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Erfahrungsheilkunde 2014; 63(1): 14-20
DOI: 10.1055/s-0033-1357605
Arterielle Hypertonie
© Karl F. Haug Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KG

Hypertonie und Orthomolekularmedizin

Udo Böhm
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Publication History

Publication Date:
21 February 2014 (online)

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Zusammenfassung

Die Hypertonie ist eine komplexe und langfristig nur schwer zu behandelnde Erkrankung mit einem hohen Risiko für Folgeschäden. Man unterscheidet zwischen der primären oder essenziellen Hypertonie und dem sekundären Hypertonus, der z. B. durch Arteriosklerose oder Erkrankungen der Niere ausgelöst werden kann. Der Artikel zeigt neben der Pathogenese der primären Hypertonie, den Risikofaktoren und der pharmakologischen Therapie die präventiven und therapeutischen Möglichkeiten der Orthomolekularmedizin auf.

Abstract

Hypertension is a complex disease with a high risk of secondary damages, which is difficult to treat in the long term. It has to be distinguished between primary or essential hypertension and the secondary hypertonus, which can be caused for example by arteriosclerosis or diseases of the kidneys. The article shows the preventive and therapeutic options of orthomolecular medicine in addition to the pathogenesis of primary hypertension, the risk factors, and the pharmacological therapy.

Schlüsselwörter

Hypertonie - Orthomolekularmedizin - Risikofaktoren - Lebensstil - Ernährung - Mikronährstoffe

Keywords

Hypertension - orthomolecular medicine - risk factors - life style - nutrition - micronutrients
 

