, lifestyle strategies, and supplements have the potential to reverse high blood pressure without the need for lifelong prescriptions.

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Nutrients for lowering blood pressure

Hypertension affects 33 percent of American adults, yet only 1 percent of hunter–gatherer populations following a traditional diet develop high blood pressure (5). The Standard American Diet, full of added sugars, refined grains, and industrial seed oils, sets the stage for hypertension to develop. The following nutrients and food guidelines, as part of a Paleo diet, can help lower blood pressure.

Sugar. Excess sugar intake increases blood pressure, and reducing added sugars lowers blood pressure (567). Added sugars can lurk in surprising foods, including salad dressings, canned beans, and bacon.

Potassium. High potassium intake is associated with lower blood pressure (8910). The average American only consumes 2,800 mg per day, far below the recommended 4,700 mg (11). Paleo diets, on the other hand, average 10,500 mg per day. Starchy vegetables and tubers are terrific sources.

Cold-water fish. Increasing serum measurements of DHA/EPA, markers of fish intake, are related to lower blood pressure (121314). However, steer clear of most fish oil supplements and instead have patients obtain beneficial nutrients from whole foods whenever possible. A recent analysis showed that the three top-selling fish oils in the United States contained oxidized lipids that may be causing more harm than good (15). Beyond DHA and EPA, fish also have selenium, zinc, iron, and a highly absorbable protein that also may reduce blood pressure (16). Aim for cold-water fatty fish three times a week.

Magnesium. High magnesium intake is associated with lower blood pressure and may have a synergistic effect with potassium. Increasing both nutrients while moderately reducing sodium can lower blood pressure to the same extent as a single medication (17). Magnesium stimulates vasodilators and can inhibit free radical formation in blood vessels (18). Nuts, seeds, spinach, beet greens, and chocolate are good whole food sources.

Vitamin K2. Adequate vitamin K2 helps keep calcium from residing in blood vessels, thereby preventing hypertension and calcification (19). Vitamins K1 and K2 have different forms and functions. Vitamin K1 is abundant in leafy greens and many other foods, while vitamin K2 sources are more uncommon: natto (fermented soy), some cheeses, butter from grass-fed cows, goose liver, and egg yolks.

Vitamin D. Vitamin D deficiency is associated with increased risk of developing hypertension (20), and large doses of vitamin D (50,000 IU per week) have been shown to lower blood pressure over eight weeks (21). One mechanism by which vitamin D may lower blood pressure is through suppressing renin, which regulates mean arterial blood pressure (22). Sun exposure is an easy and cheap way to get vitamin D.

Salt. Despite what mainstream medicine claims, restricting salt too much can actually increase the risk of death from CVD (23). Unless your patient is part of the small minority of salt-sensitive people, there is no reason to advise consuming less than 1.5 teaspoons, or 3,600 mg, per day, which is the average American consumption.

A host of other foods have been correlated with lower blood pressure: nuts (24), beet juice (2526), blueberries (27), seaweed (28), chocolate (293031), and hibiscus tea (32). Not surprisingly, all of these can be part of a Paleo diet, which has been shown to be blood pressure-lowering itself (33, 34).

Lifestyle changes are safe, effective, and underutilized

What we eat is only part of the picture of good health. Lifestyle choices carry equal weight, yet they are often only considered as afterthoughts. Take some time to seriously discuss with patients what changes need to be made.

Weight loss. Over one-third of U.S. adults are now obese. It’s no secret that gaining weight increases blood pressure, and losing weight in a healthy manner lowers blood pressure (35, 36, 37).

Exercise. Some patients will cringe at the suggestion of exercise, because they envision a chronic cardio scenario like a mouse on a running wheel. Spread the good news: exercise of all kinds—endurance, dynamic resistance, HIIT, isometric resistance—has the potential to reduce blood pressure (38). Whatever exercise your patients will actually do on a regular basis is the best recipe for success. In patients with extreme hypertension, be cautious with exercises that may further increase blood pressure to an unsafe zone (39).

Sleep. Short and poor-quality sleep are both associated with raised blood pressure (40). On the other side of the spectrum, excessively long sleep may also be harmful. One study found increased blood pressure in those who got fewer than five hours of sleep per night and in those who averaged more than nine hours of sleep per night, when compared with people who slept around seven hours (41). I suspect that it’s not the long sleep itself that is the problem, but that some underlying condition is both increasing sleep requirement and raising blood pressure.

