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Effect of lemon juice on blood pressure
Abstract
Lemon juice has commonly been used by hypertensive patients in order to lower blood pressure (BP) acutely when BP is raised or as an alternative/complementary therapy for expectation of chronic improvement. Grapefruit, a citrus fruit like lemon, causes clinically significant interactions with a variety of drugs including calcium antagonists. The aims of this study were to investigate acute and chronic effects of lemon juice on BP among hypertensive patients. Ninty-eight patients were included in this prospective study. Patients using calcium antagonists were not included in the study. In the acute study group, neither lemon juice nor water affected systolic and diastolic BPs. Blood pressure readings after two weeks of lemon juice were not different when compared to basal measurements. There is little information about drinking lemon juice in hypertensive patients. To our knowledge, acute or chronic effect of lemon juice on BP has not been investigated previously. This study did not show any beneficial effects of lemon juice on elevated BP. Besides, lemon juice has two potential risks for the users; drug interaction and noncompliance to the prescribed treatment. In conclusion, there is no evidence that lemon juice lowers BP at the present time and more studies are needed to investigate the effect of lemon juice on BP and possible interactions between lemon juice and drugs. Physicians should keep in mind that alternative therapies can have risks and train their patients about compliance to the treatment.
J. Exp. Clin. Med., 2012; 29:38-41
... Citrus limon is mainly cultivated in non-rain-fed conditions and under-irrigated conditions. It has medicinal use in lowering the risk of cardiovascular disease and stroke (Paterson et al. 2006), cancer (Kim et al. 2012), blood pressure (Sari et al. 2012). Lemon helps in maintaining a healthy complexion, preventing asthma (Gründemann et al. 2011), respiratory disorders (Nagalingam et al. 2013), throat infections, constipation (Kim et al. 2005), rheumatism, dental problems (Hurst et al. 1977), fever, internal bleeding, diarrhea (Lenoir et al. 2011), indigestion (Ledesma-Escobar et al. 2016, antifungal (Viuda-Martos et al. 2008), antibacterial, and anti-oxidant (Baratta et al. 1998). ...
Natural products, especially plants and herbs, have always been a common medicament source, either as pure active principles or traditional preparations. Traditional medicine has been used in developing and developed countries for centuries, and still, 80% of the population uses plant-based medicines for their health care needs. The present review discusses all the possible pharmacological activity reported in various literature and active chemical constituents of herbs. A list of various herbs/plants used by Ayurvedacharya Ratiram Sharma (93-year-old and practicing since 1952) and mentioned in Ayurvedic texts. The curated list was prepared by their general availability in the household and local market. This study comprehensively documented the medicinal value of sixty-six dominant plant species used in Ayurveda and local people. In the present review, each herb is discussed with its scientific and common names, geographical distribution, traditional medicinal uses, beneficial plant parts, and active chemical constituents. For each plant, pharmacological activities of different parts of plants are displayed with their chemical constituents and structure. Toxicologists, phytologists, medicinal chemists, and other researchers who are interested in the various therapeutic and related applications of plant materials will be benefited from present review. This information will open new horizons of application for the many novel drugs and drug candidates.
... In addition, lemon juice has potential risks for hypertensive patients like drug interaction and noncompliance with prescribed treatments. For example, it has been demonstrated that lime juice inhibits activity of cytochrome P450 3A4 [242]. ...
The release of reactive oxygen species (ROS) and oxidative stress is associated with the development of many ailments, including cardiovascular diseases, diabetes and cancer. The causal link between oxidative stress and cancer is well established and antioxidants are suggested as a protective mechanism against cancer development. Recently, an increase in the consumption of antioxidant supplements was observed globally. The main sources of these antioxidants include fruits, vegetables, and beverage. Herbal infusions are highly popular beverages consumed daily for different reasons. Studies showed the potent antioxidant effects of plants used in the preparation of some herbal infusions. Such herbal infusions represent an important source of antioxidants and can be used as a dietary protection against cancer. However, uncontrolled consumption of herbal infusions may cause toxicity and reduced antioxidant activity. In this review, eleven widely consumed herbal infusions were evaluated for their antioxidant capacities, anticancer potential and possible toxicity. These herbal infusions are highly popular and consumed as daily drinks in different countries. Studies discussed in this review will provide a solid ground for researchers to have better understanding of the use of herbal infusions to reduce oxidative stress and as protective supplements against cancer development.