  • Literatur

  • 1 Appel LI, Moore TJ et al. A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med 1997; 336: 1117-1124 [Ib]
    CrossrefPubMedSearch in Google Scholar
  • 2 Margetts BM, Beilin LJ, Vandongen T et al. Vegetarian diet in mild hypertension, a randomized controlled trial. BMJ 1986; 293: 1468-1471
    CrossrefPubMedSearch in Google Scholar
  • 3 Núñez-Córdoba JM et al. The Mediterranean diet and incidence of hypertension: the Seguimiento Universidad de Navarra (SUN) Study. Am J Epidemiol 2009; 169: 339-46
    PubMedSearch in Google Scholar
  • 4 Kokkinos P et al. Dietary influences on blood pressure: the effect of the Mediterranean diet on the prevalence of hypertension. J Clin Hypertens 2005; 7: 165-70 quiz 171-2
    CrossrefPubMedSearch in Google Scholar
  • 5 Panagiotakos DB et al. Status and management of hypertension in Greece: role of the adoption of a Mediterranean diet: the Attica study. J Hypertens 2003; 21: 1483-9
    CrossrefPubMedSearch in Google Scholar
  • 6 Houston MC. The role of cellular micronutrient analysis, nutraceuticals, vitamins, antioxidants and minerals in the prevention and treatment of hypertension and cardiovascular disease. Ther Adv Cardiovasc Dis 2010; 4: 165-183 und Houston MC Nutrition and nutraceutical supplements in the treatment of hypertension. Expert Rev Cardiovasc Ther 2010; 8: 821-33
    CrossrefPubMedSearch in Google Scholar
  • 7 Grossman E. Does increased oxidative stress cause hypertension?. Diabetes Care 2008; 31 Suppl 2: 185-9
    CrossrefPubMedSearch in Google Scholar
  • 8 Montezano AC, Touyz RM. Oxidative stress, Noxs, and hypertension: experimental evidence and clinical controversies. Ann Med 2012; 44 Suppl 1: S2-16
    CrossrefPubMedSearch in Google Scholar
  • 9 Touyz RM, Briones AM. Reactive oxygen species and vascular biology: implications in human hypertension. Hypertens Res 2011; 34: 5-14
    CrossrefPubMedSearch in Google Scholar
  • 10 Escobales N, Crespo MJ. Oxidative-nitrosative stress in hypertension. Curr Vasc Pharmacol 2005; 3: 231-46
    CrossrefPubMedSearch in Google Scholar
  • 11 Harrison DG, Gongora MC. Oxidative stress and hypertension. Med Clin North Am 2009; 93: 621-35
    CrossrefPubMedSearch in Google Scholar
  • 12 Tousoulis D et al. Effects of vitamin C on intracoronary L-arginine dependent coronary vasodilatation in patients with stable angina. Heart 2005; 91: 1319-23
    CrossrefPubMedSearch in Google Scholar
  • 13 Duffy SJ, Gokce N, Holbrook M et al. Treatment of hypertension with ascorbic acid. The lancet 1999; 9195: 354
    PubMedSearch in Google Scholar
  • 14 Block G et al. Vitamin C in plasma is inversely related to blood pressure and change in blood pressure during the previous year in young black and white women. Nutrition Journal 2008; 7: 35
    CrossrefPubMedSearch in Google Scholar
  • 15 Lee JH et al. Vitamin D deficiency: An important, common, and easily treatable cardiovascular risk factor?. J Am Coll Cardiol 2008; 52: 1949-1956
    CrossrefPubMedSearch in Google Scholar
  • 16 Wang TJ et al. Vitamin D deficiency and risk of cardiovascular disease; Circulation 2008; 117: 503-511
    PubMedSearch in Google Scholar
  • 17 Li YC et al. Vitamin D: a negative endocrine regulator of the renin-angiotensin system and blood pressure. J Steroid Biochem Mol Biol 2004; 89-90: 387-92
    CrossrefPubMedSearch in Google Scholar
  • 18 Vaidya A, Williams JS. The relationship between vitamin D and the renin-angiotensin system in the pathophysiology of hypertension, kidney disease, and diabetes. Metabolism 2012; 61: 450-8
    CrossrefPubMedSearch in Google Scholar
  • 19 Arora S et al. Thiamine (vitamin B1) improves endothelium-dependent vasodilatation in the presence of hyperglycemia. Ann Vasc Surg 2006; 20: 653-8
    CrossrefPubMedSearch in Google Scholar
  • 20 Bays HE, Rader DJ. Does nicotinic acid (niacin) lower blood pressure?. Int J Clin Pract 2009; 63: 151-159
    CrossrefPubMedSearch in Google Scholar
  • 21 Bays HE et al. Blood pressure-lowering effects of extended-release niacin alone and extended-release niacin/laropiprant combination: a post hoc analysis of a 24-week, placebo-controlled trial in dyslipidemic patients. Clin Ther 2009; 31: 115-22
    CrossrefPubMedSearch in Google Scholar
  • 22 Forman JP et al. Folate intake and the risk of incident hypertension among US women. JAMA 2005; 293: 320-329
    CrossrefPubMedSearch in Google Scholar
  • 23 Bechir M et al. Folic acid improves baroreceptor sensitivity in hypertension. J Cardiovasc Pharmacol 2005; 45: 44-8
    CrossrefPubMedSearch in Google Scholar
  • 24 Wu CJ et al. Impact of adding folic acid, vitamin B(12) and probucol to standard antihypertensive medication on plasma homocysteine and asymmetric dimethylarginine levels of essential hypertension patients. Zhonghua Xin Xue Guan Bing Za Zhi 2012; 40: 1003-8
    PubMedSearch in Google Scholar
