High blood pressure is one of the most common health problems in the world and a major cause of heart disease and stroke.
For most people, lifestyle changes and medicines can bring blood pressure under control, but some continue to have high readings even while taking several drugs.
Researchers from the University of Maine have examined whether B vitamins could provide another way to help some of these patients. Their work focuses on a substance in the blood called homocysteine and its possible connection with high blood pressure.
Blood pressure measures how strongly blood pushes against artery walls. When that pressure remains too high for a long time, it can damage blood vessels and organs, increasing the risk of heart attack, stroke, kidney disease, and other serious problems.
Some people have what doctors call resistant hypertension. This generally means their blood pressure remains above the recommended level despite treatment with several blood pressure medicines.
Estimates suggest resistant hypertension affects a significant share of people with high blood pressure. Because these patients already receive several medicines, researchers are interested in finding additional factors that could be treated safely.
One possible factor is homocysteine, an amino acid naturally produced when the body processes certain proteins. Small amounts normally circulate in the blood, but unusually high levels have been associated with damage to blood vessels and a greater risk of cardiovascular disease.
High homocysteine may interfere with the ability of blood vessels to relax normally. If vessels remain tighter, blood has less space to flow through, which can contribute to higher blood pressure.
Several B vitamins help the body process homocysteine. These include folate, also known as vitamin B9, as well as vitamins B6, B12, and riboflavin, or B2.
If people do not get enough of these nutrients, homocysteine levels may rise. Genetics, age, kidney function, certain medicines, and other health conditions can also influence how much homocysteine is present in the blood.
The University of Maine researchers reviewed earlier research examining this relationship. They reported evidence suggesting that lowering elevated homocysteine with B vitamins may be associated with reductions in blood pressure, with some studies reporting decreases of about 6 to 13 mmHg.
Such a reduction could be meaningful because even modest improvements in blood pressure can lower cardiovascular risk over time. However, the evidence does not show that everyone with hypertension will benefit from taking B vitamin supplements.
Researchers are also still debating what level of homocysteine should be considered ideal. Some laboratories use an upper normal level of around 11.4 micromoles per liter, while some researchers argue that levels should be kept at 10 micromoles per liter or below.
More carefully controlled studies are needed to determine which patients are most likely to benefit and which B vitamins and doses are appropriate. Researchers also need to establish whether lowering homocysteine directly reduces heart attacks, strokes, and other major health problems.
B vitamins are found naturally in many foods, including vegetables, whole grains, legumes, eggs, dairy products, meat, and fish, depending on the vitamin. Supplements are also widely available, but taking large amounts is not automatically safer or more effective.
People with difficult-to-control blood pressure should not replace prescribed medicines with vitamins or change treatment without medical advice. Instead, the research suggests that checking nutritional status and homocysteine may eventually become another useful part of understanding why blood pressure remains high in some patients.
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