... In addition, lemon juice has potential risks for hypertensive patients like drug interaction and noncompliance with prescribed treatments. For example, it has been demonstrated that lime juice inhibits activity of cytochrome P450 3A4 [242]. ...
The release of reactive oxygen species (ROS) and oxidative stress is associated with the development of many ailments, including cardiovascular diseases, diabetes and cancer. The causal link between oxidative stress and cancer is well established and antioxidants are suggested as a protective mechanism against cancer development. Recently, an increase in the consumption of antioxidant supplements was observed globally. The main sources of these antioxidants include fruits, vegetables, and beverage. Herbal infusions are highly popular beverages consumed daily for different reasons. Studies showed the potent antioxidant effects of plants used in the preparation of some herbal infusions. Such herbal infusions represent an important source of antioxidants and can be used as a dietary protection against cancer. However, uncontrolled consumption of herbal infusions may cause toxicity and reduced antioxidant activity. In this review, eleven widely consumed herbal infusions were evaluated for their antioxidant capacities, anticancer potential and possible toxicity. These herbal infusions are highly popular and consumed as daily drinks in different countries. Studies discussed in this review will provide a solid ground for researchers to have better understanding of the use of herbal infusions to reduce oxidative stress and as protective supplements against cancer development.
... However, in a recent randomized control trial with 80 older adults, no evidence was found that lemon juice lowers blood pressure. 16 Beets are a staple in the Russian cuisine and are high in nitric oxide, a well-known potent vasodilator that aids in conditions such as diabetes, hypertension, cardiovascular disease, and cognitive impairment, all of which are common conditions in older adults. 17 Older Slavic immigrants' understanding how food items can or cannot promote health is lacking. ...
The population of older immigrants in the United States is growing and they bring their health beliefs and practices with them. Older immigrants from the former Soviet Union use a variety of complementary and alternative medicine (CAM) remedies which includes in part: 1) foods to which medicinal properties are attributed, 2) herbs, 3) external treatments, and 4) pharmaceuticals manufactured in the former Soviet Union and available over-the-counter. These remedies vary in their efficacy and are often used in combination with or in lieu of prescribed allopathic (Western) medications. Health beliefs regarding medicine in the United States has led older Slavic immigrant to distrust their US health care providers and system. Nurses are in a key position to inquire and work with older Slavic immigrants to safely use their CAM and provide more information about prescribed allopathic medications and the harmful effects of combining remedies without consultation.
Objective:
The objective of this systematic review was to synthesize the best available research evidence on the effectiveness of flavonoid rich fruits in the treatment of hypertension.
Introduction:
Hypertension is a serious public health concern as it contributes to a significant burden of disease, attributable for millions of deaths globally. Complementary therapies including flavonoids have generated interest in assisting the treatment of hypertension. Flavonoids are a type of polyphenol abundant in fruits and a growing body of evidence suggests antihypertensive effects of the flavonoids due to its antioxidant properties. To date, no systematic review has been performed to collate the evidence on the effects of flavonoid rich fruits on hypertension in adults.
Inclusion criteria:
This systematic review included only randomized controlled trials (RCTs) that compared the administration of any type of flavonoid rich fruit or equivalent supplement with a placebo or other intervention in adults with hypertension. Trials that measured blood pressure using objective outcome measures such as a manual mercury sphygmomanometer were included. Studies that did not specify the flavonoid component of the fruit or fruit supplement were excluded in the review. Secondary outcomes, including change in weight, blood glucose level, triglycerides and total blood cholesterol levels were also assessed.
