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Heart & Cardiology/Mechanisms By Which Natural Supplements Work


Hello Dr Ahmed,

I've had some success lowering my BP with natural products.  In my experience I've found :-

1. Many natural supplements that are said to lower BP in others may in fact do nothing for me, or worse, raise my BP.  Why is the body's reaction to supplements so individual?  Are our metabolic pathways so different?

2.  Natural supplements may not need to be taken continuously.  A bout of a supplement, then cessation, may work just as well as taking the supplement continuously eg Rauwolfia serpentina. Do natural supplements temporarily "reset" the body in some way?  Perhaps turn off genes?

3.  A natural supplement may lower BP one time, but another time have less effect or no effect.  Why is the body's reaction so dynamic?

It seems I'll need a range of supplements to fully bring my BP down, no one supplement can do the job.  R. serpentina works very well for me, and I'll be looking at Terminalia arjuna ("abana") soon.  (Of course, diet and exercise are part of the equation.)

Many thanks for helping me think out these issues.

Best regards,


A couple general things first, I maintain some reservation when it comes to openly recommending so-called “natural products” or other herbs, spices, or plant-based remedies for medical conditions. I do support holistic medicine and alternative medicine approaches to some medical conditions. However, natural products and supplements carry concerns of their own given the lack of regulation. Traditional prescribed medications have to pass stringent and rigorous safety, manufacturing, and effectiveness testing in order to be available to you as a consumer. Natural products, on the other hand, do not and that is the problem.

For your specific issue, hypertension or high blood pressure, we have several evidence-based (meaning, passed through stringent and rigorous clinical trials in humans) medications that have been shown to effectively reduced blood pressure, prevent cardiovascular disease events, and prolong life. Therefore, if your blood pressure needs to be lowered (<140/90 mm Hg) and diet and exercise are not enough – then, an evidence-based medication for lowering your blood pressure would be right for you. I would maintain a reservation regarding unproven and potentially risky natural products.

To answer your questions:

1. Everyones reaction may be different to supplements because supplements are made differently because they are not regulated. This is just another reason why supplements can be dangerous.

2. It is hard to say what supplements actually do because they are usually a concoction of several different compounds. It is unlikely that supplements really “reset” anything. Pretty much anything and everything you do will alter gene expression in some way, sometimes for the better and sometimes for the worse, with supplements it is hard to say as these issues have not been adequately evaluated at a basic level.

3. Again, because there is no consistency with natural products, you will get varying effects.

As stated above, if you need to lower your blood pressure there are a few things you can do:

1. Weight management to a body mass index less than 25.
2. Tobacco use cessation.
3. Diet – low sodium (2-4 grams per day), low sugar-sweetened beverage, high fiber, and increased fruit and vegetable intake.
4. Exercise – stay physically active for at least 150 minutes at moderate intensity or 75 minutes at vigorous intensity each week.
Also, see the American Heart Association's national goals for cardiovascular health promotion and disease reduction ( If your blood pressure remains above 140/90 mm Hg after the above recommendations are tried, then you would benefit from the addition of medications to lower your blood pressure.

I wish that those backing natural products would take the time to prove the efficacy, safety and satisfactory long term outcomes that many of these agents claim. Then and only then will it be ok to recommend them on a widespread basis.

Hope that was helpful,  

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Mustafa Ahmed MD


Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease


Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology


Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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