Are there any natural supplements that work similarly to Angiotensin-Converting Enzyme (ACE) inhibitors?

From the Guidelines

Natural supplements such as garlic extract, fish oil, hibiscus tea, whey protein, and pomegranate extract may have effects similar to ACE inhibitors, but their potency and efficacy are generally less than pharmaceutical ACE inhibitors, and they should not replace prescribed medications without medical supervision. Several natural supplements have been studied for their potential to lower blood pressure and improve cardiovascular health, similar to the effects of Angiotensin-Converting Enzyme (ACE) inhibitors.

• Garlic extract has shown modest blood pressure-lowering effects by inhibiting angiotensin II production, with typical doses ranging from 600-1200mg daily of aged garlic extract 1.
• Fish oil (omega-3 fatty acids) at 2-4g daily may help reduce blood pressure through multiple mechanisms, including effects on the renin-angiotensin system 1.
• Hibiscus tea, consumed as 1-2 cups daily, contains anthocyanins that may have mild ACE inhibitory effects 1.
• Whey protein (20-50g daily) contains bioactive peptides that can inhibit ACE activity 1.
• Pomegranate extract (about 500mg daily) contains polyphenols with ACE inhibitory properties 1. These supplements work by either directly inhibiting ACE or through related pathways that affect blood pressure regulation. However, it is essential to note that the evidence for these supplements is generally less robust than for pharmaceutical ACE inhibitors, and they should not be used as a replacement for prescribed medications without consulting a healthcare provider, especially for patients with hypertension or cardiovascular disease 1. The most critical consideration is to prioritize prescribed medications and consult with a healthcare provider before starting any supplement regimen, as the potential benefits of natural supplements may not outweigh the risks of uncontrolled hypertension or cardiovascular disease. In the context of real-life clinical medicine, the use of natural supplements should be approached with caution, and patients should be advised to consult with their healthcare provider before starting any supplement regimen, especially if they have a history of hypertension or cardiovascular disease 1.

From the Research

Natural Supplements and ACE Inhibitors

• There are natural supplements that have been found to have Angiotensin-Converting Enzyme (ACE) inhibitory activities, which may work similarly to ACE inhibitors 2.
• These natural ACE inhibitors include alkaloids, amino acids, anthocyanidins, flavonoids, glucosinolates, isoflavonoids, phenolic acids, polyphenolics, and triterpenoids, which can be found in various herbs such as Rosmarinus officinalis, Hibiscus sabdariffa, and Curcuma longa 2.
• Some studies suggest that omega-3 fatty acids may have cardioprotective effects, including improving blood pressure, cardiac function, and vascular function, which may be beneficial for individuals with hypertension or cardiovascular disease 3, 4.

Omega-3 Fatty Acids and Blood Pressure

• Omega-3 fatty acids, particularly docosahexaenoic acid (DHA), may have a favorable effect on lowering blood pressure and heart rate, as well as improving vascular function 3.
• However, the effects of omega-3 fatty acids on blood pressure may vary depending on the target population and the dosage used 3, 4.
• Modest decreases in blood pressure have been observed with significantly higher dosages of omega-3 fatty acids 4.

Limitations and Future Research

• While natural supplements may have potential health benefits, more clinical trials are needed to confirm their efficacy and safety before they can be recommended as a treatment for hypertension or cardiovascular disease 2.
• The current evidence on omega-3 fatty acids and ACE inhibitors is largely based on animal studies or small-scale human trials, and more research is needed to fully understand their effects on human health 5, 6.