Endothelial Dysfunction and High Blood Pressure Treatment

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Years ago at a lecture, the speaker asked attendants "What Exactly is High Blood Pressure?" Each physician in the audience gave an answer by defining a numeric value of 140/90 mmHg.

None of them were the answers that the presenter was looking for.

"Hypertension," she said, "is a dysfunction of the endothelium."  The key to treating high blood pressure, she said, was treating the endothelial dysfunction

The Endothelium

The blood vessels in your body are not just simple vessels through which blood flows. They are much more. They contain several layers and the innermost level of the blood vessel is called the endothelium. Think of this layer as a city unto itself. There is a lot going on. The endothelium is responsible for not only blood clotting but also helps to regulate blood pressure. It produces many substances that regulate how a blood vessel dilates or narrows (constricts). Endothelin is an example of a local mediator produced by this layer that promotes constriction, or narrowing of the blood vessel. Nitric oxide is a local mediator that promotes dilation of the vessels. In the endothelial layer, there is a constant battle occurring between substances that promote vasoconstriction and those that promote vasodilation.

It is thought that the imbalance in this battle favoring vasoconstriction greatly contributes to the development of high blood pressure. At the level of a cell, this imbalance can cause increased oxidative stress to the cell, formation of toxic oxygen (or free radicals) which over time can damage the blood vessel wall which decreases its flexibility. Endothelial dysfunction contributes to the development of plaque buildup within the blood vessel wall.

Factors That Favor Endothelial Dysfunction

There are several factors that can favor the development of dysfunction of the endothelium:

  • Magnesium Deficiency: Magnesium is a smooth muscle vasodilator
  • Low Ubiquinone (Coenzyme Q10) Levels: Ubiquinone is a potent antioxidant within the cells that not only increases energy to the cell but also keeps the cell viable
  • Increased Stress as any type of emotional stress directly stimulates constriction of the blood vessels
  • Western diet high in pro-oxidants
  • Cigarette smoking
  • Increased total body inflammation
  • High cholesterol levels
  • Obesity 


Here is my opinion concerning this: prescription medications, while they can lower blood pressure, may only be so effective if you have an endothelium that is not healthy. Think about it this way: calcium channel blockers and alpha blockers are classes of medications that achieve their blood pressure lowering effects by working on specific receptors in the blood vessel to cause dilation of the blood vessel. If your endothelium is not healthy, how effective do you think that these medications will be?

There are certain things that you can do to improve the health of your blood vessels and treat high blood pressure:

  • Change your diet to include more vegetables; an excellent nutrition plan for someone with high blood pressure is the DASH diet. Another excellent diet that is great for not only blood pressure but your blood vessel health is the Mediterranean diet.
  • Stop smoking and drinking excessive alcohol.
  • Normalize your potassium and magnesium levels
  • Consider supplementing with Ubiquinone on a daily basis.
  • Add other supplements that can improve blood vessel health including resveratrol and olive leaf extract.
  • Add mercury free salmon to your diet on a daily basis or supplement with omega 3 fish oil to help keep your blood vessels soft and pliable.
  • The statin class of medications also can help improve endothelial function.
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