Life Extension Magazine®
The World Health Organization has determined that hypertension is the leading cause of cardiovascular mortality.1
It affects as many as 1.5 billion people worldwide and is a major risk factor for atherosclerosis.
Drug therapy for hypertension is often comprised of one or a combination of medications that may include an angiotensin II receptor blocker, calcium channel blocker, beta blocker, angiotensin converting enzyme (ACE) inhibitor, and/or a diuretic.2,3
Some of these drugs and drug combinations have potential side effects, which is troubling since blood pressure medications may be required for the rest of a person’s life.4,5 That does not mean a person with hypertension should discontinue their prescribed medications. But if natural approaches can reduce blood pressure readings so that drug doses can be reduced or eliminated, then side effect concerns can be mitigated.
In an exciting new discovery, scientists have uncovered two natural extracts that have similar mechanisms to some of the most effective drug therapies for hypertension.
Olive leaf extract has been shown to function as an ACE inhibitor and celery seed extract has potent calcium channel blocking properties.6,7 Clinical studies have demonstrated that both extracts are able to safely lower blood pressure.8,9
These specialized extracts offer a natural approach to blood pressure management.
Current Treatments For Hypertension
Numerous recent, large, randomized clinical trials have indicated that treating hypertension in older adults can reduce the risk of kidney disease, stroke, and cardiovascular events.10 Unfortunately, bringing blood pressure down to healthy levels is easier said than done.
Many clinicians start therapy with a mild diuretic (“water pill”) at low doses, then gradually increase doses until either blood pressure is controlled or the maximum dose is reached.10
However, nearly 75% of patients do not get adequate blood pressure control on a single drug, which means a second medication is often necessary.11 This process may continue until a person finds himself or herself on three, four, or more drugs.2,11,12
A frequently prescribed class of antihypertensives used today are the angiotensin II receptor blockers. These drugs block the angiotensin II receptor and often induce more profound and sustained blood pressure control than older classes of medications. However, there are side effect risks associated with angiotensin II receptor blocker drugs. In some individuals, angiotensin II receptor blockers can cause an increase in potassium and changes in kidney function. Also, do not take angiotensin receptor blockers if you are pregnant or plan on becoming pregnant because this class of medication can cause harm to the fetus.
One of the most commonly used approaches to treating hypertension involves the combination of two drugs: an ACE inhibitor and a calcium channel blocker.2,3 A large 2013 study demonstrated that for most people, this combination was more effective at reducing cardiovascular consequences of hypertension than using either drug with a diuretic.13 This combination also demonstrated the greatest probability of reducing death.14
Here’s how the combination drug therapy works.
Angiotensin converting enzyme, or ACE, is a natural enzyme in the body that activates the hormone angiotensin, which causes blood vessels to constrict, thus increasing blood pressure.15 Inhibiting ACE can return blood pressure to lower levels. ACE inhibitors alone, however, are not always entirely effective, which is why doctors often combine them with a second drug called a calcium channel blocker.16
Calcium channel blockers lower blood pressure by a different mechanism than ACE inhibitors. They prevent the entry of calcium ions into muscle cells in the arterial wall. Since calcium ions are a major signal telling those cells to contract and raise muscle tone in the artery, blocking calcium influx into the cells will prevent contraction and lower blood pressure.17
Use of the combination of an ACE inhibitor and a calcium channel blocker has become one of the mainstays of modern pharmacological blood pressure control, since the two drugs act in parallel, but different ways. Unfortunately, as is usually the case, both drugs bring with them side effects.17,18
Scientists have discovered two natural ingredients that work in ways similar to mainstream drugs, but without the numerous side effects. Olive leaf extract and celery seed extract act as ACE inhibitors and calcium channel blockers, respectively.6,7 Each has been shown in clinical studies to lower blood pressure.
What You Need To Know
Natural Extracts Lower Blood Pressure
- High blood pressure (hypertension) is the leading cause of cardiovascular disease and is an important contributor to premature death and disability.
- Despite widespread awareness of hypertension as a health threat, only a minority of Americans manage to control their blood pressure.
- Patients using prescription medications may have to take two or more drugs before their blood pressure is controlled.
- One of the most effective drug combinations pairs an angiotensin converting enzyme (ACE) inhibitor with a calcium channel blocker.
- New scientific evidence shows that olive leaf extract provides ACE inhibition, while celery seed extract offers calcium channel blocking effects.