  • 25 Broker C et al. Vitamin E prevents extensive lipid peroxidation in patients with hypertension. Br J Biomed Sci 2003; 60: 5-8
    PubMedSearch in Google Scholar
  • 26 Poeggler B. L-Arginin schützt vor nitrosativem Stress: Stickstoffmonoxid als endogener Regulator des nitrosativen Stoffwechsels. Perfusion 2012; 25: 40-434
    PubMedSearch in Google Scholar
  • 27 Facchinetti F et al. L-arginine infusion reduces blood pressure in preeclamptic women through nitric oxide release. J Soc Gynecol Investig 1999; 6: 202-7
    CrossrefPubMedSearch in Google Scholar
  • 28 Palloshi A et al. Effect of oral L-arginine on blood pressure and symptoms and endothelial function in patients with systemic hypertension, positive exercise tests, and normal coronary arteries. Am J Cardiol 2004; 93: 933-5
    CrossrefPubMedSearch in Google Scholar
  • 29 Higashi Y et al. Intravenous administration of L-arginine inhibits angiotensin-converting enzyme in humans. J Clin Endocrinol Metab 1995; 80: 2198-202
    PubMedSearch in Google Scholar
  • 30 Burke BE et al. Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in isolated systolic hypertension. South Med J 2001; 94: 1112-1117
    CrossrefPubMedSearch in Google Scholar
  • 31 Ho MJ et al. Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension. Cochrane Database Syst Rev 2009; 4 CD007435.
    PubMedSearch in Google Scholar
  • 32 Rosenfeldt FL et al. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum Hypertens 2007; 21: 297-306
    PubMedSearch in Google Scholar
  • 33 Digiesi V et al. Effect of coenzyme Q10 on essential arterial hypertension. Current Therapeutic Research 1990; 47: 841-845 und Singh RB et al. Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease. J Hum Hypertens 1999; 13: 203-208 und Langsjoen PH et al. Treatment of essential hypertension with Coenzyme Q10. Molec Aspects Med 1994; 15: 265-272
    PubMedSearch in Google Scholar
  • 34 Stolarz-Skrzypek K et al. Sodium and potassium and the pathogenesis of hypertension. Curr Hypertens Rep 2013; 15: 122-30
    CrossrefPubMedSearch in Google Scholar
  • 35 van Bommel E, Cleophas T. Potassium treatment for hypertension in patients with high salt intake: a meta-analysis. Int J Clin Pharmacol Ther 2012; 50: 478-82
    PubMedSearch in Google Scholar
  • 36 Cappuccio FP, MacGregor GA. Does potassium supplementation lower blood pressure? A meta-analysis of published trials. J Hypertens 1991; 9: 465-473
    CrossrefPubMedSearch in Google Scholar
  • 37 Heran BS et al. Blood pressure lowering efficacy of potassium-sparing diuretics (that block the epithelial sodium channel) for primary hypertension. Cochrane Database Syst Rev 2012; 11 CD008167.
    PubMedSearch in Google Scholar
  • 38 Li S et al. Oral low-dose magnesium gluconate preventing pregnancy induced hypertension. Zhonghua Fu Chan Ke Za Zhi 1997; 32: 613-615
    PubMedSearch in Google Scholar
  • 39 Rudnicki M et al. Comparison of magnesium and methyldopa for the control of blood pressure in pregnancies complicated with hypertension. Gynecol Obstet Invest 2000; 49: 231-235
    CrossrefPubMedSearch in Google Scholar
  • 40 Sanjuliani AF et al. Effects of magnesium on blood pressure and intracellular ion levels of Brazilian hypertensive patients. Int J Cardiol 1996; 56: 177-183
    CrossrefPubMedSearch in Google Scholar
  • 41 Witteman JC et al. Reduction of blood pressure with oral magnesium supplementation in women with mild to moderate hypertension. Am J Clin Nutr 1994; 60: 129-135
    PubMedSearch in Google Scholar
  • 42 Wirell MP et al. Nutritional dose of magnesium in hypertensive patients on beta blockers lowers systolic blood pressure: a double-blind, cross-over study. J Intern Med 1994; 236: 189-195
    CrossrefPubMedSearch in Google Scholar
  • 43 Itoh K et al. The effects of high oral magnesium supplementation on blood pressure, serum lipids and related variables in apparently healthy Japanese subjects. Br J Nutr 1997; 78: 737-50
    CrossrefPubMedSearch in Google Scholar
  • 44 Boenaa KH et al. Effect of eicosapentaenic and docosaheaxaenoic acids on blood pressure in hpertension; a population-base intervention trial from the tromsoe study. N Engl J Med 1990; 322: 795-801
    CrossrefPubMedSearch in Google Scholar
  • 45 Cicero AF, Ertek S, Borghi C. Omega-3 polyunsaturated fatty acids: their potential role in blood pressure prevention and management. Curr Vasc Pharmacol 2009; 7: 330-337
    CrossrefPubMedSearch in Google Scholar
  • 46 Albert CM et al. Blood levels of long-chan n-3 fatty acids and the risk of sudden death. N Engl J Med 2002; 346: 1113-1118
    CrossrefPubMedSearch in Google Scholar
  • 47 He J et al. Effect of Soybean Protein on Blood Pressure: A Randomized, Controlled Trial. Ann Intern Med 2005; 143: 1-9
    CrossrefPubMedSearch in Google Scholar
  • 48 Buijsse B et al. Cocoa intake, blood pressure, and cardiovascular mortalitiy. The Zutphen Elderly Study Arch Intern Med 2006; 166: 411-417
    CrossrefPubMedSearch in Google Scholar
