Herbs, spices, grains, legumes, nuts, fruit, berries, vegetables... are rich in chemical compounds: polyphenols. Those consuming diets rich in polyphenols (these are plant forward diets) have better long-term health outcomes and there is growing evidence for their beneficial effects to combat hypertension aka high blood pressure.
An Overview of Polyphenols and Hypertension
Research generally shows that dietary polyphenols, particularly flavonoid subclasses, have positive effects on blood pressure and the risk of hypertension.
Some evidence suggests that phenolic acids might have beneficial effects. Major dietary sources of phenolic acids include fruits, wholegrains and nuts, cocoa as well as beverages such as coffee. The association between phytoestrogens, such as isoflavones and lignans (flaxseed is a rich source), and blood pressure are more consistent although results varied by sex and study design.
Among flavonoid subclasses, anthocyanins (found in berries) are significantly linked to a reduced risk of hypertension. With an 8% risk reduction when comparing the highest and lowest levels of anthocyanin intake. Results for total flavonoids and flavones also show potential benefits.
Flavonoid-rich foods, particularly fruits, vegetables, berries, and dark chocolate, were shown to reduce systolic and diastolic blood pressure. Specific foods like pomegranate juice and berries have demonstrated potential blood pressure-lowering effects, while blueberry supplementation did not show consistent results. Isoflavones from soybeans are also linked to lower blood pressure, especially in postmenopausal women consuming at least 25 grams of soy protein per day. Lignans found in seeds, such as flaxseeds and sesame, are associated with reduced blood pressure in clinical trials.
Coffee, another major source of phenolic acids, shows a modest decrease in hypertension risk in cohort studies. Long-term tea consumption (over 12 weeks) is associated with blood pressure reduction, particularly among overweight and hypertensive individuals.
Meta-analyses of clinical trials on polyphenol supplementation yield inconsistent results, suggesting that whole foods may be more effective than supplements. For example, flaxseed is more beneficial when consumed whole (and ground) rather than as a lignan extract.
Not limited to hypertension, polyphenols support health in other cardiometabolic illnesses.
To see the collection of studies (that we will add to when new research is published), scroll down to bottom of page. If you have any suggestions of other studies to include, add them in the Comments section, also at bottom of page.
Polyphenols are not a magic bullet. They should be part of a healthy eating pattern and lifestyle.
To get the benefits of polyphenols, we enjoy using a whole food approach. What does this mean? At a minimum, enjoying fruit, nuts and seeds on a daily basis. Consuming herbs and spices. Prioritising as wide variety of foods as possible, including vegetables, whole grains and legumes. A polyphenol rich diet supports health across multiple areas, so don't overthink what to eat.
Polyphenols are not a magic bullet. Benefits come from daily eating, daily living - over the course of time. Some may prefer a Western, Mediterranean diet; others a similarly plant forward Asian diet. To note, the DASH diet was specifically created (in the West) to lower to lower hypertension. A similar diet, the China Heart Healthy diet has been used successfully in Asia.
Be wary of using supplements where the evidence, safety, quality of manufacture or formulation is not as strong as the marketing behind them. As ever, please talk to your doctor or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise or lifestyle, especially if you are under treatment.
Have specific polyphenol questions? Try the online Phenol-Explorer. The database "contains more than 35,000 content values for 500 different polyphenols in over 400 foods. These data are derived from the systematic collection of more than 60,000 original content values found in more than 1,300 scientific publications."
Stay Healthy,
Alastair
Scroll down to see the studies.
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Hypertension / High Blood Pressure
Ebrahimzadeh A, Mohseni S, Safargar M, Mohtashamian A, Niknam S, Bakhoda M, Afshari S, Jafari A, Ebrahimzadeh A, Fooladshekan S, Mohtashami A, Ferns GA, Babajafari S, Sohrabi Z. Curcumin effects on glycaemic indices, lipid profile, blood pressure, inflammatory markers and anthropometric measurements of non-alcoholic fatty liver disease patients: A systematic review and meta-analysis of randomized clinical trials. Complement Ther Med. 2024 Mar;80:103025. doi: 10.1016/j.ctim.2024.103025. Epub 2024 Jan 15. PMID: 38232906.
