December 2017

Suggested Citation: Garko, M. G. (2017, December). Managing high blood pressure, the silent killer. Health and Wellness Monthly. Retrieved (insert month, day, year), from

Cardiovascular Health: High Blood Pressure  

Michael Garko, Ph.D.

Nationally Syndicated Host & Producer of Let’s Talk Nutrition


High blood pressure (HBP), clinically termed “hypertension,” is a major independent risk factor for cardiovascular disease (CVD) and stroke. Specifically, HBP increases the risk for heart attack, stroke, congestive heart failure (CHF) and coronary heart disease (CHD), the leading cause of death in the United States since 1921. According to the American Heart Association’s  2014 update on heart disease and stroke, “[a]pproximately 69% of people who have a first heart attack, 77% of those who have a first stroke, and 74% of those who have CHF have BP >140/90 mm Hg” (Mozaffarian et. al, 2014, p. e109).

In addition to increasing a person’s risk for CVD and stroke, HBP is responsible for nearly 20% of all deaths in the United States Further, those suffering from HBP typically experience a shorter overall life expectancy, a shorter life expectancy free from cardiovascular disease and more years living with cardiovascular disease (see Mozaffarian et. al, 2014).

In terms of its prevalence, the American Heart Association’s most recent statistical snapshot of HBP in the United States reveals that it affects about one-in-three adults, with approximately six percent of American adults suffering from undiagnosed HBP. The estimated prevalence for HBP in the United States is 77.9 million for adults 20 years of age and older. Of those with HBP, 81.5% know of their condition; 74.9% are under treatment; 52.5% have their HBP under control and 47.5% do not (see Mozaffarian et. al, 2014).

When it comes to gender, HBP is an equal opportunity health offender. Men and women suffering from HBP is 37.6% and 40.1%, respectively. Age tends to interact with gender and the prevalence of HBP among men and women. That is, there is a higher percentage of men than women who suffer from HBP up until age 45 and then from 45-54 but from 55-64 years of age the percentages associated with men and women are pretty much the same. Beyond 64 years of age, there are more women than men with HBP (see Mozaffarian et. al, 2014).



Clearly, HBP is a serious cardiovascular health issue. It is termed the “silent killer” because it develops frequently out of awareness and without advance warning. Also disturbing is that, according to the American Heart Association (2009), the cause of 90-95% of HBP cases is not known. Making matters worse, it is predicted that by 2030, approximately 41.4% of adults in America will suffer from hypertension, representing an increase of 8.4% from estimates in 2012 (Mozaffarian et. al, 2014).

Given its increased risk for CVD, stroke and death, its current and projected prevalence, its association with a shorter overall life expectancy and life expectancy free from cardiovascular disease, along with its association with living more years suffering from CVD, the December, 2017, issue of Health and Wellness Monthly is devoted to discussing important aspects of HBP, including its definition, measurement, classification and risk factors, with special attention given to diet and lifestyle approaches to help manage it.

Blood Pressure Defined

Blood pressure is the force of circulating blood pushing against the walls of the arteries each time the heart contracts and pumps blood into and throughout the arterial system.

Blood Pressure Measurements

Blood pressure measurements include systolic and diastolic pressure readings represented in millimeters of mercury (mm Hg). The systolic pressure number represents the highest force against the walls of the arteries upon contraction of the heart, while the diastolic pressure represents the lowest pressure against the walls of the arteries between contractions when the heart is at rest. A blood pressure cuff is used to measure blood pressure.

Typically, blood pressure numbers are recorded with the systolic number above or before the diastolic number. For example, 120/80 mmHg (mmHg means millimeters of mercury, the units used to measure blood pressure) would represent a systolic measurement of 120 mmHg and a diastolic measurement of 80 mmHg.