- Each of these supplements has independently been shown to lower blood pressure in human trials.
- ACE inhibition plus calcium channel blocking effects are available through the use of the natural ingredients olive leaf and celery seed extract.
Olive Leaf Extract: A Natural ACE Inhibitor
Extracts from leaves of the olive tree (Olea europaea) contain compounds known as secoiridoid glycosides.6 When ingested, these substances break down into molecules with the ability to inhibit angiotensin converting enzyme (ACE) and its harmful effects on blood vessels.6,19 Studies now show that olive leaf extract is effective at lowering blood pressure, just as would be expected from an ACE inhibitor.20
In preclinical trials, researchers found that when they gave rats an olive leaf extract at the same time as hypertension-inducing chemicals, it prevented them from developing experimentally induced hypertension.21 Similarly, in rats that had already been hypertensive for six weeks, administration of olive leaf extract normalized blood pressure, even when the rats continued receiving the hypertension-inducing chemical.21 Animal studies have also shown that olive leaf extract is effective at reducing the signs of metabolic syndrome, a major cardiovascular risk factor.22
Human studies have been extremely encouraging as well. A cleverly designed human trial using identical twins demonstrated the antihypertensive effects of olive leaf extract, with one twin serving as a control.8 Treated twins received either 500 or 1,000 mg/day of the extract while the other received advice regarding a “favorable lifestyle.”
After eight weeks, compared to their controls, twins taking 500 mg/day saw an average drop in systolic pressure of 6 mm Hg, while the twins taking 1,000 mg/day saw an average drop in systolic pressure of 13 mm Hg. In the group taking the higher dose, blood pressure fell from an average of 137/80 at baseline to 126/76 after eight weeks and LDL cholesterol was also reduced.
Olive leaf extract was recently compared directly with the ACE inhibitor captopril in patients with Stage I hypertension and it was found to be almost equally as effective.20 The extract dose was fixed at 500 mg twice daily for the eight weeks of the study, while captopril dosing started at 12.5 mg twice daily, and increased to 25 mg twice daily if needed for blood pressure control.
At the end of the study, both groups experienced significant reductions in systolic and diastolic blood pressure as compared to baseline. The olive leaf extract group experienced a mean systolic blood pressure reduction of 11.5 mm Hg, while the captopril group reduced systolic blood pressure by 13.7 mm Hg. Diastolic pressures fell 4.8 mm Hg in the olive leaf extract group and 6.4 mm Hg in the captopril group. The differences between groups were not statistically significant.20
In addition, triglyceride levels fell significantly from baseline in the olive leaf supplemented group but not in the drug group. This important study showed that olive leaf extract was similar in effect to the ACE-inhibiting drug, but with the added benefit of triglyceride reduction.
A subsequent human study showed that olive leaf extract could also improve insulin sensitivity by 15% in overweight middle-aged men, an important step in further reducing cardiovascular risk.23 It also led to a 28% improvement in pancreatic responses to blood sugar.
Why At-Home Blood Pressure Testing is So Important
To ensure that the drugs, nutrients, and lifestyle changes you are using to combat hypertension are achieving optimal results, have your blood pressure checked regularly.
Ideally this should be done every 12 hours initially using an at-home monitoring device.
The reason you should check every 12 hours is that some blood pressure drugs wear off after 12-18 hours, leaving you vulnerable to considerable periods of higher-than-desired blood pressure. It’s during periods of high blood pressure that damage to the delicate endothelial linings of our arteries occurs.
Once you have established a program of drugs, nutrients, and/or lifestyle that produces reliable optimal blood pressure ranges, then testing several times a week should be adequate for most people.
Relying only on your doctor to check your blood pressure exposes you to long periods when your blood pressure could be dangerously elevated without you or your doctor knowing it. We offer an at-home blood pressure testing device. You can also purchase one at your local pharmacy.