Methods:
A three-step search was undertaken, including a comprehensive search of the MEDLINE, Embase, Cochrane Trials (CENTRAL) and CINAHL databases, in September 2018. We also searched Dissertation Abstracts International, ProQuest Dissertations and Theses, MedNar and ClinicalTrials.gov to identify unpublished studies. The title and abstracts of the studies were reviewed by two independent reviewers against the inclusion/exclusion criteria. The methodological quality of the potential studies for inclusion were assessed using the critical appraisal checklist for randomized controlled trials as recommended by the Joanna Briggs Institute. Data were pooled in a statistical meta-analysis model. Subgroup-analysis according to type of intervention and length of intervention period was performed. Where statistical pooling was not possible, the findings have been presented in a narrative form.
Results:
Fifteen randomized controlled trials involving 572 participants were included in the review. The subclasses of flavonoids assessed included: anthocyanins, naringin, narirutin and flavan-3-ols. The overall methodological quality of the trials was high. Six trials investigated the effect of the flavonoid intervention on blood pressure within four weeks. Meta-analysis of five of the trials demonstrated evidence of no effect of flavonoids on systolic or diastolic blood pressure when compared to placebo (systolic mean difference = -1.02, 95% CI -3.12, 1.07; p = 0.34, I = 0%; diastolic mean difference = -0.90, 95% CI -2.10, 0.31; p = 0.15, I = 0%). Similarly, pooled results from two cross-over RCTs with two-timed dosed interventions in a 24-hour period demonstrated evidence of no effect on a reduction in diastolic blood pressure (p = 0.38) but did reveal evidence of a reduction in systolic blood pressure (p = 0). Six trials that assessed blood pressure following the flavonoid intervention at more than four weeks follow-up demonstrated evidence of no effect on either systolic (mean difference = -0.95, 95%CI -3.58, 1.68; p = 0.478, I = 0%) or diastolic blood pressure (mean difference = 0.86, 95%CI -1.11, 2.82; p = 0.393, I = 0%).
Conclusions:
The findings from this systematic review should be interpreted with caution, given that the results are obtained from single-center trials with small sample sizes. Given the results provided in this review, there is evidence of no effect of flavonoids on systolic and diastolic blood pressure. Further robust randomized controlled trials using sample sizes based on power calculations are needed to provide evidence for the use of flavonoid rich fruits for the management of hypertension.
Aim: With the increase in chronic diseases, the number of patients using complementary and alternative medicine is increasing. In this study, it was aimed to examine the opinions and practices of complementary and alternative therapy usage status and attitudes of hypertension patients. Methods: A descriptive and cross-sectional study consisting of 290 patients was performed with patients who applied to the cardiology and internal diseases outpatient clinic of a public hospital and diagnosed with hypertension. Data were collected by using the patient information form which including socio-demographic form, disease-related characteristics and opinions, and also practices of the patients about the use of complementary and alternative therapies and attitudes towards Holistic Complementary and Alternative Medicine Scale. Results: The mean age of the patients was 61.52±11.19 and 63.1% were female, 83.4% were married, and 74.8% were at primary school and lower education level. Of patients, 56.9% use complementary and alternative treatment methods in addition to hypertension therapy. 27.3% of them think that they are more effective than drugs, 63% of them do not share the method they use with health care workers. The total score of the Holistic Complementary and Alternative Medicine Scale is 23.05±5.80. The scores are taken out of the scale and the sub-dimensions differ according to the age groups, education level, monthly income status and complementary and alternative treatment methods usage status (p <0.05). Conclusion: It was found that patients use complementary and alternative methods but do not share them with health care workers, and they have a positive attitude towards holistic complementary and alternative medicine. It is considered important for health care professionals to question the use of these methods in planning the patients’ treatment.
Review question:
The question of this review is: what is the effectiveness of flavonoid rich fruits for blood pressure in adults with hypertension?
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