Jennings A, Thompson AS, Tresserra-Rimbau A, O'Neill JK, Hill C, Bondonno NP, Kühn T, Cassidy A. Flavonoid-Rich Foods, Dementia Risk, and Interactions With Genetic Risk, Hypertension, and Depression. JAMA Netw Open. 2024 Sep 3;7(9):e2434136. doi: 10.1001/jamanetworkopen.2024.34136. PMID: 39292460; PMCID: PMC11411383.
Amoah I, Lim JJ, Osei EO, Arthur M, Tawiah P, Oduro IN, Aduama-Larbi MS, Lowor ST, Rush E. Effect of Cocoa Beverage and Dark Chocolate Consumption on Blood Pressure in Those with Normal and Elevated Blood Pressure: A Systematic Review and Meta-Analysis. Foods. 2022 Jul 1;11(13):1962. doi: 10.3390/foods11131962. PMID: 35804776; PMCID: PMC9265772.
Grosso G, Godos J, Currenti W, Micek A, Falzone L, Libra M, Giampieri F, Forbes-Hernández TY, Quiles JL, Battino M, La Vignera S, Galvano F. The Effect of Dietary Polyphenols on Vascular Health and Hypertension: Current Evidence and Mechanisms of Action. Nutrients. 2022 Jan 27;14(3):545. doi: 10.3390/nu14030545. PMID: 35276904; PMCID: PMC8840535.
Wang X, Wang Y, Xu W, Lan L, Li Y, Wang L, Sun X, Yang C, Jiang Y, Feng R. Dietary isoflavones intake is inversely associated with non-alcoholic fatty liver disease, hyperlipidaemia and hypertension. Int J Food Sci Nutr. 2022 Feb;73(1):60-70. doi: 10.1080/09637486.2021.1910630. Epub 2021 Apr 25. PMID: 33899670.
Ren J, An J, Chen M, Yang H, Ma Y. Effect of proanthocyanidins on blood pressure: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res. 2021 Mar;165:105329. doi: 10.1016/j.phrs.2020.105329. Epub 2021 Jan 16. PMID: 33465473.
Giacco R, Costabile G, Fatati G, Frittitta L, Maiorino MI, Marelli G, Parillo M, Pistis D, Tubili C, Vetrani C, Vitale M. Effects of polyphenols on cardio-metabolic risk factors and risk of type 2 diabetes. A joint position statement of the Diabetes and Nutrition Study Group of the Italian Society of Diabetology (SID), the Italian Association of Dietetics and Clinical Nutrition (ADI) and the Italian Association of Medical Diabetologists (AMD). Nutr Metab Cardiovasc Dis. 2020 Mar 9;30(3):355-367. doi: 10.1016/j.numecd.2019.11.015. Epub 2019 Dec 5. PMID: 31918979.
Godos J, Vitale M, Micek A, Ray S, Martini D, Del Rio D, Riccardi G, Galvano F, Grosso G. Dietary Polyphenol Intake, Blood Pressure, and Hypertension: A Systematic Review and Meta-Analysis of Observational Studies. Antioxidants (Basel). 2019 May 31;8(6):152. doi: 10.3390/antiox8060152. PMID: 31159186; PMCID: PMC6616647.
Zhu Y, Bo Y, Wang X, Lu W, Wang X, Han Z, Qiu C. The Effect of Anthocyanins on Blood Pressure: A PRISMA-Compliant Meta-Analysis of Randomized Clinical Trials. Medicine (Baltimore). 2016 Apr;95(15):e3380. doi: 10.1097/MD.0000000000003380. PMID: 27082604; PMCID: PMC4839848.
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