The National Heart Lung and Blood Institute (NHLB) (2009) provides blood pressure gudielines for normal, prehypertensive and high blood pressure. According to the NHLB (2009), if blood pressure readings are above normal (i.e., greater than 120/80 mmHg) most of the time, then this would indicate being at risk for HBP. The following table of blood pressure categories is from the NHLB (2009):

Categories for Blood Pressure Levels in Adults (in mmHg, or millimeters of mercury)

Category Systolic
(top number)
(bottom number)
Normal Less than 120 And Less than 80
Prehypertension 120–139 Or 80–89
High blood pressure
     Stage 1 140–159 Or 90–99
     Stage 2 160 or higher Or 100 or higher

(National Heart Lung and Blood Institute, 2009, pp.1-2)

Risk Factors for HBP

Experts tend to agree that the exact cause(s) of HBP is/are unknown. Nevertheless, a number of modifiable and non-modifiable risk factors and markers for the development of HBP have been identified and include age, atherosclerosis, high cholesterol and triglyceride levels, dietary factors (e.g., increased intake of saturated fats and sodium and lower potassium intake), lifestyle factors, (e.g., excessive alcohol intake, smoking, chronic stress and lack of physical activity/exercise), ethnicity, family history of and genetic predisposition for HBP, lower education and socioeconomic status, overweight and obesity, among others. Given the range of risk factors bearing upon the development of HBP, it would be unrealistic to claim that any one herb would serve as an all-encompassing solution lowering HBP or restoring blood pressure to normal levels. Thus, based on the literature, the three herbs presented here, garlic, hawthorn berry and cayenne, are intended to prohibit the on-set of HBP and modulate the progression of existing HBP by helping to prevent atherosclerosis (i.e., hardening of the arteries) or slowing its progression, modulating or otherwise lowering blood lipid levels (i.e., high cholesterol and triglyceride levels) and preventing the oxidation of low-density lipoproteins (LDL), all recognized risk factors for HBP.

Natural Alternatives to Help Manage High Blood Pressure

Garlic (Allium Sativum)

Garlic’s medicinal properties, especially its cardioprotective features, have been touted for centuries. Over the past 50 years, thousands of scientific studies on garlic have been conducted demonstrating its cardioprotective properties such as inhibiting plaque formation in the coronary arteries, modulating blood pressure, lowering serum levels of cholesterol and triglycerides, boosting high-density lipoproteins (HDL), lowering LDL, inhibiting LDL oxidation, among other important effects (see Doreen, 2008, Wakunaga, 2008 & Mindell, 1996).

Garlic is available in four different forms: 1. Raw whole-clove garlic (includes fresh garlic juice & cooked garlic), 2. dehydrated garlic powders (drying clove garlic), 3. garlic oils (distilling garlic extracts & diluting with vegetable oils) and 4. aged garlic extract (see Mindell, 1996). The form recommended here is aged garlic extract (AGE) manufactured by Wakunaga of America.

There are more than 580 scientific, university-sponsored studies on AGE. These studies have confirmed the cardioprotective properties of AGE in terms of balancing HBP. They have also confirmed other cardioprotective features such as lowering serum cholesterol and triglyceride levels, lowering LDL levels, raising HDL levels, inhibiting LDL oxidation, inhibiting of plaque formation in coronary arteries and anti-platelet aggregation and adhesion, all of which would contribute to the balancing of HBP (see Wakunaga, 2008).

There are various oil-soluble and water-soluble compounds contained in AGE that derive from the aging process and behave synergistically to help produce these cardioprotective effects. The aging process converts typically harsh and unstable organosulfur compounds into milder and more effective sulfur-containing amino acids unique to AGE (e.g., S-allylcysteine – SAC & S-allylmercaptocysteine – SAMC) and Maillard reaction products (e.g., N-Fructosyl Glutamate & N-Fructosyl Arginine) (see Wakunaga, 2008).

Hawthorn Berry (Crataegus Oxyacantha)

Hawthorn Berry contributes to cardiovascular health, generally, and HBP, specifically, in four ways by 1.dilating peripheral blood vessels (i.e., peripheral vasodilation), thereby, reducing blood pressure and the workload on the heart), 2.mildly dilating the coronary arteries, 3.increasing the heart’s enzyme metabolism and 4.increasing the heart’s utilization of oxygen (see Mowrey, 1986).

Hawthorn berries contain biologically active flavonoid compounds such as anthocyanidins and proanthocyanidins, which are responsible for the red color of the hawthorn berries and help provide their cardioprotective properties.

