Can Cosmetics Raise Your Blood Pressure?

October 21, 2025 by Dr. Steve Chaney

Do Phenols And Parabens Raise Blood Pressure?

Author: Dr. Stephen Chaney

We live in a toxic world. While we are exposed to hundreds of toxic chemicals, most research in recent years has focused on two classes of toxic chemicals – phenols and parabens. They are widely used as antimicrobial agents and preservatives in personal care products, cosmetics, pharmaceuticals, and foods.

Almost 80% of personal care products contain parabens.

You find them in unexpected places like toothpaste, soap, and skin care products.

You won’t find them listed on the label of fragrances because fragrance ingredients are considered proprietary.

These chemicals are excreted in the urine, are incompletely removed during wastewater treatment, and end up in our drinking water.

With so many routes of exposure, it is no wonder our bodies have become toxic waste dumps.

Methyl and propyl parabens have been detected in the urine of 95% of adults and 99% of teenagers in this country.

Multiple phenols and parabens have been detected in the urine of most US adults.

Levels are higher in women than men because women use more personal care products.

And that is a concern because phenols and parabens:

Are endocrine disruptors.

Are associated with reproductive difficulties and developmental delays, pregnancy complications (hypertension and gestational diabetes), and birth defects.

The best evidence for these effects comes from animal studies. It has been difficult to reproduce these effects in human studies because it has been difficult to identify a large group of subjects with high enough phenol and paraben levels to give statistically significant results.

The study (JR Varshavsky et al, Journal of Environmental Health Perspectives, volume 134, Issue 8, August, 2024) I will discuss today was designed to overcome those difficulties. It determined the effect of maternal phenol and paraben levels on blood pressure and hypertension during pregnancy in a high-risk group of women – women who live in a region of Puerto Rico with 18 Superfund sites that have high concentrations of phenols and parabens in the groundwater.

How Was This Study Done?

The investigators used data from the PROTECT Center that studies exposure to environmental contamination in drinking water in Puerto Rico and its contribution to adverse pregnancy outcomes.

A total of 1,433 pregnant women between the ages of 18 and 40 (average ~25 years old) were included in the study.

They lived in the heavily contaminated Karst region in the northern part of Puerto Rico.

They were evenly split between normal and overweight + obese.

Most of them had household incomes <$30,000 per year.

Women were excluded from the study if they:

Used in vitro fertilization or oral contraceptives within 3 months of the study.

Had any known medical condition.

Were already experiencing pregnancy-related high blood pressure or gestational diabetes at the time of enrollment.

They visited clinics within the region at weeks 16-20 (visit 1) and 24-28 (visit 2) of pregnancy.

Demographic information (e.g. age, BMI, income, etc) was collected at the first visit. Blood pressure and urine samples were taken at both visits. The blood samples were analyzed for 12 phenols and parabens.

The study participants were divided into two categories according to their blood pressure.

The non-hypertensive group (<120-129 mmHg systolic blood pressure and <80 mmHg diastolic blood pressure.

The hypertensive group (130->140 mmHg systolic blood pressure and 80->90 mmHg diastolic blood pressure.

The investigators then calculated the effect of each of these phenols and parabens on the odds (risk) that the pregnant mothers would have blood pressure in the hypertensive range rather than the non-hypertensive range.

Do Phenols And Parabens Raise Blood Pressure During Pregnancy?

When the investigators combined the data from clinical visits 1 and 2, the following phenols and parabens significantly increased the odds of maternal blood pressure being in the hypertensive range:

M-PB (methylparaben) – found in cosmetics (foundations, concealers, blushes, eyeshadows, mascara, lip liners, and lipstick), skincare (moisturizers, lotions, creams, serums, face cleansers, facial treatments, and sunscreens), haircare (shampoos, conditioners, hair color and bleaching products, and styling gels), and other personal care products (shaving creams and gels, aftershave, deodorants, baby lotions, and diaper creams).

P-PB (propylparaben – found in many of the same products as M-PB (often in combination).

TCS (triclosan) – found in toothpaste, mouthwash, soaps, shampoos, deodorants, and skin creams.

TCC (triclocarban) – found in antibacterial and deodorant soaps, cosmetics, deodorants and antiperspirants.

2,4-DCP (2,4-dichlorophenol) – found in personal care products from the breakdown of triclosan.