Sunlight. Sunlight exposure increases the vasodilator nitric oxide and can lower blood pressure. UVB rays also help manufacture subcutaneous vitamin D3, a nutrient already discussed above (42).

Meditation. Meditation of all types is associated with blood pressure control, enhanced insulin resistance, and reduced lipid peroxidation (43). Its relaxing effects on the nervous system are effective in both young and older adults (44, 45).

Stress management. I have several articles about the importance of stress management, as stress is a major risk factor for high blood pressure and CVD (46). Self-care, proper sleep, and letting go of “busyness” are several strategies.

Other effective activities for reducing blood pressure include tai chi (47, 48), listening to music (49, 50), biofeedback (51), and deep breathing (52).

Knowing what changes to make is only the first step; following through in sustainable, practical ways is the tougher aspect of healthy living. This is where health coaching, one of the fastest-growing professional fields, can make all the difference. Many patients know what diet and lifestyle changes are needed, but they have trouble following through day to day. A health coach can provide the more frequent support and accountability that a general healthcare provider cannot.

Supplements for lowering blood pressure

Below are supplements I recommend for lowering blood pressure. However, prescription medications should be considered if diet and lifestyle aren’t adequate or if blood pressure has been high for a while because high blood pressure is such a significant risk factor for CVD and death.

CoQ10. CoQ10 is an antioxidant that has vasodilation effects (53). Levels are generally lower in patients with high blood pressure, CVD, and type 2 diabetes. Newer formulas help improve absorption of this fat-soluble supplement.

Garlic. Allicin, found in garlic, is a vasodilating agent and can reduce blood pressure (54, 55). Because heat during processing can lower the allicin content of supplements, not all products are equal. My preference is Garlicin.

Magnesium. Doses of 500 to 1,000 milligrams per day can have a small but significant effect on lowering blood pressure (56, 57). Chelated forms like magnesium glycinate are best absorbed.

Potassium. Supplementing with 1,000 to 2,000 milligrams per day of potassium can be effective, especially when dietary potassium is inadequate, such as when a patient is on a low-carb diet and avoiding starchy foods like potatoes, sweet potatoes, plantains, and bananas (58).

Cod liver oil. If patients are not eating cold-water fatty fish a few times a week, one gram per day of cod liver oil may help.

Now I’d like to hear from you. Have you had success treating high blood pressure with any of the strategies or supplements above? Does your practice have health coaches to help patients implement lifestyle and diet changes? Let us know in the comments below!

25 Comments

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  1. Hello all,

    I have had “pre hypertension” with BPs of 135/90. I started a twice a day meditation/deep breathing practice, and an attitude shift away from “being busy”, and my BP fell to the 110/70 range. This process works. I am a physician myself. Go for it. Don’t fall for the myth that everyone has to be on physician prescribed medications for virtually every health issue in the galaxy.

  2. Hey Chris,
    I am reading your newsletter since quite a while and I read “Your personal Paleo Cure” recently.
    My BP was 145 / 85 some months ago. Now I’m including movements into my life (exercise, bike, walk) and I changed my diet to vegetable oil free and grain free whole foods.

    Its amazing, I had acid reflux since I was 19 and took PPIs for years –> Dont need them anymore! And my BP is down to 125/70

    I can really only recommend to people to try and change things instead of accepting modern “realities” that seem to be “laws of nature” – they’re NOT!

  3. Chris, this is just an excellent article that l am sure is going to help millions of people suffering from hypertension. Thank you so much for this information.

  4. Chris, I often hear a lot of health Gurus mention high doses of Magnesium supplementation, but the upper limit for supplementation is established at 350mg/day. Wouldn’t 500mg to 1000mg taken daily cause issues? I know personally if I take 400mg/day long enough I start getting symptoms that go away when ceasing the Magnesium.

    • I will second that, to much mag is bad for the heart is my understanding. I was taking 300 to 400 a day and my intercellular levels when tested were way high. Living life in moderation and finding balance is the key. Supplementation and meds can throw that balance out of whack…then you get sick.

      • Very curious to see if Chris has any thoughts on this; I have had similar experiences with over 400 mg of magnesium in any form.. I’ve tried various chelates versions. I’m also wary of mega-dosing with supplements. My father has tried all kinds of mega-doses of all these things over the last decade to get off meds and still ends up with scarily high bp after a month or so off meds. Everything in moderation and I think sometimes that has to include conventional medication. Side effects at this late stage in his life can’t be as bad as a potentially debilitating stroke 🙁

      • Chris,
        Thank you for your informative post. Can you please address the question about the risks of too much Mag?

