Hypertension and the Eyes

High Blood Pressure and Vision Health

blood vesselsHypertension increases sharply with advancing age; hence older persons are those most affected by its negative consequences.

High blood pressure can damage blood vessels in the retina. The retina is the layer of tissue at the back part of the eye. It changes light and images that enter the eye into nerve signals that are sent to the brain.

Those with high pressure not carefully controlled have a high incidence of heart attacks and strokes, as well as retinal disorders that can result in retinal bleeding, and other eye conditions such as hypertensive retinopathy, Central serous choroidopathy (CSCR), also referred to as central serous retinopathy (CSR) and glaucoma.

Although high blood pressure is not a direct cause of glaucoma, many studies have found it to be related.1 2, as much as a 17% increased risk.3

The link is clear. Arterial hypertension is the most common systemic disease in glaucoma patients. Even though hypertension increases IOP only slightly, it has a significant negative effect on ocular perfusion (the relationship of blood pressure and IOP).4. Klin Monbl Augenheilkd. Feb;231(2):136-43.] In the brain there is a close relationship between nerve activity and essential blood flow at the head of the optic nerve.5

Nutrients, Hypertension and Vision

Vitamin D3

The most common nutritional deficiency, especially in seniors, is vitamin D.  Vitamin D is derived from sun exposure as well as supplementation.  The seasonal changes in blood pressure linked to vitamin D receptors in the body connects this lack with cardiovascular problems, including high blood pressure.  While there is experimental evidence that vitamin D signaling is critical to heart and vascular functioning, more recent clinical studies in which vitamin D is used as an intervention do not prove such a causal relationship.6

Whether there is a direct connection between vitamin D levels and glaucoma is controversial but some studies have identified vitamin D lack as a risk factor.  On the other hand a study of over 143 thousand women failed to find a connection.7 The exact mechanism of benefits of D is still unknown, but in the case of glaucoma, vitamin D’s anti-inflammatory capacity appears to play an important role.8

A minimum adequate range of Vitamin D blood levels is 20ng/ml(50nmol/l), and minimum supplementation based on RDA for vitamin D is 800 IU for people over age 70 years and 600 IU for ages 50–70 years, though for seniors who do not get regular sunlight exposure 2000 IU – 5,000 IU per day may be appropriate.

Vitamin D3 is a good, easily absorbed form of Vitamin D. Supplements often add a small amount of Vitamin K for better absorption.

Omega-3 Fatty Acids

Two omega-3 polyunsaturated fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) can reduce blood pressure and vasodilation. In the endothelium, DHA and EPA improve function including increased nitric oxide bioavailability.9

Supplementing with omega-3 fatty acids helps reduce arrhythmias, a common heart issue that increases one’s risk of HF, and is attributed to over 500,000-plus cardiac deaths that occur each year in the United States. Omega-3 fats also lower blood pressure and heart rate, improve blood vessel function, and, at higher doses, lower triglycerides and may ease inflammation, which plays a role in the development of atherosclerosis.10 11

Furthermore, omega 3s help to alleviate dry eye symptoms, decrease tear evaporation rate, and improve computer fatigue related dry eye.12

Magnesium

Researchers have also identified a close connection between magnesium deficiency and high blood pressure through experimental, epidemiological, and clinical studies. There are a number of physiological mechanisms which may explain this protective effect against hypertension and hypertension complications. Dominguez, et al writes, “the evidence for a favorable effect of magnesium on hypertension risk emphasizes the importance of broadly encouraging the intake of foods such as vegetables, nuts, whole cereals and legumes, optimal dietary sources of magnesium, and avoiding processed foods, which are very poor in magnesium and other fundamental nutrients, in order to prevent hypertension. In some cases, when diet is not enough to maintain an adequate magnesium status, magnesium supplementation may be of benefit and has been shown to be well tolerated.”13 Hypertension increases sharply with advancing age, hence older persons are those most affected by its negative consequences.

CoQ10

Early research assessing the value of supplementing with CoQ10 found marked reduction in blood pressure in study subjects.14 15

CoQ10 is anti-inflammatory, scavenges free radicals, supports vasodilation, adjusts angiotension, and reduces aldosterone levels.16

Nitric Oxide (NO)

Peripheral artery disease (PAD) patients have lowered synthesis or function of NO, which leads to suppression of endothelium-dependent vasodilation.17 Replenishing nitrate levels can have beneficial effects on the retinal microvasculature.