2,5-DCP (2,5-dichlorophenol) – a breakdown product of 1,4-dichlorobenzene.

When the effect of these phenols and parabens on maternal hypertension was analyzed individually, the increased risk of maternal hypertension (high blood pressure) was 10-50%.

But when the combined effect of all the phenols and parabens was analyzed, the increased risk of maternal hypertension was almost double.

The authors concluded, “Our findings suggest that exposure to certain phenols, parabens, and their mixture may be related to maternal blood pressure differences during pregnancy, as well as to increased risk of hypertension, especially during the later stages of pregnancy.

This is important given the critical nature of cardiometabolic health during pregnancy on the future health of the both the mother and their children.”

Can Cosmetics Raise Your Blood Pressure?

At the beginning of this article I raised the question, “Can Cosmetics Raise Your Blood Pressure?”

The answer appears to be, “Yes, with a few caveats.”

1) It is the phenols and parabens in cosmetics that are responsible for the increase in blood pressure.

2) When you consider all the personal care products that contain phenols and parabens, cosmetics are just “the tip of the iceberg”

3) Most importantly, this study is what is called a “proof of concept study”. It simply shows that phenols and parabens can raise blood pressure in humans under the right conditions.

- Because the investigators selected a population with very high exposure to toxic chemicals, there were enough women with high levels of polyphenols and parabens in their bodies to obtain a statistically significant association between phenols and parabens with hypertension.

- The investigators also chose a population group (pregnant moms) that have a high risk of developing hypertension.

But what does this mean for you? That’s a hard question to answer.

If you are a pregnant mom with similar exposure to phenols and parabens, your risk of maternal hypertension is probably similar.

But if you’re not pregnant and your exposure is less, it is almost impossible to extrapolate your risk from these data. That’s what makes this field of research so difficult.

But let me just make these observations.

If you use personal care products, your exposure to phenols and parabens is not zero.

This, and other studies, show that we can’t just focus on the risks of individual toxic chemicals. In today’s world, we are exposed to hundreds of toxic chemicals, and their combined effects are much greater than that of any individual toxic chemical.

It’s not just blood pressure that is affected. These chemicals are endocrine disruptors that negatively affect our health in multiple ways.

In short, nobody can tell you the risks you will experience from phenol and paraben exposure, but that risk is not zero. It only makes sense to proactively limit your exposure. But how do you do that in today’s world?

How Can You Reduce Your Exposure To Phenols And Parabens?

Here are a few simple tips for reducing your exposure to phenols, parabens, and other toxic chemicals.

Start By Choosing Personal Care Products With EWG (Environmental Working Group) Verification: EWG verification means the products are free of over 500 chemicals of concern (including phenols and parabens), have full ingredient transparency (what’s in the product is on the label), and meet rigorous health and safety standards based on the latest scientific research.

Use a Water Filter: This removes contaminants, including phenols and parabens, from your tap water.

Avoid Non-Stick Cookware: Switch from non-stick (PFOA/PFAS-free) cookware to stainless steel or cast iron to avoid potential exposure to other harmful chemicals.

Keep the Air Fresh: Let in outside air to maintain good indoor air quality and reduce exposure to various environmental chemicals found in drapes, upholstery, carpets, and mattresses.

Shop Fresh and Organic: Choose fresh, organic foods and reduce your consumption of foods in plastic containers, as they may contain these chemicals.

Limit Processed Foods: Reduce or limit your intake of fast food, microwave popcorn, and takeout food.

The Bottom Line

Phenols and parabens are widely used as preservatives in cosmetics and other personal care products. Both are known endocrine disruptors and have been linked to a wide variety of adverse health consequences.

But most of the studies linking these chemicals to adverse health effects have been done with animals. It has been difficult to confirm these effects in human studies.

In this article, I describe a study with a high-risk group of women who were exposed to high levels of phenols, parabens, and other toxic chemicals. This study showed that phenol and paraben exposure increases the risk of maternal hypertension in this group of high-risk, high-exposure women.

This is what is called a “proof of concept” study. It clearly shows that phenol and paraben exposure can have adverse health effects in humans. But it is not clear how this risk extrapolates to low-risk, low-exposure populations.

In this article I discuss what the study means for you and how you can reduce your risk of exposure to phenols, parabens, and other toxic chemicals

For more information on this study, what it means for you, and how you can reduce your exposure to toxic chemicals, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

_____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

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About The Author

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years. Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Which Exercise Is Best For Reducing Blood Pressure?

