Impact of Supplements on Blood Pressure
Several herbal supplements can increase blood pressure, particularly those with stimulant properties like yohimbine, while others like artichoke extract and nettle root have not been clearly linked to blood pressure elevation. 1
Supplements Known to Increase Blood Pressure
- Herbal supplements are categorized as having "high" potential to increase blood pressure according to clinical guidelines 1
- Yohimbine (found in some formulations of tongkat ali) is specifically identified as a substance that can increase blood pressure 1
- Ginseng (including Panax ginseng) has shown mixed effects:
- Some research indicates it may cause a temporary decrease in diastolic blood pressure 2 hours after ingestion 2
- Meta-analyses suggest ginseng generally has neutral effects on blood pressure in most people 3
- Earlier observational studies raised concerns about potential blood pressure elevation, but controlled trials have not consistently confirmed this 4
Supplements with Limited Evidence of BP Effects
- Ashwagandha, fenugreek, maca root, artichoke extract, and nettle root are not specifically mentioned in major hypertension guidelines as substances that increase blood pressure 1
- Boron is not listed among substances that increase blood pressure in clinical guidelines 1
Risk Factors for BP Elevation with Supplements
- Pre-existing hypertension increases susceptibility to blood pressure changes from supplements 1
- Body mass index may influence blood pressure response to supplements like ginseng, with higher BMI potentially associated with greater BP effects 3
- Concurrent use of multiple substances with cardiovascular effects can potentiate blood pressure changes 1
Clinical Recommendations
- Screen all patients for use of supplements that may increase blood pressure or interfere with antihypertensive medications 1
- Monitor blood pressure when starting any new supplement, especially in patients with pre-existing hypertension or cardiovascular risk factors 1
- Consider discontinuation of supplements if blood pressure increases significantly after initiation 1
- Exercise caution with supplements marketed for athletic performance or sexual enhancement, as these often contain stimulants or other ingredients that may affect blood pressure 1
Important Caveats
- Supplement quality and standardization vary widely, making definitive statements about safety difficult 5
- Many supplements lack rigorous clinical testing for cardiovascular effects 5
- Individual responses to supplements may vary based on genetics, existing medical conditions, and concurrent medications 1
- The FDA does not strictly regulate supplements, so actual ingredients may differ from what's listed on labels 6
When considering any supplement, patients with hypertension or at risk for hypertension should consult with their healthcare provider before use and monitor blood pressure regularly if supplements are taken 1.