Impact of Micronutrients on Arterial Hypertension (High Blood Pressure)

The pathophysiology of arterial hypertension (AH) is a complex process with multifactorial etiology. However, oxidative stress, inflammation, immunomodulation, and endothelial dysfunction are considered the primary pathological factors associated with AH. A very recent review (2021) analyzed the evidence regarding micronutrients and their relationship to AH. Various minerals such as sodium, potassium, magnesium, zinc, selenium, copper, and calcium can directly or indirectly influence AH.

SODIUM: A recent meta-analysis (D'Elia et al. 2018) suggested that a reduction in Na intake could significantly lower blood pressure in both hypertensive and normotensive individuals.

POTASSIUM: Recently, Filippini et al. (2020) conducted a meta-analysis including 32 trials in hypertensive individuals supplemented with potassium (30 to 140 mmol/day), which showed a significant decline in systolic and diastolic pressure, especially in hypertensive individuals with higher levels of sodium intake.

CALCIUM: A meta-analysis, including 40 trials, indicated that individuals supplemented with calcium (800-1200mg) reduced SBP by -1.86 mm Hg and DBP by -0.99 mm Hg. However, in individuals with low calcium intake (<800mg), Ca2+ supplementation reduced SBP and DBP by -2.63 and -1.30 mm Hg, respectively.

MAGNESIUM: Mg supplementation can be included in a blood pressure-reducing diet, such as the well-known DASH diet, as Mg can regulate vascular function.

ZINC: A recent systematic review and meta-analysis comprising nine trials indicated a significant reduction in SBP in hypertensive individuals.

SELENIUM: Recently, a nutritional examination survey inferred a positive association between blood Se levels and AH. This association of Se with AH is still controversial; therefore, individuals with AH should be very cautious before Se supplementation to combat AH and its related complications.

VITAMIN C: In a systemic review and meta-analysis, it was demonstrated that supplementation with vitamin C (500mg/day) showed a significant reduction in SBP (−4.09) and DBP (−2.30) levels in individuals with essential or primary hypertension.

VITAMIN D: Oral supplementation would effectively increase Vit D3 levels, which, in turn, has an inverse association with blood pressure and can be combined with other minerals and macronutrients (adjuvant therapy) for a better hypotensive effect in hypertensive patients with vitamin deficiency.

VITAMIN E: Its administration (long-term) can help improve overall vascular health (increase NO bioavailability), but it is more effective in elderly hypertensive patients and pregnant women with severe pre-eclampsia.

B COMPLEX: Vit B6 or B12 can be included along with other hypotensive nutrients and conventional antihypertensive agents for a better hypotensive response.

This review suggests that increasing the supplementation of certain micronutrients, especially K, Mg, Zn, and vitamins C, D, and B6, as well as reduced intake of Na and Se, can positively modulate blood pressure levels and thus decrease the risk of associated comorbidities, such as cerebrovascular diseases and renal dysfunction. Furthermore, these micronutrients may exhibit anti-hypertensive activity when combined with macronutrients and certain nutraceutical/functional foods that act as a complementary tool in the treatment of AH.

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