title: Nutraceuticals for blood pressure control in patients with high-normal or grade 1 hypertension.
abstract: BACKGROUND
  Current hypertension management guidelines do not recommend drug treatment in subjects with blood pressure (BP) in the high-normal range due to the risk of side effects of the currently available antihypertensive agents that overcomes the possible benefit. Nutraceuticals are free from relevant side effects and could be a valuable strategy for the treatment of these patients.
  
  
  OBJECTIVE
  The objective of this study was to compare the efficacy of two nutraceutical compositions given by the combination of policosanol, red yeast rice extract, berberine, folic acid and coenzyme Q(10) with or without Orthosiphon stamineus in lowering the BP and lipid profile.
  
  
  METHODS
  Thirty patients with grade 1 essential hypertension and low cardiovascular risk were analysed. At the end of a run-in period, patients were divided into two study arms and assigned to receive the nutraceutical combination with and without Orthosiphon stamineus. All participants underwent 24-hour ambulatory BP monitoring at the end of the run-in period and of the 4-week treatment with each of the two different nutraceutical combinations.
  
  
  RESULTS
  In patients treated with Orthosiphon stamineus a significant reduction of mean 24-hour systolic and diastolic BP levels compared with baseline values was registered and the smoothness index calculated for systolic and diastolic BP showed a more reliable and homogeneous effect on BP over 24 hours. In contrast, nutraceutical treatment without Orthosiphon stamineus was not associated with a significant reduction of BP.
  
  
  CONCLUSIONS
  Our results show that the addition of Orthosiphon stamineus to the combination of nutraceuticals confers an antihypertensive effect that allows a surprisingly effective 24-hour BP control in hypertensive patients.
authors.affiliation: Department of NeuroSciences, Federico II University, Via S. Pansini 5, Naples, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Trimarco
authors.forename: Claudia Sara
authors.initials: CS
authors.lastname: Cimmino
authors.forename: Mario
authors.initials: M
authors.lastname: Santoro
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Pagnano
authors.forename: Maria Virginia
authors.initials: MV
authors.lastname: Manzi
authors.forename: Anna
authors.initials: A
authors.lastname: Piglia
authors.forename: Caterina Anna
authors.initials: CA
authors.lastname: Giudice
authors.forename: Nicola
authors.initials: N
authors.lastname: De Luca
authors.forename: Raffaele
authors.initials: R
authors.lastname: Izzo
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001688:Biological Products / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D002940:Circadian Rhythm / Q000502:physiology; D019587:Dietary Supplements; D004359:Drug Therapy, Combination; D005260:Female; D005492:Folic Acid / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D031342:Orthosiphon; D010936:Plant Extracts / Q000494:pharmacology* / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014451:Ubiquinone / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D001688:Biological Products; D010936:Plant Extracts; C117343:red yeast rice; D014451:Ubiquinone; D005492:Folic Acid; C024989:coenzyme Q10