In the United States, about 77.9 million (1 out of every 3) adults have high blood pressure.(ref) High blood pressure, or hypertension, is a big deal because it increases your risk of heart attack, stroke, heart failure, aneurysm, and dementia, to name a few.(ref)

Unfortunately, the primary treatment for the majority of patients is blood pressure medication. These include:

  • Thiazide diuretics
    • Chlorothiazide (Diuril)
    • Chlorthalidone.
    • Hydrochlorothiazide (Microzide)
    • Indapamide.
    • Metolazone.
  • Angiotensin-converting enzyme (ACE) inhibitors
    • Benazepril (Lotensin)
    • Captopril.
    • Enalapril (Vasotec)
    • Lisinopril (Prinivil, Zestril)
  • Calcium channel blockers
    • Amlodipine (Norvasc)
    • Diltiazem (Cardizem, Tiazac, others)
    • Felodipine.
    • Isradipine.
    • Nicardipine.
    • Nifedipine (Adalat CC, Afeditab CR, Procardia)
  • Beta-blockers
    • Acebutolol (Sectral)
    • Atenolol (Tenormin)
    • Bisoprolol (Zebeta)
    • Metoprolol (Lopressor, Toprol XL)
    • Nadolol (Corgard)
    • Nebivolol (Bystolic)
    • Propranolol (Inderal, InnoPran XL)
  • Angiotensin receptor blockers (ARBs)
    • Azilsartan (Edarbi)
    • Candesartan (Atacand)
    • Eprosartan.
    • Irbesartan (Avapro)
    • Losartan (Cozaar)
    • Olmesartan (Benicar)
    • Telmisartan (Micardis)
    • Valsartan (Diovan)

Each of these categories come with its own host of side effects. Some studies have indicated that long term use can possibly:

  • Increase the risk of gout, muscle cramps, impotence from diuretics (ref)
  • increase the risk of osteoporosis (1) and heart attacks (especially with high doses or combined with diuretics) (2, 3) with calcium channel blockers
  • Increase the risk of dementia / cognitive impairment (4, 5) with beta blockers
  • Increase the risk of leg swelling, vomiting / diarrhoea, respiratory problems, back pain, and dizziness from Angiotensin receptor blockers (ref)

Now, I am not trying to say that no one should take these drugs. In fact, they have prolonged the lives of many, many people, and we should be thankful to have them as options.

Disclaimer: Nothing in this article is intended as medical advice. Everything on this article and website is for informational purposes only. Do not stop any medications or add any supplements before discussing it with and clearing it with your primary physician.

My goal in writing this article is that I personally do not believe that they should be the first line of treatment. I believe that the ethical doctor should do a little investigating as to why the patient has high blood pressure in the first place.

{Is the patient consuming too much processed and heated fats/oils (see the image in my post about coconut oil)? Are they eating enough fruits and veggies to get enough potassium? (6) Are they consuming processed table salt instead of natural sea salt? (7)}

There can be many reasons that can cause a patient to have high blood pressure, and usually it is a combination of those reasons. Reversing the diet and lifestyle changes that precipitated the high blood pressure in the first place can make a huge difference, and it can allow the patient to take less medication and thus have fewer side effects. (ref)

Today we are going to focus on just one factor that can contribute to high blood pressure. This is a factor that is commonly overlooked but plays a very large role.

The Role Magnesium Plays in Blood Pressure Control

High blood pressure is really a “surrogate” endpoint measurement. Meaning, no one really cares what their blood pressure is by itself. They care what having high blood pressure means.

They are concerned because high blood pressure has been shown to increase the risk of suffering from or dying from other conditions.

This is important to remember, because much of the time correcting your low blood pressure naturally (say, through magnesium supplementation) will also lead to a reduced risk of dying from other conditions.

For example, low serum magnesium levels have been associated with a high risk for coronary artery calcification (i.e. hardening of the arteries) even in individuals who were thought to be at low risk for cardiovascular disease. (8)

This is partially because magnesium is actually nature’s calcium channel blocker. (9) So it acts somewhat similar to that group of blood pressure medications above, but instead of side effects, you usually get side benefits!

“With the advent of “calcium blockers” in the treatment of cardiovascular disorders, one’s attention is drawn to the role of calcium in myocardial contractility, impulse formation, and smooth muscle tone. This increased awareness of calcium has also drawn attention to the role of magnesium, which in many situations has been shown to counter the actions of calcium. The present report attempts to show that excess magnesium will block, and that deficiency of magnesium will potentiate, the action of calcium. Clinical experiences, both recent and in the past, have also suggested the possibility that magnesium may effectively control certain cardiovascular functions. In a sense, magnesium may be considered nature’s physiologic calcium blocker. “

“Magnesium: Nature’s physiologic calcium blocker” (9)

Clinical studies have shown that “Magnesium intake of 500 mg/d to 1000 mg/d may reduce blood pressure (BP) as much as 5.6/2.8 mm Hg”, though with a wide variability. (10, 16) This rivals the effect of synthetic calcium channel antagonists.