L-arginine

L-arginine may be helpful in reducing high blood pressure. Some studies suggest that it improves endothelium-derived nitric oxide production and function on endothelium cells, which line blood vessels and reduce systemic blood pressure in some models of hypertension.18

Coleus forskohlii

One small study suggests that coleus acts as an effective anti-hypertensive.19 Forskolin, the active component of coleus, is a naturally occurring diterpene which exhibits beneficial vascular effects and is helpful in treating both hypertension and glaucoma.20

Lifestyle Considerations

Anti-inflammatory diet. Since the 1960s researchers have been accumulating evidence that inflammation contributes to the development of hypertension. Biomarkers of inflammation are elevated in humans with hypertension. Emerging evidence suggests that hypertension is accompanied and indeed initiated by interdependent inflammatory events are interdependent through mechanisms involving oxidative stress, protein proteins, and antigen processing.21

See our anti-inflammatory Vision Diet and Alkalizing Food Chart.

Maintain a diet low in sugar and refined carbohydrates. Sweeteners of all kinds contribute to inflammation. Sugar is one of the most acidic foods, and excess sugar in one’s diet is considered a leading contributor to disease, such as type 2 diabetes, cardiovascular disease, high blood pressure, dementia, and cancer.22

Numerous research studies have linked a number of these health conditions to eye diseases, such as cataracts, glaucoma, and diabetic retinopathy; studies have also linked diets high on the glycemic index with macular degeneration.23 

Limit alcohol intake. Alcohol reduces protective glutathione levels because it interferes with liver functioning. Heavy drinking increases the risk of many diseases, including hypertension, anemia, cirrhosis, depression, seizures, hypertension, immune system suppression, nerve damage, and pancreatic disease.24

Try to do some form of meditation daily. Vedic meditation and Transcendental meditation (TM) are examples in which no concentration/contemplation is used, but which yield qualitatively different end results. These are good techniques even if you live a demanding, stressful life. They have been found to produce good physical outcomes, especially reducing anxiety, addiction, hypertension, sleeplessness, and migraines. In these forms of meditation, which have been scientifically studied, frontal lobe activity changes and alpha functioning improves across the brain.25

Exercise regularly. It is well known that exercise is a critical tool in reducing age-related eye disease. Aerobic exercise protects the retina from deterioration26 (and in lab animals, protects even in cases of genetically-based retinal degeneration).27

Exercise reduces intraocular pressure, central retinal vein occlusion, and age-related macular degeneration, as well as hypertension and diabetes.

At a minimum, take a brisk 15–20-minute walk per day. Jogging and running are not essential but are helpful if you enjoy them. The point is to get outside every day and move around. If you are working at a desk job, full or part time, then be sure to get up and move around for a few minutes every hour or two.

Chinese Medicine Perspective

There are a number of patterns in Chinese Medicine that can be related to hypertension. For example, excess yin reduces the heat in the body, while excess yang increases it. People with excess yin tend toward diseases with a quality of dampness, such as high cholesterol and obesity. People with excess yang can be prone to conditions like arthritis, hypertension, and headaches.

Liver Wind/Liver Yang Rising. This pattern results when the yin energy of the liver and the kidney becomes extremely depleted, the Liver Yang energy becomes erratic, undernourished, and imbalanced. This can also result in heat rising. Major ocular symptoms include glaucoma, wet or dry AMD, eyestrain or temple headaches, blurry vision, as well as other symptoms such as tinnitus, hearing impairment, tremors, tics, hypertension, and restlessness.

Recommended Supplements

Nitric Oxide Supplement

UBQH 100mg 60 softgelseasily absorbed form of CoQ10.

Blood Pressure Health 90 vegcaps (N3066)

Advanced Eye & Vision Support Formula (whole food) 60 vcaps

OmegaGenics EPA-DHA 2400 5 fl oz

Dr. Grossman’s Coleus Ultra Herbal Formula 2oz (60ml)

ACG Glutathione EXTRA STRENGTH Spray 2oz.

Gamma E Mixed Tocopherols 60 softgels (L07061)