October 29, 2024 by Dr. Steve Chaney

How Can You Keep Your Blood Pressure Under Control?

Author: Dr. Stephen Chaney

Hypertension (high blood pressure) is called a silent killer. That’s because you often don’t notice any symptoms until you die from a stroke or heart attack.

Nearly half of all American adults (120 million or 48%) have high blood pressure. Of Americans with high blood pressure:

About half (46%) of them don’t know it.

And of those who know they have high blood pressure:

Only half of them have it under control.

- In case you weren’t doing the math, that means that only 1 in 4 Americans with high blood pressure has it under control.

That is scary because every 20 mm Hg increase in systolic blood pressure:

Doubles your risk of death from a stroke or heart attack.

And if the personal costs of high blood pressure were not enough, the cost of high blood pressure to our health care system is enormous.

The CDC estimates that the cost of high blood pressure in the United States is around $131 to $198 billion per year. And this may be an underestimate because it does not include productivity losses from non-fatal illnesses caused by high blood pressure.

Medications are effective at reducing blood pressure, but they have significant side effects. And those side effects have two unintended consequences.

Around half of patients stop taking their blood pressure medication within the first year because of side effects or cost.

For patients who continue taking blood pressure medication, they are usually prescribed other medications to reduce the side effects from their blood pressure medication.

This is often the start of a downward spiral in which they need more medications to reduce the side effects of the medicines they were just prescribed. And they end up on multiple medications, and a poor quality of life because of it.

Because of this, many patients and health care practitioners are looking for natural ways to keep blood pressure under control. One of the most recommended approaches is to increase exercise, and the type of exercise most frequently recommended is aerobic exercise.

But is that the best advice? That advice is based on clinical studies performed 20 to 30 years ago. And those studies were an excellent example of “the tail wagging the dog”.

Let me explain. In the early days most experts believed that aerobic exercise would be the most effective exercise for reducing blood pressure. So, most of the original studies on the effect of exercise at reducing blood pressure were done using aerobic exercise.

From those studies we knew that aerobic exercise was effective at reducing blood pressure, but we didn’t really know whether it was the most effective exercise for reducing blood pressure. And more recent studies have suggested a more nuanced view of exercise and blood pressure control.

For that reason, the authors of the current article (JJ Edwards et al, British Journal of Sports Medicine, 57: 1317-1326, 2023) decided to conduct a comprehensive review of all randomized controlled studies between 1990 and February 2023 on the effect of exercise on reducing blood pressure.

How Was The Study Done?

The investigators performed a comprehensive, systematic review of all randomized controlled studies (meaning patients were randomly assigned to an exercise or non-exercise group) looking at reductions in blood pressure following an exercise intervention of ≥ 2 weeks.

They excluded studies that:

Included dietary counseling or exercise recommendations in the control group.

Included dietary counseling, supplementation, or medication in the exercise group.

However, there were no exclusions based on the health or disease state in the patient population.

Their analysis included 270 randomized controlled trials with a total of 15,827 participants. All the studies reported systolic and/or diastolic blood pressure before and after the exercise intervention.

Exercise interventions were divided into five classifications:

Aerobic exercises.
Resistance exercises.
Combined exercises (a combination of aerobic and resistance exercises).
High-intensity interval exercises (high-intensity, short-duration exercises).
Isometric exercises.

Several of these exercise classifications were further subdivided into individual exercises (see below)

Which Exercise Is Best For Reducing Blood Pressure?

When the reduction in systolic blood pressure was considered, the rank order of exercise effectiveness was:

High-intensity interval exercise (4.08 mm Hg reduction).
Aerobic exercise (4.48 mm Hg reduction).
Resistance exercise (4.53 mm Hg reduction).
Combined aerobic and resistance exercise (6.04 mm Hg reduction).
Isometric exercise (8.24 mm Hg reduction).

When the reduction in diastolic blood pressure was considered, the amount of reduction was less but the rank order of exercise effectiveness was the same:

High-intensity interval exercise (2.50 mm Hg reduction).
Aerobic exercise (2.53 mm Hg reduction).
Resistance exercise (3.04 mm Hg reduction).
Combined aerobic and resistance exercise (3.54 mm Hg reduction).
Isometric exercise (4.00 mm Hg reduction).

When the exercise classifications were subdivided into individual exercises.

