Supplements for hypertension

The hypertension stack — rationale by ingredient

Potassium 2,000–4,000 mg/day total intake (mostly from food)

Increasing dietary potassium reduces systolic BP by approximately 5–10 mmHg in stage 1 hypertensives and offsets some of the BP impact of high sodium intake. Most of the increase should come from food (leafy greens, beans, potatoes, bananas, tomatoes); supplemental potassium chloride is appropriate for some patients but should be coordinated with a clinician — particularly in chronic kidney disease, on potassium-sparing diuretics, or on ACE inhibitors/ARBs, where excess potassium is dangerous. Get clearance before supplementing.

Magnesium glycinate or citrate 300–400 mg elemental evenings

Modest but reproducible BP reductions (2–4 mmHg systolic) in trials selecting for low-magnesium-status patients or stage 1 hypertensives. Glycinate is well-tolerated; citrate is more laxative at higher doses. Avoid in advanced kidney disease.

Beetroot nitrate (juice or concentrated extract) before exercise or 500 mL/day

Inorganic nitrate from beetroot is converted to bioactive nitric oxide via the enterosalivary pathway, producing measurable BP reductions (4–10 mmHg systolic) in trials. Effect attenuates with chronic use as the gut microbiome adapts. Avoid antibacterial mouthwash on dosing days — that can abolish the benefit by killing the oral nitrate-reducing bacteria. Do not stack with PDE5 inhibitors (sildenafil etc.) without clinician oversight — additive hypotension.

Omega-3 EPA+DHA 2–3 g/day combined

Modest BP reductions (3–5 mmHg systolic at higher doses) plus the broader cardiovascular evidence base. Particularly relevant in users with elevated triglycerides as a co-target. Discuss with prescriber if on anticoagulants.

Hibiscus tea 2–3 cups/day or standardised extract

Reasonable signals in stage 1 hypertensives — typically 5–8 mmHg systolic reductions in trials. Generally safe; theoretical interaction with hydrochlorothiazide and other diuretics. A pleasant, low-risk intervention.

Aged garlic extract (Kyolic) 600–1,200 mg/day

The standardised aged-garlic preparations have the better evidence base than fresh garlic supplementation; modest BP reductions in trials. Discuss with prescriber if on anticoagulants — additive bleeding risk.

CoQ10 Ubiquinol 100–200 mg/day with meals

Specifically relevant in patients on statins (replacement of CoQ10 depleted by statin mechanism) and in heart failure patients (Q-SYMBIO trial). The BP-specific effect is modest; the broader cardiovascular case is the main reason to consider it.