  • 49 Taubert D et al. Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide; JAMA 2007; 298: 49-60
    PubMedSearch in Google Scholar
  • 50 Mennen LI et al. Consumption of foods rich in flavonoids is related to a decreased cardiovascular risk in appaently healthy french women. J Nutr 2004; 134: 923-926
    PubMedSearch in Google Scholar
  • 51 Wallerath T et al. Reveratrol, a polyphenolic phytoalexin present in red wine, enhances expression and activity of endothelial nitric oxide synthase. Circulation 2002; 106: 1652-1658
    CrossrefPubMedSearch in Google Scholar
  • 52 Wallerath T et al. Red Wine increases the expression of human endothelial nitric oxide synthase. J Am Coll Cardiol 2003; 41: 471-478
    PubMedSearch in Google Scholar
  • 53 Lekakis J et al. Polyphenolic compounds from red grapes acutualy improve endothelial function in patients with coronary heart disease. Eur J Cardiovasc Prev Rehabil 2005; 12: 596-600
    CrossrefPubMedSearch in Google Scholar
  • 54 Wong RHX, et al. Acute effects of Resveratrol-supplementation on cardiovascular risk factors. Nutrition Society of Australia and Nutrition Society of New Zealand 2009 Joint Annual Scientific Meeting. 6 November 2009 und Wong RHX. et al. Acute resveratrol supplementation improves flow-mediated dilatation in overweight/obese individuals with mildly elevated blood pressure. Nutrition Metabolism and Cardiovascular Diseases 2010 (in press).
    PubMed
  • 55 Corder R, Douthwaite JA, Lees DM et al. Endothelin-1 synthesis reduced by red wine. Nature 2001; 414: 863-864
    CrossrefPubMedSearch in Google Scholar
  • 56 Carrizzo A et al. Resveratrol improves vascular function in patients with hypertension and dyslipidemia by modulating NO metabolism. Hypertension 2013; 62: 359-66
    CrossrefPubMedSearch in Google Scholar
  • 57 Moreno-Luna R et al. Olive oil polyphenols decrease blood pressure and improve endothelial function in young women with mild hypertension. Am J Hypertens 2012; 25: 1299-304
    PubMedSearch in Google Scholar
  • 58 Ferrara LA et al. Olive oil and reduced need for antihypertensive medications. Arch Intern Med 2000; 160: 837-42
    CrossrefPubMedSearch in Google Scholar
  • 59 Galleano M et al. Hypertension, nitric oxide, oxidants, and dietary plant polyphenols. Curr Pharm Biotechnol 2010; 11: 837-48
    CrossrefPubMedSearch in Google Scholar
  • 60 Antonello M et al. Prevention of hypertension, cardiovascular damage and endothelial dysfunction with green tea extracts. Am J Hypertens 2007; 20: 1321-8
    CrossrefPubMedSearch in Google Scholar
  • 61 Yang YC et al. The protective effect of habitual tea consumption on hypertension. Arch Intern Med 2004; 164: 1534-40
    CrossrefPubMedSearch in Google Scholar
  • 62 McKay DL. Hibiscus sabdariffa L. Tea (Tisane) lowers blood pressure in prehypertensive and mildly hypertensive adults. American Heart Association 2008 Scientific Sessions, Abstract 3278, November 10, 2008. Circulation 2008 118. 1123
    PubMedSearch in Google Scholar
  • 63 Perez-Vizcaino F et al. Antihypertensive effects of the flavonoid quercetin. Pharmacol Rep 2009; 61: 67-75
    PubMedSearch in Google Scholar
  • 64 Steinberg FM et al. Soy protein with isoflavones has fevorable effects on endothelial function that are indipendent of lipid and antioxidant effects in healthy postmenopausale women. Am J Clin Nutr 2003; 8: 123-130
    PubMedSearch in Google Scholar
  • 65 Lim U et al. Homocysteine and Blood Pressure in the Third National Health and Nutrition Examination Survey, 1988-1994. Am J Epidemiol 2002; 156: 1105-1113
    CrossrefPubMedSearch in Google Scholar
  • 66 Sawai A et al. Influence of mental stress on the plasma homocysteine level and blood pressure change in young men. Clin Exp Hypertens 2008; 30: 233-41
    CrossrefPubMedSearch in Google Scholar
  • 67 Fakhrzadeh H et al. Plasma homocysteine concentration and blood pressure in healthy Iranian adults: the Tehran homcysteine survey (2003-2004). J Hum Hypertens 2005; 19: 869-76
    CrossrefPubMedSearch in Google Scholar
  • 68 Dinavahi R et al. Plasma homocysteine concentration and blood pressure in young adult African Americans. Am J Hypertens 2003; 16: 767-70
    CrossrefPubMedSearch in Google Scholar
  • 69 van Guldener C et al. Homocysteine and blood pressure. Curr Hypertens Rep 2003; 5: 26-31
    CrossrefPubMedSearch in Google Scholar
  • 70 Tayama J et al. Higher plasma homocysteine concentration is associated with more advanced systemic arterial stiffness and greater blood pressure response to stress in hypertensive patients. Hypertens Res 2006; 29: 403-9
    CrossrefPubMedSearch in Google Scholar
  • 71 Stehouwer CD, van Guldener C. Does homocysteine cause hypertension?. Clin Chem Lab Med 2003; 41: 1408-11
    PubMedSearch in Google Scholar
  • 72 Forman JP et al. Folate intake and the risk of incident hypertension among US women. JAMA 2005; 293: 320-9
    CrossrefPubMedSearch in Google Scholar