Running and cycling were significantly more effective than walking for aerobic exercise, with running being the most effective form of aerobic exercise.
Cycling was the most effective form of high-intensity interval exercise.
No effect of exercise type was seen for the effectiveness of resistance training.
Isometric wall squats and leg extensions were much more effective than isometric handgrip exercises.

There was not enough data from diastolic blood pressure studies to subdivide into individual exercises.

There were two other results of interest.

Aerobic exercise interventions were slightly more effective with lower exercise frequency, suggesting that 3 times a week may be more effective than 5 or more times a week.

All exercise interventions were much more effective for people with significantly elevated blood pressure than for people with slightly elevated blood pressure or normal blood pressure.

Of course, the important question for people with normal blood pressure is the effectiveness of exercise in preventing future increases in blood pressure, and this study is not designed to answer that question.

The authors concluded, “Various exercise training modes improve resting blood pressure, particularly isometric exercise. The results of this analysis should inform future exercise guideline recommendations for the prevention and treatment of arterial hypertension.”

What Does This Study Mean For You?

The takeaways from this study are clear.

If you wish to reduce your blood pressure:

Any kind of exercise is helpful, but current recommendations that prioritize aerobic exercise may be misleading.

If you want to get the most “bang for your buck”:

- Isometric exercise is the most effective and high intensity interval exercise is the least effective.

- Aerobic and resistance exercise are equally effective.

- A combination of aerobic and resistance exercise is more effective than either alone.

And if you want to know the most effective individual exercises:

- Wall squats and leg extensions are the most effective isometric exercises.

- Running and cycling are the most effective aerobic exercises.

- Any kind of resistance exercise is equally effective.

Here are my thoughts about this study:

If you haven’t been keeping up with clinical studies on exercise and blood pressure (like me), the conclusions of this comprehensive review are probably a surprise. I would not have expected isometric exercises to be more effective than aerobic exercises for lowering blood pressure.

The authors of this review postulated that isometric exercise decreases blood flow to the muscles involved. When those muscles relax, blood flow increases which sends metabolic signals that cause blood vessels to relax.

This study is good news for people with health conditions that limit their ability to do aerobic exercises or traditional resistance exercises.

We also need to remember that lowering blood pressure is not the only value of exercise.

- Aerobic exercise improves cardiovascular function.

- Resistance exercise increases muscle mass, which is particularly important for seniors who are trying to maintain muscle mass and function. Regular resistance exercise also helps minimize bone loss as we age.

Isometric exercise can be considered a form of resistance exercise, but it may need to be supplemented with resistance exercises that target other muscle groups.

As I said above, this study shows that all forms of exercise reduce blood pressure. The most effective exercise for you is the one you enjoy and will do on a regular basis.

Finally, while this study looked at the effectiveness of different exercises at reducing high blood pressure, these findings are probably also applicable to the types of exercise that can reduce risk of developing high blood pressure as we age.

How Can You Keep Your Blood Pressure Under Control?

Exercise alone is not a “magic bullet” for controlling blood pressure. And therein lies a story.

One reason so many people choose medications to control their blood pressure is that there is no “magic bullet” natural approach for controlling blood pressure. Exercise is just one part of a holistic approach for controlling blood pressure that also includes:

The DASH (Dietary Approaches To Stop Hypertension) was designed to prevent high blood pressure. I refer to it as an Americanized version of the Mediterranean diet.

Both diets are rich in fruits, vegetables, and whole grains and limit high fat meats and dairy products. And both diets have been shown to reduce the risk of high blood pressure.

Weight control. Overweight and obesity are both associated with increased risk of high blood pressure. One estimate is that every two pounds of weight gain increases blood pressure by 1 mm Hg.

Supplementation. The most effective supplements appear to be:

- Omega-3 fatty acids.

- Supplements containing grape seed extract and/or nitrates from beetroots and leafy greens.

- Calcium and magnesium if dietary intakes are not optimal.

Diet, weight control, supplementation, and exercise are the top 4 lifestyle factors for keeping blood pressure under control, but a comprehensive holistic approach to controlling blood pressure includes:

Low sodium/potassium ratio. I mention it here for completeness, but it is an integral part of the DASH diet.

Stress management. Chronic stress can increase blood pressure.

Adequate sleep.

We may be outliers, but my wife and I have followed this approach for years and in our 80s have the blood pressure of teenagers.