Cayenne (Capsicum Annum)

Cayenne serves as a cardiac stimulant and promotes overall cardiovascular function, while at the same time lowering blood pressure. It contributes further to cardiovascular health by reducing cholesterol and triglycerides levels, thereby, decreasing the likelihood of developing atherosclerosis, a risk factor for HBP (see Mowrey, 1986; Murray, 1995).


HBP is a serious risk factor for CHD. While diagnosing it is rather easy, determining the exact cause(s) of HBP is another matter. Given the host of modifiable and non-modifiable risk factors for HBP, it would be unrealistic and unethical to claim that any given herb, herbal formula, nutritional or non-nutritional therapy will “cure” HBP. Nevertheless, there are effective steps that can be taken to help modulate HBP and its deleterious effects. For example, leading a lifestyle that includes at least 30 minutes a day of moderate physical activity, a wholesome daily diet, nutritional supplementation, sufficient sleep and relaxation and excludes (to the best of one’s ability), refined processed carbohydrates containing large amounts of sugar, foods containing high amounts of saturated and trans fats, surplus calorie consumption leading to overweight and obesity, excessive alcohol intake, sodium-laden foods, smoking on a regular basis, and chronic stress can go a long way in preventing and managing HBP.

With respect to nutritional/dietary supplementation, there are a numerous choices to help people prevent and manage HBP. This April, 2009, issue of Healthful Hints focused on just three herbs, aged garlic extract, hawthorn berry and cayenne. Each herb possesses its own unique mechanism of action and medicinal properties to keep blood pressure levels in the normal range. In combination, the three herbs make an important contribution in maintaining cardiovascular health, generally, sustaining healthy blood pressure levels on a day-to-day basis, specifically.

Health consumers would most likely not have much difficulty in finding existing heart health supplement products containing all three herbs. There is always the choice of taking each herb individually or having an herbalist create a HBP formula containing the herbs.

Readers are encouraged to consult with their physician before taking any dietary supplement, especially if they are using prescribed medications.



American Heart Association (n.d.). High blood pressure statistics. Retrieved April, 22, 2009 from

Dorren, R.B. (2008). Aged garlic extract: Impacting cardiovascular disease & metabolic syndrome with aged garlic extract. Mission Viejo, CA: Wakunaga of America Co., Ltd.

Go, A.S., Mozaffarian, D., Roger,V.L., Benjamin,E.J., Berry, J.D., Borden, Bravata, D.M., Dai, S., Ford, E.S., Fox, C.S., Franco, S., Fullerton, H.J., Gillespie, C., Hailpern, S.M., Heit, J.A., Howard, V.J., Huffman, M.D., Kissela, B.M., Kittner, S.J., Lackland, D.T., Lichtman, J.H., Lynda D. Lisabeth, David Magid, Gregory M. Marcus, Ariane Marelli, David B. Matchar, Darren K. McGuire, Emile R. Mohler, Claudia S. Moy, Michael E. Mussolino, Graham Nichol, Nina P. Paynter, Pamela J. Schreiner, Paul D. Sorlie, Joel Stein, Tanya N. Turan, Salim S. Virani, Nathan D. Wong, Daniel Woo and Melanie B. Turner (2013). Association heart disease and stroke statistics–2013 update: A report from the american heart association. Circulation, 127:e6-e245.

Mindell, E. (1996). Earl Mindell’s herb bible. New York: Simon & Schuster/Fireside.

Murray, M.T. (1995). The healing power of herbs: The enlightened person’s guide to the wonders of medicinal herbs (2nd ed.).

Mowrey, D. B. (1986). The scientific validation of herbal medicine. How to remedy and prevent disease with herbs, vitamins, minerals, and other nutrients. Lincolnwood, Illinois: Keats Publishing.

National Heart Lung and Blood Institute (n.d.). What is high blood pressure? Retrieved April 22, 2009, from

Wakunaga of America Co., Ltd. (2008). Aged garlic extract: Research excerpts from peer reviewed scientific journals & scientific meetings. Mission Viejo, CA: Wakunaga of America Co., Ltd.

Suggested Citation: Garko, M. G. (2017, December). Managing high blood pressure, the silent killer. Health and Wellness Monthly. Retrieved (insert month, day, year), from