Footnotes

  1.  Choi J, Kim KH, Jeong J, Cho HS, Lee CH, et al. (2007). Circadian fluctuation of mean ocular perfusion pressure is a consistent risk factor for normal-tension glaucoma. Invest Ophthalmol Vis Sci. 48:104-111.
  2. Hulsman CA, Vingerling JR, Hofman A, Witteman JC, de Jong PT. (2007). Blood pressure, arterial stiffness, and open-angle glaucoma: the Rotterdam study. Arch Ophthalmol, 125:805-812.
  3. Newman-Casey. (2011). Diabetes and hypertension may increase your risk of glaucoma. To be safe, ask your eye doctor for a yearly glaucoma test. Heart Advis, Nov;14(11):5.
  4. Erb C, Predel HG. (2014). [Relevance of arterial hypertension in primary open-angle glaucoma
  5. Orgül S, Gugleta K, Flammer J. Physiology of perfusion as it relates to the optic nerve head. Surv Ophthalmol. 1999 Jun;43 Suppl 1:S17-26.
  6. Latic N, Erben RG. (2020). Vitamin D and Cardiovascular Disease, with Emphasis on Hypertension, Atherosclerosis, and Heart Failure. Int J Mol Sci. Sep 4;21(18):6483.
  7. Huynh B, Shah P, Sii F, Hunter D, Carnt N, White A. (2021). Low systemic vitamin D as a potential risk factor in primary open-angle glaucoma: a review of current evidence. Br J Ophthalmol. May;105(5):595-601.
  8. Huynh B, Shah P, Sii F, Hunter D, Carnt N, White A. (2021). Low systemic vitamin D as a potential risk factor in primary open-angle glaucoma: a review of current evidence. Br J Ophthalmol. May;105(5):595-601.
  9. Bercea CI, Cottrell GS, Tamagnini F, McNeish AJ. (2021). Omega-3 polyunsaturated fatty acids and hypertension: a review of vasodilatory mechanisms of docosahexaenoic acid and eicosapentaenoic acid. Br J Pharmacol. Feb;178(4):860-877.
  10. Leaf A. (2007). Prevention of sudden cardiac death by n-3 polyunsaturated fatty acids. J Cardiovasc Med. (Hagerstown). 8 Suppl 1:S27-29.
  11. Jain AP, Aggarwal KK, Zhang PY. (2015). Omega-3 fatty acids and cardiovascular disease. Eur Rev Med Pharmacol Sci. 19(3):441-5.
  12. Bhargava R, Kumar P, Phogat H, Kaur A, Kumar M. Oral omega-3 fatty acids treatment in computer vision syndrome related dry eye. Cont Lens Anterior Eye. 2015 Jun;38(3):206-10.
  13. Dominguez L, Veronese N, Barbagallo M. Magnesium and Hypertension in Old Age. Nutrients. 2020 Dec 31;13(1):139.
  14. Folkers K, Drzewoski J, Richardson PC, Ellis J, Shizukuishi S, et al. (1981). Bioenergetics in clinical medicine. XVI. Reduction of hypertension in patients by therapy with coenzyme Q10. Res Commun Chem Pathol Pharmacol, Jan;31(1):129-40.
  15. Singh RB, Niaz MA, Rastogi SS, Shukla PK, Thakur AS. (1999). Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease. J Hum Hypertens. Mar;13(3):203-8.
  16. Zozina VI, Covantev S, Goroshko OA, Krasnykh LM, Kukes VG. Coenzyme Q10 in Cardiovascular and Metabolic Diseases: Current State of the Problem. Curr Cardiol Rev. 2018;14(3):164-174.
  17. Allen JD, Miller EM, Schwark E, Robbins JL, Duscha BD, Annex BH. Plasma nitrite response and arterial reactivity differentiate vascular health and performance. Nitric Oxide. 2009;20(4):231-237.
  18. Gokce N. (2004). L-arginine and hypertension. J Nutr. Oct;134(10 Suppl):2807S-2811S; discussion 2818S-2819S.
  19. Jagtap M, Chandola HM, Ravishankar B. (2011). Clinical efficacy of Coleus forskohlii (Willd.) Briq. (Makandi) in hypertension of geriatric population. Ayu.  Jan;32(1):59-65.
  20. Tirapelli CR, Ambrosio SR, de Oliveira AM, Tostes RC. (2010). Hypotensive action of naturally occurring diterpenes: a therapeutic promise for the treatment of hypertension. Fitoterapia.  Oct;81(7):690-702.
  21. Xiao L, Harrison DG. Inflammation in Hypertension. Can J Cardiol. 2020 May;36(5):635-647.
  22. Doheny, K. (2012). Americans Sweet on Sugar: Time to Regulate? WebMD. Retrieved from https://www.webmd.com/diet/news/20120201/americans-sweet-on-sugar-time-to-regulate#1
  23. Chiu C, Milton RC, Gensler G, Taylor A. (2007). Association between dietary glycemic index and age-related macular degeneration in nondiabetic participants in the Age-Related Eye Disease Study. Am J Clin Nutr, July; (86):180-188.
  24. Freeman D. (2018). 12 Health Risks of Chronic Heavy Drinking. Retrieved April 18 2018 from https://www.webmd.com/mental-health/addiction/features/12-health-risks-of-chronic-heavy-drinking#1
  25. Williams, W. (2014). How to Choose the Right Meditation Technique for You. Retrieved Jul 9 2018 from https://www.mindbodygreen.com/0-15506/how-to-choose-the-right-meditation-technique-for-you.html
  26. Pardue MT, Chrenek MA, Schmidt RH, Nickerson JM, Boatright JH. (2015). Potential Role of Exercise in Retinal Health. Prog Mol Biol Transl Sci, 134:491-502.
  27. Lawson, E.C., Han, M.K., Sellers, J.T., Chrenek, M.A., Hanif, A. (2014). Aerobic exercise protects retinal function and structure from light-induced retinal degeneration. J Neurosci, Feb 12;34(7):2406-12.