The Bottom Line

Most experts recommend aerobic exercise for reducing blood pressure, but these recommendations are based on outdated studies. A recent study examined the effectiveness of various exercises at reducing blood pressure based on all randomized controlled clinical trials between 1990 and 2023.

This study shows:

If you wish to reduce your blood pressure:

Any kind of exercise is helpful, but current recommendations that prioritize aerobic exercise may be misleading.

If you want to get the most “bang for your buck”:

- Isometric exercise is the most effective and high intensity interval exercise is the least effective.

- Aerobic and resistance exercise are equally effective.

- A combination of aerobic and resistance exercise is more effective than either alone.

For more information on this study, what it means for you, and recommendations for a holistic approach for controlling blood pressure naturally, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

______________________________________________________________________________

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_____________________________________________________________________

About The Author

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Eating Of The Green

March 29, 2022 by Dr. Steve Chaney

Why Is Eating Green Good For Your Heart?

Author: Dr. Stephen Chaney

You may be one of the millions of Americans who celebrated St. Patrick’s Day a couple of weeks ago. If so, you may have sung the famous Irish folk song “The Wearing of the Green”. If you are Irish, that song has special meaning for you. However, when I hear that song, I think of “Eating of the Green.”

And when I think of eating green, I don’t mean that everything we eat should be green. I am thinking of whole fruits and vegetables in a variety of colors. We have known for years that fruits and vegetables are good for our health. Consumption of fruits and vegetables is associated a lower risk of high blood pressure, heart disease, cancer, inflammatory diseases, and much more.

For today’s health tip, I am going to focus on heart health and an unexpected explanation for how fruits and vegetables reduce our risk of heart disease.

Why Is Eating Green Good For Your Heart?

We have assumed that whole fruits and vegetables lower our risk of heart disease because they are low in saturated fats and provide heart-healthy nutrients, phytonutrients, and fiber. All of that is true. But could there be more?

Recent research has suggested that the nitrates found naturally in fruits and vegetables may also play a role in protecting our hearts. Here is what recent research shows:

The nitrates from fruits and vegetables are converted to nitrite by bacteria in our mouth and intestines.

- Fruits and vegetables account for 80% of the nitrate in our diet. The rest comes from a variety of sources including the nitrate added as a preservative to processed meats.

- Although all fruits and vegetables contain nitrates, the best sources are green leafy vegetables and beetroot. [Beet greens are delicious and also a good source of nitrate, but beetroot is the part of the beet we usually consume.]

Nitrite is absorbed from our intestine and converted to nitric oxide by a variety of enzymes in our tissues.

Both reactions require antioxidants like vitamin C, which are also found in fruits and vegetables.

Nitric oxide has several heart healthy benefits. For example:

It helps reduce inflammation in the lining of blood vessels. Inflammation stimulates atherosclerosis, blood clot formation, and is associated with an increased risk of heart disease.

It relaxes the smooth muscle cells that surround our blood vessels. This makes the blood vessels more flexible and helps reduce blood pressure.

It prevents smooth muscle cells from proliferating, which prevents them from invading and constricting our arteries. This, in turn, has the potential to reduce the risk of atherosclerosis.

It prevents platelet aggregation. This, in turn, has the potential to reduce the risk of heart attack and stroke due to blood clots that block the flow of blood to our heart or brain.

It is well established that nitrates from fruits and vegetables reduce blood pressure. More importantly, they can help slow the gradual increase in blood pressure as we age.

However, few studies have asked whether this reduction in blood pressure translates into improved cardiovascular outcomes. This study (CP Bondonno et al, European Journal of Epidemiology, 36: 813-825, 2021) was designed to answer that question.

How Was This Study Done?

This study made use of data from the Danish Diet, Cancer, and Health Program. That program enrolled 53,150 participants from Copenhagen and Aarhus between 1993 and 1997 and followed them for an average of 21 years. None of the participants had a diagnosis of cancer or heart disease at the beginning of the study.

Other characteristics of the participants at the time they were enrolled in the study were:

46% male

Average age = 56

BMI = 26 (>20% overweight)

Average systolic blood pressure = 140 mg Hg

Average diastolic blood pressure = 84 mg Hg

At the beginning of the study, participants filled out a 192-item food frequency questionnaire that assessed their average intake of various food and beverage items over the previous 12 months. The vegetable nitrate content of their diets was analyzed using a comprehensive database of the nitrate content of 178 vegetables. For those vegetables not consumed raw, the nitrate content was reduced by 50% to account for the nitrate loss during cooking.