However, when you choose magnesium instead of a synthetic calcium channel blocker, you get a host of side-benefits:

“Preliminary evidence suggests that insulin sensitivity, hyperglycemia, diabetes mellitus, left ventricular hypertrophy, and dyslipidemia [high bad cholesterol and triglycerides] may be improved with increased magnesium intake.” (10)

Moreover, if you are already taking a drug for high blood pressure, magnesium has repeatedly been shown to increase the effectiveness of that anti-hypertensive medication! (10, 11)

So instead of adding another synthetic medication to further try to improve blood pressure control (and get even more side effects due to the mix), first ask your doctor if you can try magnesium.

Besides its effect on calcium, magnesium also likely protects the endothelium (the lining of the blood vessels) by countering chronic inflammation. Furthermore, being deficient in magnesium promotes inflammatory responses. (20)

Most People are Deficient in Magnesium in the U.S.

Most of the magnesium in our bodies is stored inside the cells, not outside in the plasma. Just like plasma calcium levels tend to remain stable even if the person is not taking in enough calcium to support their bones, serum or plasma magnesium levels tend to stay stable even if the person is not taking in enough to support intracellular magnesium levels.

This is why so many people who are magnesium deficient remain undiagnosed, even if the doctor happens to test their blood magnesium levels. (12)

A better way is to test the red blood cell or erythrocyte magnesium levels. Any functional medicine doctor will automatically do this, but you might have to persuade your regular GP to.

Actually, it was shown that over 90% of patients with low serum magnesium never even get their magnesium levels tested even when they are being checked for electrolyte disturbances! (21)

When tested, 34% of apparently healthy university students had a low plasma magnesium level, which was due to a low dietary magnesium intake. (14)

“Dietary surveys of people in Europe and in the United States still reveal that intakes of magnesium are lower than the recommended amounts. Epidemiological studies in Europe and North America have shown that people consuming Western-type diets are low in magnesium content, i.e. <30%–50% of the RDA for magnesium.” (17)

Why do we have such a wide-spread deficiency?

Our culture has now normalized the consumption of very processed foods. This is very, very new as far as human history is concerned, and during the processing, much of the magnesium that was originally in the food gets lost (along with other vitamins and minerals). (13, 15) The U.S. government fortifies some of these back, like the b-vitamins (in their synthetic form) and iron, but magnesium is never added back.

This means that for most people, supplementation will likely be necessary to avoid a deficiency.

With respect to blood pressure, keep in mind that magnesium is not the only thing that matters. Even though it can play a big role, increasing potassium intake, removing added processed table salt, decreasing the consumption of oxidized fat from fast food / restaurants, increasing your silica intake, and increasing your fiber intake from natural sources can all influence your blood pressure positively.

How to Take Magnesium

There are many magnesium supplements that will work for rising your magnesium levels. However, many also function as a laxative, and thus have decreased absorption and also may cause GI distress.

The type I usually recommend is magnesium taurate because it has great bioavailability and taurine itself has additional beneficial actions that protect against high blood pressure, diabetes, and artherosclerosis. (18, 19) This type also seems to have the most beneficial effect on anxiety. (19) Magnesium oxide and citrate are common types, but they have low bioavailability and can have laxative effects, respectively. (19)

This is the brand that I would recommend for oral magnesium (double wood is a very respected brand in my opinion). Keep in mind that I am an Amazon affiliate, and thus when you purchase anything using the link below, you will be helping to support this site at NO extra cost to you! All of my recommendations are always hand-picked with no outside pressure or influence whatsoever.

The usual dose for this brand would be 3-6 capsules a day. Yet, if your blood pressure is particularly resistant, you will not be going over the upper limit by taking up to 9 pills a day if needed. Experiment and talk with your doctor to see what works for you. If taking many doses, spread them out to two or three times of the day.

Please let me know if you have any comments, questions, or suggestions by leaving a comment below! Please share this article so that others may benefit from the information!