Celery Seed Extract: A Natural Calcium Channel Blocker
Celery is a simple food with a complex chemical makeup. Studies show that celery seed components produce a relaxing, dilating effect that lowers blood pressure. This appears to occur, at least in part, by blocking or antagonizing the flow of calcium into muscle cells lining blood vessels—similar to the action performed by calcium channel blocking drugs.7,24,25 One key blood pressure-lowering compound in celery seeds has the technical name of L-3-n-butylphthalide, abbreviated as 3nB.26,27
3nB has been used in a number of studies for the management of vascular diseases in the brain, such as stroke and vascular dementia.26,28,29 And even now, a synthetic form of 3nB is being developed as a drug in China for the treatment of cerebral ischemic stroke and mild cognitive impairment as well as for the prevention of Alzheimer’s disease—all of which have components of abnormalities in blood flow.26,30-33
Animal and lab studies reveal that 3nB-rich extracts of celery seeds produce blood pressure reductions of up to 38 mm Hg in hypertensive rats (this effect was not seen in those with normal blood pressures).27 Animal studies also demonstrate that celery seed extract has no significant toxic effects even at very high doses.34
A human study demonstrating the effectiveness of a celery seed extract standardized to 85% 3nB recently appeared in the Natural Medicine Journal.9 For the study, 30 middle-aged patients with mild-to-moderate hypertension took 75 mg doses of a celery seed extract twice daily for six weeks. To obtain an equivalent amount of 3nB, one would have to consume approximately 530 stalks (nearly 50 pounds) of celery.
Mean blood pressures at baseline were 139.4/85.4 mm Hg. At three weeks, they fell to 134.8/80.9, and at six weeks they fell to 131.2/76.9. This represents total drops of 8.2 mm Hg systolic and 8.5 diastolic from baseline.
Of great importance, while pharmacological calcium channel blockers and ACE inhibitors are known to reduce blood flow to the brain—which can leave patients feeling tired, depressed, dizzy, or forgetful—celery seed extracts rich in 3nB appear to improve brain blood flow, prevent stroke, and may protect brain cells and enhance their energy consumption.9,30,33,35
The Dangers Of High Blood Pressure
Hypertension is classified as blood pressure greater than 139/89 mm Hg.
It is now reported that once you are older than 50, a systolic (top number) blood pressure higher than 140 mm Hg is a greater cardiovascular risk factor than diastolic (bottom number) pressure.42 As blood pressure increases, cardiovascular disease risk rises rapidly. Beginning at 115/75, risk doubles for each additional 20/10 mm Hg rise. Even among those with normal pressures at age 55, the lifetime risk for developing hypertension is 90%.42
Although the consequences of untreated hypertension take time to develop, they are deadly when they arise and can include coronary artery disease, heart failure, and atrial fibrillation, a common arrhythmia.45
There is now evidence that cardiac disease related to hypertension has its origins early in life.45 Arterial stiffening, occurring with age and advancing atherosclerosis, is a major underlying cause of adult hypertension, especially so-called “isolated systolic hypertension,” in which only the systolic (top) number in the measurement is elevated.46 Stiff arteries create “back pressure” on the heart, which not only further raises blood pressure, but also puts extreme stress on the heart muscle, leading eventually to heart failure, coronary artery disease, stroke, vascular dementia, and chronic kidney disease.46
Hypertension: The Silent Killer
Olive leaf and celery seed extracts could not have been developed at a better time. Hypertension is quickly becoming a global epidemic.1 It is estimated that nearly 30% of adults around the globe have hypertension36—and that percentage climbs to 75% in some European nations.37 Even in the US, which has one of the highest rates of awareness of the disease, hypertension affects between nearly 30 to 50% of the population.37-39
Hypertension has long been known as the “silent killer.”8,40 Despite increased awareness and treatment of hypertension, it is estimated that more than 50% of people worldwide with high blood pressure are unaware of their condition, and only a minority have been able to achieve control of their blood pressure.41,42
If you’re unsure of your blood pressure levels, you should have them tested as soon as possible. Life Extension suggests that optimally, blood pressure should be maintained at 115/75 mm Hg. Blood pressure levels greater than 139/89 mm Hg should be treated right away. Talk to your doctor about possible treatments and consider adding the combination of celery seed extract and olive leaf extract to your treatment plan.
Rather than blindly assuming anything works, obtain an at-home blood pressure monitor to ensure that the drugs, nutrients, and lifestyle changes you are using to lower blood pressure are achieving optimal results.
Are You Predisposed To High Blood Pressure?
Many conditions cause or predispose a person to having hypertension.