Blood pressure was measured at the beginning of the study. Data on the incidence (first diagnosis) of heart disease during the study was obtained from the Danish National Patient Registry. Data were collected on diagnosis of the following heart health parameters:

Cardiovascular disease (all diseases of the circulatory system).

Ischemic heart disease (lack of sufficient blood flow to the heart). The symptoms of ischemic heart disease range from angina to myocardial infarction (heart attack).

Ischemic stroke (lack of sufficient blood flow to the brain).

Hemorrhagic stroke (bleeding in brain).

Heart failure.

Peripheral artery disease (lack of sufficient blood flow to the extremities).

Is Nitrate From Vegetables Good For Your Heart?

Intake of nitrate from vegetables ranged from 18 mg/day (<1/3 serving of nitrate-rich vegetables per day) to 168 mg (almost 3 servings of nitrate-rich vegetables per day). The participants were grouped into quintiles based on their vegetable nitrate intake. When the group with the highest vegetable nitrate intake was compared to the group with the lowest vegetable nitrate intake:

Systolic blood pressure was reduced by 2.58 mg Hg.

Diastolic blood pressure was reduced by 1.38 mg Hg.

Risk of cardiovascular disease was reduced by 14%.

Risk of ischemic heart disease (angina and heart attack) was reduced by 13%.

Risk of ischemic stroke (stroke caused by lack of blood flow to the brain) was reduced by 14%.

Risk of heart failure was reduced by 17%.

Risk of peripheral artery disease was reduced by 31%.

Risk of hemorrhagic stroke (bleeding in the brain) was not significantly reduced.

Two other observations were of interest:

Blood pressure and risk of peripheral artery disease decreased with increasing vegetable nitrate intake in a relatively linear fashion. However, the other parameters of heart disease plateaued at a modest intake of vegetable nitrate intake (around one cup of nitrate-rich vegetables per day). This suggests that as little as one serving of nitrate-rich vegetables a day is enough to provide some heart health benefits.

Only about 21.9% of the improvement in heart health could be explained by the decrease in blood pressure. This is not surprising when you consider the other beneficial effects of nitric oxide described above.

The authors concluded, “Consumption of at least ~60 mg/day of vegetable nitrate (~ one serving of green leafy vegetables or beets) may mitigate risk of cardiovascular disease.”

Are Nitrates Good For You Or Bad For You?

You are probably thinking, “Wait a minute. I thought nitrates and nitrites were supposed to be bad for me. Which is it? Are nitrates good for me or bad for me?”

It turns out that nitrates and nitrites are kind of like Dr. Jekyll and Mr. Hyde. They can be either good or bad. It depends on the food they are in and your overall diet.

Remember the beginning of this article when I said that the conversion of nitrates to nitric oxide depended on the presence of antioxidants? Vegetables are great sources of antioxidants. So, when we get our nitrate from vegetables, most of it is converted to nitric oxide. And, as I discussed above, nitric oxide is good for us.

However, when nitrates and nitrites are added to processed meats as a preservative, the story is much different. Processed meats have zero antioxidants. And the protein in the meats is broken down to amino acids in our intestine. The amino acids combine with nitrate to form nitrosamines, which are cancer-causing chemicals. Nitrosamines are bad for us.

Of course, we don’t eat individual foods by themselves. We eat them in the context of a meal. If you eat small amounts of nitrate-preserved processed meats in the context of a meal with antioxidant-rich fruits and vegetables, some of the nitrate will be converted to nitric oxide rather than nitrosamines. The processed meat won’t be as bad for you.

Eating Of The Green

Your mother was right. You should eat your fruits and vegetables!

The USDA recommends at least 3 servings of vegetables and 2 servings of fruit a day.

Based on this study, at least one of those servings should be nitrate-rich vegetables like green leafy vegetables and beets.

If you don’t like any of those, radishes, turnips, watercress, Bok choy, Chinese cabbage, kohlrabi, chicory leaf, onion, and fresh garlic are also excellent sources of nitrate.

The good news is that you may not need to eat green leafy vegetables and beets with every meal. If this study is correct, one serving per day may have heart health benefits. That means you can enjoy a wide variety of fresh fruits and vegetables as you try to meet the USDA recommendations.