        My husband has high blood pressure which is currently being treated with two medications and some supplements. The medication has brought it down from 180 to 140/90, but it has plateaued at the maximum dose of the meds. 180 is very dangerous so I don’t feel good about going off the medication. I am hopefull some of your suggestions will bring it down to a healthy range.

    • With magnesium, my understanding is that the actual rate of absorption varies enormously between types. Further, any oral form significantly reduces absorption to about 20%. So 1000 mg of a good chelated form is internalised as 200 mg. I have seen an Epsom salts bath three times weekly proposed as a cheaper and better alternative due to it being absorbed through the skin. Another alternative is liquid magnesium but in that case dosage is not controlled.

    • This is an interesting thread. I take 400 mg per day of Magnesium on the advice of my naturopath, have done so for a few years now, with some cycling on and off. I successfully manage my tendency towards hypertension through this one simple action (although constantly improving my health in other ways has its’ effects I’m sure!). I find when I cycle off it for too long I start to get muscle cramps and insomnia as well. I have observed a familial link between muscle pain and cramps in my maternal lineage, and believe there is some kind of genetic/epigenetic link to how our family utilises Mg in the body although I have no proof or idea of the mechanism of this. All I know is I’d prefer to supplement Mg moderately than take pharmaceuticals. I look forward to the day I can explain this with science (as I’m a scientist!) – would love any thoughts from Chris or the Kresser Institute experts on this 😊

  5. You didn’t mention the number one element lacking, particularly in the aging – water. Adequate water keeps vessels fuller and easier to pump. I have tried all of your listed suggestions above. None worked until I began hydrating adequately. Was 165/85, now 130/75. I am 74.

  6. “The three top selling fish oils” should be “Three of the top selling fish oils” – the study does not say they were the top three.

  7. If you use a well rounded approach and don’t over supplement on any one thing, you should be fine and reap the benefits. Also, if I ever get high blood pressure, I would have my levels tested on what Chris mentions above. This way you have a clue as to what You should supplement and the proper dosing. Sleep is one thing I have not mastered yet, but I’m working on it.

  8. I’ve heard in the past that deep slow breathing is one of the fastest ways to reduce high blood pressure. Most people breathe very shallow and fast, and this is not optimum for many body systems. I can’t find the references at the moment — but I swear studies have been done showing that deep breathing’s effects last for many hours after you finish. There’s a great app called Breathing Zone which can help guide you to the therapeutic rate of breathing. It’s great for those who are not “meditation or yoga types.”

  9. For most part I stay away from supplementing anything other than protein powder .There was a time when I figured the more supplements the better and my stomach soon said otherwise .The biggest key in my health and we’ll being has been staying active as much as possible .my job requires me to be constantly moving throughout day so I’ve got lots of energy afterwork compared to a sedentary job .My whole world changed once I incorporated proper balance in my life with my family , work and play time 🙂

  10. Hi Chris,
    Very educational all your emails. But what about hypotension, low blood pressure. Cause symptoms and there is nothing to treat that. Many doctors recommend to increase sodium in meals, also drink coffee. This is not a healthy advise. Please, can you write about that. There is any treatment for that? Could you help me?

  11. Ayush herbs makes a great supplement for BP…Carditone
    Aurvedic formula combined with magnesium…I say a lot of it in my BP lecture I give, and I am always honored when I see I am on the same page as Chris : )
    Great article!

  12. Hi Chris

    I am now in menopause and my BP despite doing most of the natural approaches remains high unless I do a detox or something short term. Is there something more relevant for women in early years of menopause?

  13. I do all of that. I as on bp meds for 10 years, got sick in 2008, went off all pharma meds, got lots of help from alternative medicine, was off all pharma meds for 9 years and completely and totally changed my diet and lifestyle, then in Oct 2016 my bp started to climb again and, after I had hernia surgery in Nov 2016, my bp went sky-high and won’t come back down no matter what alternative thing I do and won’t stay down unless I am taking bp pills. My primary doctor and cardiologist are trying to say I have essential hypertension–when I was off all bp and pharma meds for 9 years and had no issues with my bp. Nope. Not buying it. Baffled to the high heavens why this time, I can’t seem to get back off bp meds. Working on lots of different things, but haven’t found that magic “aha” item that is causing this yet. Started NP Thyroid and low-dose Naltrexone for hypo/Hashi and all-over body pain/autoimmune and am hoping once they help stabilize my body processes that maybe they will also impact the hbp. Also naturally taking care of female hormones that are off (postmenopausal at age 50).

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