Over 25% of US adults have metabolic syndrome, which includes hypertension as one of its defining features.47
Obesity, another component of metabolic syndrome, is a leading cause of high blood pressure, with 60 to 70% of hypertension in adults related to excess body fat, especially “central” obesity located around the abdomen.48 Being overweight or obese is associated with a significantly increased risk of hypertension compared with people of normal weight.49,50 Obesity imposes unusual stresses on the body’s self-regulatory mechanisms, among which are over-activation of the renin-angiotensin-aldosterone hormone system, which promotes fluid retention and boosts blood pressure.48,51
High levels of uric acid in the blood is directly related to hypertension. In one study, people with high uric acid levels were 2.6 times more likely to have high blood pressure than those with normal levels. And people with both high uric acid and obesity were more than 4.5 times as likely to be hypertensive, compared with normal-weight people with normal uric acid levels.50
Another cause of hypertension is obstructive sleep apnea (also called obstructive sleep apnea-hypopnea syndrome), in which a person’s breathing temporarily ceases or becomes very shallow during sleep.52 In one study, over 50% of people with the syndrome had hypertension compared with only 30% in controls.52
Regardless of the cause of hypertension, it is essential to treat it.
While most Americans are aware of hypertension’s risks and many are receiving treatment, only a minority have been able to successfully control their blood pressure. The colored bars above represent the percentages of American adults who express awareness of the dangers of hypertension, those who are being treated for hypertension, and those who have their hypertension under control. Each color represents a different National Health and Nutrition Examination Survey (NHANES) study, which began in 1976.
Summary
Despite billions of dollars spent on drugs to lower blood pressure,43 Americans are still losing the battle to keep their hypertension under control. Even drugs that are effective at bringing down high blood pressure have uncomfortable, sometimes dangerous, side effects.
One of the most effective blood pressure drug combinations is an ACE inhibitor paired with a calcium channel blocker. But for those with early or mild-to-moderate hypertension (Stage I), ACE inhibition and calcium channel blocking may be accomplished with extracts from olive leaf and celery seed, respectively. Even those with more advanced cases of hypertension may be able to reduce their dosing of drugs by adding this nutrient combo.
Clinical studies show that each of these supplements alone is effective at significantly lowering blood pressure, generally without the adverse effects often associated with prescription medications. Using olive leaf and celery seed extract together is a powerful natural combination modeled on solid science.
If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.
References
- Chockalingam A. World Hypertension Day and global awareness. Can J Cardiol. 2008 Jun;24(6):441-4.
- Leon MM, Mitu F. The clinical-epidemological study of drugs used to treat arterial hypertension and associated comorbidities. Rev Med Chir Soc Med Nat Iasi. 2013 Apr-Jun;117(2):488-94.
- Edelman DA, Paul RA. Does combination therapy with a calcium channel blocker and an ACE inhibitor have additive effects on blood pressure reduction? Int J Clin Pract. 2000 Mar;54(2):105-9.
- Available at: http://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=1&contentid=788 . Accessed July 16, 2014.
- Available at: http://www.heart.org/heartorg/conditions/highbloodpressure/preventiontreatmentofhighbloodpressure/prevention-treatment-of-high-blood-pressure_ucm_002054_article.jsp . Accessed July 16, 2014.
- Hansen K, Adsersen A, Christensen SB, Jensen SR, Nyman U, Smitt UW. Isolation of an angiotensin converting enzyme (ACE) inhibitor from Olea europaea and Olea lancea. Phytomedicine. 1996 Mar;2(4):319-25.
- Jorge VG, Angel JR, Adrian TS, et al. Vasorelaxant activity of extracts obtained from Apium graveolens: possible source for vasorelaxant molecules isolation with potential antihypertensive effect. Asian Pac J Trop Biomed. 2013 Oct;3(10):776-9.
- Perrinjaquet-Moccetti T, Busjahn A, Schmidlin C, Schmidt A, Bradl B, Aydogan C. Food supplementation with an olive (Olea europaea L.) leaf extract reduces blood pressure in borderline hypertensive monozygotic twins. Phytother Res. 2008 Sep;22(9):1239-42.
- Madhavi D, Kagan D, Rao V, Murray MT. A pilot study to evaluate the antihypertensive effect of a celery extract in mild to moderate hypertensive patients. Nat Med J. 2013;4(4):1-3.
- Kithas PA, Supiano MA. Practical recommendations for treatment of hypertension in older patients. Vasc Health Risk Manag. 2010;6:561-9.
- Gorostidi M, de la Sierra A. Combination therapy in hypertension. Adv Ther. 2013 Apr;30(4):320-36.