Finally, if you don’t like any of those foods, you may be asking, “Can’t I just take a nitrate supplement?”

For blood pressure, there are dozens of clinical trials, and the answer seems to be yes – especially when the nitrate comes from vegetable sources and the supplement also contains an antioxidant like vitamin C.

For heart health benefits, the answer is likely to be yes, but clinical trials to confirm that would take decades. Double blind, placebo-controlled trials of that duration are not feasible, so we will never know for sure.

Moreover, you would not be getting all the other health benefits of a diet full of fresh fruits and vegetables. Supplementation has its benefits, but it is not meant to replace a healthy diet.

The Bottom Line

We have known for years that fruits and vegetables are good for our hearts. We have assumed that was because whole fruits and vegetables are low in saturated fats and provide heart-healthy nutrients, phytonutrients, and fiber. But could there be more?

It is well established that nitrates from fruits and vegetables reduce blood pressure. More importantly, they can help slow the gradual increase in blood pressure as we age.

However, few studies have asked whether this reduction in blood pressure translates into improved cardiovascular outcomes. A recent study was designed to answer that question.

When the study compared people with the highest vegetable nitrate intake to people with the lowest vegetable nitrate intake:

Blood pressure was significantly reduced.

The risk of cardiovascular disease was reduced by 14%.

Risk of ischemic heart disease (angina and heart attack) was reduced by 13%.

Risk of ischemic stroke (stroke caused by lack of blood flow to the brain) was reduced by 14%.

Risk of heart failure was reduced by 17%.

Risk of peripheral artery disease was reduced by 31%.

Blood pressure and risk of peripheral artery disease decreased with increasing vegetable nitrate intake in a relatively linear fashion.

However, the other parameters of heart disease plateaued at a modest intake of vegetable nitrate intake (around one cup of nitrate-rich vegetables per day). This suggests that as little as one serving of nitrate-rich vegetables a day is enough to provide some heart health benefits.

The authors concluded, “Consumption of at least ~60 mg/day of vegetable nitrate (~ one serving of green leafy vegetables or beets) may mitigate risk of cardiovascular disease.”

Of course, you may have heard that nitrates and nitrites are bad for you. I discuss that in the article above.

For more details about this study and what it means for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Do Omega-3s Lower Blood Pressure?

May 6, 2014May 6, 2014 by Dr. Steve Chaney

The Good News About Fish Oil

Author: Dr. Stephen Chaney

High blood pressure or hypertension is a major problem in this country. Over 60% of Americans have high blood pressure. Only 47% of those with hypertension are adequately controlled. 20% of them don’t even know that they have high blood pressure.

In this case, ignorance is definitely not bliss. That’s because high blood pressure significantly increases the risk of stroke, heart attacks and congestive heart failure.

The causes of high blood pressure are many. Genetics, obesity, lack of exercise, sodium, alcohol, saturated fats and too few fresh fruits and vegetables all play a role. Age also plays a role. As we age, our blood vessels become less flexible and our blood pressure rises by about 0.6 mm Hg per year.

Medications can help, but many of them have significant side effects and often aren’t fully effective in controlling blood pressure. That’s why natural approaches are so important.

Because there are so many causes of hypertension, natural approaches for lowering your blood pressure are not simple. Natural approaches start with weight loss, restricting sodium intake, increasing physical activity, moderating alcohol intake and something called the DASH diet. In short, there is not just one simple change that you can make that will totally eliminate hypertension. It requires a complete lifestyle change.

That’s why the latest study on the effect of omega-3s on blood pressure is so exciting. If the headlines are true, adding omega-3s to your diet may be one of the most effective things you can do to lower your blood pressure naturally. So let’s examine the study to see if the headlines are accurate.

How Was The Study Designed?

This study (Miller et al, American Journal of Hypertension, doi:10.1093/ajh/hpu024) was a very large, well designed study. It is a meta-analysis of 70 randomized, placebo controlled clinical studies. Key characteristics of these studies were:

The mean study duration was 69 days. That means these beneficial effects occur relatively quickly.

The mean EPA + DHA dose was 3.8 g/day (range = 0.2 – 15 g/day). A wide range of doses was included.

The EPA & DHA came from all sources (seafood, EPA+DHA fortified foods, fish oil, algal oil, and purified ethyl esters. The source did not affect the outcome.