References
  1. Ağaçayak KS, Güven S, Koparal M, Güneş N, Atalay Y, Atılgan S. Long-term effects of antihypertensive medications on bone mineral density in men older than 55 years. Clin Interv Aging. 2014;9:509–513. Published 2014 Mar 27. doi:10.2147/CIA.S60669
  2. Psaty BM, Heckbert SR, Koepsell TD, Siscovick DS, Raghunathan TE, Weiss NS, Rosendaal FR, Lemaitre RN, Smith NL, Wahl PW, et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA. 1995 Aug 23-30;274(8):620-5. PubMed PMID: 7637142.
  3. Wassertheil-Smoller S, Psaty B, Greenland P, Oberman A, Kotchen T, Mouton C, Black H, Aragaki A, Trevisan M. Association between cardiovascular outcomes and antihypertensive drug treatment in older women. JAMA. 2004 Dec 15;292(23):2849-59. Erratum in: JAMA. 2005 Apr 6;293(13):1594. PubMed PMID: 15598916.
  4. Fares, A. (2012). Use of Beta-Blockers and Risk of Dementia in Elderly Patients. The Journal of Neuropsychiatry and Clinical Neurosciences, 24(4), E20–E21. https://doi.org/10.1176/appi.neuropsych.11100240
  5. Gliebus G, Lippa CF. The influence of beta-blockers on delayed memory function in people with cognitive impairment. Am J Alzheimers Dis Other Demen. 2007 Feb-Mar;22(1):57-61. PubMed PMID: 17534003.
  6. McDonough AA, Nguyen MT. How does potassium supplementation lower blood pressure?. Am J Physiol Renal Physiol. 2012;302(9):F1224–F1225. doi:10.1152/ajprenal.00429.2011
  7. Lee BH, Yang AR, Kim MY, McCurdy S, Boisvert WA. Natural sea salt consumption confers protection against hypertension and kidney damage in Dahl salt-sensitive rats [published correction appears in Food Nutr Res. 2017 Mar 20;61(1):1300375]. Food Nutr Res. 2016;61(1):1264713. Published 2016 Dec 20. doi:10.1080/16546628.2017.1264713
  8. Lee, S. Y., Hyun, Y. Y., Lee, K. B., & Kim, H. (2015). Low serum magnesium is associated with coronary artery calcification in a Korean population at low risk for cardiovascular disease. Nutrition, Metabolism and Cardiovascular Diseases, 25(11), 1056–1061. https://doi.org/10.1016/j.numecd.2015.07.010
  9. Iseri, L. T., & French, J. H. (1984). Magnesium: Nature’s physiologic calcium blocker. American Heart Journal, 108(1), 188–193. https://doi.org/10.1016/0002-8703(84)90572-6
  10. Houston, M. (2011). The Role of Magnesium in Hypertension and Cardiovascular Disease. The Journal of Clinical Hypertension, 13(11), 843–847. https://doi.org/10.1111/j.1751-7176.2011.00538.x
  11. Touyz, R. M. (1991). Magnesium supplementation as an adjuvant to synthetic calcium channel antagonists in the treatment of hypertension. Medical Hypotheses, 36(2), 140–141. https://doi.org/10.1016/0306-9877(91)90256-x
  12. DiNicolantonio, J. J., O’Keefe, J. H., & Wilson, W. (2018). Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis. Open Heart, 5(1), e000668. https://doi.org/10.1136/openhrt-2017-000668
  13. Louzada, M. L. da C., Martins, A. P. B., Canella, D. S., Baraldi, L. G., Levy, R. B., Claro, R. M., … Monteiro, C. A. (2015). Impact of ultra-processed foods on micronutrient content in the Brazilian diet. Revista de Saúde Pública, 49(0), 1–8. https://doi.org/10.1590/s0034-8910.2015049006211
  14. Célia Colli. (2014). HAY DEFICIENCIA CRÓNICA LATENTE DE MAGNESIO EN ESTUDIANTES. NUTRICION HOSPITALARIA, (1), 200–204. https://doi.org/10.3305/nh.2014.30.1.7510
  15. Marier JR. Magnesium content of the food supply in the modern-day world. Magnesium. 1986;5(1):1-8. Review. PubMed PMID: 3515057.
  16. Kass, L., Weekes, J., & Carpenter, L. (2012). Effect of magnesium supplementation on blood pressure: a meta-analysis. European Journal of Clinical Nutrition, 66(4), 411–418. https://doi.org/10.1038/ejcn.2012.4
  17. Gröber U, Schmidt J, Kisters K. Magnesium in Prevention and Therapy. Nutrients. 2015;7(9):8199–8226. Published 2015 Sep 23. doi:10.3390/nu7095388
  18. McCarty, M. F. (1996). Complementary vascular-protective actions of magnesium and taurine: A rationale for magnesium taurate. Medical Hypotheses, 46(2), 89–100. https://doi.org/10.1016/s0306-9877(96)90007-9
  19. Uysal, N., Kizildag, S., Yuce, Z., Guvendi, G., Kandis, S., Koc, B., … Ates, M. (2018). Timeline (Bioavailability) of Magnesium Compounds in Hours: Which Magnesium Compound Works Best? Biological Trace Element Research, 187(1), 128–136. https://doi.org/10.1007/s12011-018-1351-9
  20. Nielsen FH. Magnesium deficiency and increased inflammation: current perspectives. J Inflamm Res. 2018;11:25–34. Published 2018 Jan 18. doi:10.2147/JIR.S136742
  21. Whang R, Ryder KW. Frequency of hypomagnesemia and hypermagnesemia. Requested vs routine. JAMA. 1990 Jun 13;263(22):3063-4. PubMed PMID: 2342219.

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