- Póvoa R, Barroso WS, Brandão AA, Jardim PC, Barroso O, Passarelli O Jr, et al. I Brazilian position paper on antihypertensive drug combination. Arq Bras Cardiol. 2014 Mar;102(3):203-10.
- Riva N, Lip GY. Which is the optimal antihypertensive combination in different diseases, a renin- angiotensin-aldosterone system inhibitor with a diuretic or with a calcium channel blocker? Curr Pharm Des. 2013;19(21):3753-65.
- Wu HY, Huang JW, Lin HJ, et al. Comparative effectiveness of renin-angiotensin system blockers and other antihypertensive drugs in patients with diabetes: systematic review and bayesian network meta-analysis. BMJ. 2013;347:f6008.
- Fyhrquist F, Metsärinne K, Tikkanen I. Role of angiotensin II in blood pressure regulation and in the pathophysiology of cardiovascular disorders. J Hum Hypertens. 1995 Nov;9 Suppl 5:S19-24.
- Naidu MUR, Usha PR, Rao TRK, Shobha JC. Evaluation of amlodipine, lisinopril, and a combination in the treatment of essential hypertension. Postgrad Med J. 2000;76(896):350-53.
- Elliott WJ, Ram CV. Calcium channel blockers. J Clin Hypertens (Greenwich). 2011 Sep;13(9):687-9.
- MacNab M, Mallows S. Safety profile of benazepril in essential hypertension. Clin Cardiol. 1991 Aug;14(8 Suppl 4):IV33-7; discussion IV51-5.
- Parzonko A, Czerwinska ME, Kiss AK, Naruszewicz M. Oleuropein and oleacein may restore biological functions of endothelial progenitor cells impaired by angiotensin II via activation of Nrf2/heme oxygenase-1 pathway. Phytomedicine. 2013 Sep 15;20(12):1088-94.
- Susalit E, Agus N, Effendi I, et al. Olive (Olea europaea) leaf extract effective in patients with stage-1 hypertension: comparison with Captopril. Phytomedicine. 2011 Feb 15;18(4):251-8.
- Khayyal MT, el-Ghazaly MA, Abdallah DM, Nassar NN, Okpanyi SN, Kreuter MH. Blood pressure lowering effect of an olive leaf extract (Olea europaea) in L-NAME induced hypertension in rats. Arzneimittelforschung. 2002;52(11):797-802.
- Poudyal H, Campbell F, Brown L. Olive leaf extract attenuates cardiac, hepatic, and metabolic changes in high carbohydrate-, high fat-fed rats. J Nutr. 2010 May;140(5):946-53.
- de Bock M, Derraik JG, Brennan CM, et al. Olive (Olea europaea L.) leaf polyphenols improve insulin sensitivity in middle-aged overweight men: a randomized, placebo-controlled, crossover trial. PLoS One. 2013;8(3):e57622.
- Heyen BJ, Alsheikh MK, Smith EA, Torvik CF, Seals DF, Randall SK. The calcium-binding activity of a vacuole-associated, dehydrin-like protein is regulated by phosphorylation. Plant Physiol. 2002 Oct;130(2):675-87.
- Ko FN, Huang TF, Teng CM. Vasodilatory action mechanisms of apigenin isolated from Apium graveolens in rat thoracic aorta. Biochim Biophys Acta. 1991 Nov 14;1115(1):69-74.
- Peng Y, Sun J, Hon S, et al. L-3-n-butylphthalide improves cognitive impairment and reduces amyloid-beta in a transgenic model of Alzheimer’s disease. J Neurosci. 2010 Jun 16;30(24):8180-9.
- Moghadam MH, Imenshahidi M, Mohajeri SA. Antihypertensive effect of celery seed on rat blood pressure in chronic administration. J Med Food. 2013 Jun;16(6):558-63.
- Peng Y, Hu Y, Xu S, et al. L-3-n-butylphthalide reduces tau phosphorylation and improves cognitive deficits in AbetaPP/PS1-Alzheimer’s transgenic mice. J Alzheimers Dis. 2012;29(2):379-91.
- Zhang L, Yu WH, Wang YX, et al. DL-3-n-Butylphthalide, an anti-oxidant agent, prevents neurological deficits and cerebral injury following stroke per functional analysis, magnetic resonance imaging and histological assessment. Curr Neurovasc Res. 2012 Aug;9(3):167-75.
