The role of nutrition, nutraceuticals, vitamins, antioxidants, and minerals in the prevention and treatment of hypertension.

Macronutrient and micronutrient deficiencies are very common in the general population and may be even more common in patients with hypertension and cardiovascular disease due to genetic or environmental causes and prescription drug use. These deficiencies will have an enormous impact on present and future cardiovascular health and outcomes, such as hypertension, myocardial infarction, stroke and renal disease, and on overall health costs. The diagnosis and treatment of these nutrient deficiencies can reduce blood pressure; improve vascular health, endothelial dysfunction, and vascular biology; and decrease cardiovascular events. Vascular biology assumes a pivotal role in the initiation and perpetuation of hypertension and target organ damage (TOD). Endothelial activation, oxidative stress, inflammation, autoimmune vascular dysfunction, and vascular smooth-muscle dysfunction are initial events in hypertension. Nutrient gene interactions determine a broad array of phenotypic consequences, such as vascular problems and hypertension. In addition to other lifestyle modifications, optimal nutrition, nutraceutical supplements, vitamins, antioxidants, minerals, weight loss, exercise, smoking cessation, and moderate restriction of alcohol and caffeine can prevent and control hypertension in many patients. An integrative approach combining these lifestyle suggestions with the correct pharmacologic treatment will best achieve new goals for blood pressure levels, reduce cardiovascular risk factors, improve vascular biology and vascular health, reduce cardiovascular TOD, and reduce health care expenditures. In this article, the expanded scientific role for nutraceutical supplements in the treatment of essential hypertension will be discussed. It is the purpose of this article to review only the hypertension clinical trials that have evaluated the clinical use and efficacy of nutrition, weight loss, exercise, and nutritional supplements, vitamins, minerals, and antioxidants.