Olive oil was the most commonly used placebo, with omega-6 vegetable oils being used as placebos in a few studies. The choice of placebo did not affect the outcome.

None of the people in these studies were taking blood pressure lowering medications. That means these studies were specifically designed to see whether omega-3s lowered blood pressure, not whether they had any additional benefit for people already taking medications. This is important because if you only focus on groups who are already taking multiple medications, you tend to obscure the beneficial effects of omega-3s (see my recent Health Tip “Is Fish Oil Really Snake Oil?”)

Do Omega-3s lower Blood Pressure?

The authors of the study reported that:

Compared to placebo, EPA+DHA reduced systolic blood pressure (that’s the upper reading) by 1.52 mm Hg and diastolic blood pressure (that’s the lower reading) by 0.99 mm Hg.

When they looked at those participants who already had high blood pressure, the numbers were even more impressive – a 4.51 mm Hg decrease in systolic blood pressure and a 3.05 mm Hg decrease in diastolic blood pressure. That’s important because for each 2 mm Hg reduction in blood pressure there is a 6% decrease in stroke mortality, a 4% decrease in heart disease mortality, and a 3% decrease in total mortality.

More to the point, the authors of the study concluded that “A decrease of 4.51 mm Hg in systolic blood pressure among those with high blood pressure could help an individual avoid having to take medication to control blood pressure levels”.

When they looked at the study participants who had normal blood pressure the numbers were still significant – a 1.25 mm Hg decrease in systolic blood pressure and a 0.62 decrease in diastolic blood pressure. The authors pointed out that this could prevent, or at least delay, the age-related progression towards hypertension.

The effect of omega-3s on systolic blood pressure (4.51 mm Hg decrease) was comparable to the most successful lifestyle interventions – 3-10 mm Hg decrease for 10 pound weight loss, 4-9 mm Hg decrease for increased physical activity, 2-8 mm Hg decrease for sodium restriction, and 2-4 mm Hg for decreased alcohol consumption.

A dose of at least 1 gm/day of EPA+DHA was required for a significant decrease in systolic blood pressure, and a dose of over 2 gm/day was required for a significant decrease in both systolic and diastolic blood pressure

While this is a single study, it is consistent with a number of previous studies in this area. Based on the existing body of literature I would recommend omega-3s as part of a holistic approach for keeping your blood pressure under control.

The Bottom Line:

1) A recent meta-analysis of 70 published clinical studies (AJH, doi: 10.1093/ajh/hpu024) has shown fairly convincingly that omega-3 fatty acids are effective at lowering blood pressure. Moreover, this study is consistent with a number of previous studies. The evidence appears to be strong enough for omega-3s to be considered as part of a holistic approach to keeping your blood pressure under control.

2) If you already have high blood pressure, you should know that omega-3s caused blood pressure to decrease by 4.51 mm Hg in people like you. The authors of the study concluded that this decrease in blood pressure is large enough that some people may be able to avoid blood pressure medicines entirely. For others addition of omega-3s to their diet will likely allow their physicians to reduce the dose of medications required to keep their blood pressure under control – thus minimizing the side effects of the medications.

3) If you already have slightly elevated blood pressure that has not yet progressed to clinical hypertension, you should know that omega-3s also give a modest decrease in blood pressure in people like you. The authors of the study concluded that this decrease was enough to prevent or delay the age-related onset of hypertension.

4) The effect of omega-3s on reducing blood pressure is equivalent to the most successful lifestyle changes (weight loss, increased physical activity, sodium restriction and alcohol moderation). That doesn’t mean that you should pop fish oil pills and forget the other lifestyle changes. The idea is to combine as many of those lifestyle changes as possible so that you may never have to worry about high blood pressure again.

5) You need at least 1 gm/day of EPA+DHA to reduce systolic blood pressure and more than 2 gm/day to reduce both systolic and diastolic blood pressure.

6) Contrary to the hype you may have been reading elsewhere, the source of EPA+DHA didn’t matter. The only caveat is that many people really struggle with trying to get 1-2 gm/day of EPA+DHA from fish. It’s a bit too much of a good thing.

7) Don’t think of hypertension as a “Do it yourself” project. Hypertension is a silent killer. It’s one of those diseases where the first symptom is often sudden death – or, even worse, a life that is no longer worth living. Work with your physician. Let them help you find the right balance between lifestyle changes (including omega-3s) and medications to keep your blood pressure under control.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.