- Chong Z, Feng Y. Protective effects of dl-3-n-butylphthalide on changes of regional cerebral blood flow and blood-brain barrier damage following experimental subarachnoid hemorrhage. Chin Med J (Engl). 1998 Sep;111(9):858-60.
- Chong Z, Feng Y. dl-3-n-butylphthalide reduces brain damage in mice with closed head injury. Chin Med J (Engl). 2000 Jul;113(7):613-6.
- Peng Y, Zeng X, Feng Y, Wang X. Antiplatelet and antithrombotic activity of L-3-n-butylphthalide in rats. J Cardiovasc Pharmacol. 2004 Jun;43(6):876-81.
- Zhang Y, Wang L, Li J, Wang XL. 2-(1-Hydroxypentyl)-benzoate increases cerebral blood flow and reduces infarct volume in rats model of transient focal cerebral ischemia. J Pharmacol Exp Ther. 2006 Jun;317(3):973-9.
- Powanda MC, Rainsford KD. A toxicological investigation of a celery seed extract having anti-inflammatory activity. Inflammopharmacology. 2011 Aug;19(4):227-33.
- Peng Y, Xu S, Chen G, Wang L, Feng Y, Wang X. l-3-n-Butylphthalide improves cognitive impairment induced by chronic cerebral hypoperfusion in rats. J Pharmacol Exp Ther. 2007 Jun;321(3):902-10.
- Angeli F, Reboldi G, Verdecchia P. Hypertension around the world: new insights from developing countries. J Hypertens. 2013; 31(7), 1358-61.
- Colosia AD, Palencia R, Khan S. Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review. Diabetes Metab Syndr Obes. 2013;6:327-38.
- Egan BM, Zhao Y. Different definitions of prevalent hypertension impact: the clinical epidemiology of hypertension and attainment of healthy people goals. J Clin Hypertens (Greenwich). 2013 Mar;15(3):154-61.
- Joffres M, Falaschetti E, Gillespie C, et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study. BMJ Open. 2013;3(8):e003423.
- Kim HS, Kim DG. Effect of long-term resistance exercise on body composition, blood lipid factors, and vascular compliance in the hypertensive elderly men. J Exerc Rehabil. 2013 Apr;9(2):271-7.
- Egan BM, Li J, Shatat IF, Fuller JM, Sinopoli A. Closing the gap in hypertension control between younger and older adults: National Health and Nutrition Examination Survey (NHANES) 1988 to 2010. Circulation. 2014 May 20;129(20):2052-61.
- Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003 Dec;42(6):1206-52.
- Available at: http://meps.ahrq.gov/mepsweb/data_files/publications/st404/stat404.shtml . Accessed July 18, 2014.
- Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013 Jul;34(28):2159-219.
- Lawler PR, Hiremath P, Cheng S. Cardiac target organ damage in hypertension: insights from epidemiology. Curr Hypertens Rep. 2014 Jul;16(7):446.
- Franklin SS. Hypertension in older people: part 1. J Clin Hypertens (Greenwich). 2006 Jun;8(6):444-9.
- Falkner B, Cossrow ND. Prevalence of metabolic syndrome and obesity-associated hypertension in the racial ethnic minorities of the United States. Curr Hypertens Rep. 2014 Jul;16(7):449.
- Kotchen TA. Obesity-related hypertension: epidemiology, pathophysiology, and clinical management. Am J Hypertens. 2010 Nov;23(11):1170-8.
- Available at: http://www.sciencedaily.com/releases/2007/09/070928180348.htm. Accessed July 18, 2014.
- Han GM, Gonzalez S, Devries D. Combined effect of hyperuricemia and overweight/obesity on the prevalence of hypertension among US adults: result from the National Health and Nutrition Examination Survey. J Hum Hypertens. 2014 May 1.
- Becton LJ, Shatat IF, Flynn JT. Hypertension and obesity: epidemiology, mechanisms and clinical approach. Indian J Pediatr. 2012 Aug;79(8):1056-61.
- Wang Y, Li C, Feng L, Feng J, Cao J, Chen B. Prevalence of hypertension and circadian blood pressure variations in patients with obstructive sleep apnoea-hypopnoea syndrome. J Int Med Res. 2014 Mar 20;42(3):773-80.
- Fein A. ACE inhibitors worsen inflammatory pain. Med Hypotheses. 2009 Jun;72(6):757.