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Does vitamin C affect high blood pressure?

For example, vitamin C may act as a diuretic, causing the kidneys to remove more sodium and water from the body, which helps to relax the blood vessel walls, thereby lowering blood pressure.

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Taking large doses of vitamin C may moderately reduce blood pressure, according to an analysis of years of research by Johns Hopkins scientists. But the researchers stopped short of suggesting people load up on supplements. “Our research suggests a modest blood pressure lowering effect with vitamin C supplementation, but before we can recommend supplements as a treatment for high blood pressure, we really need more research to understand the implications of taking them,” says Edgar “Pete” R. Miller III, M.D., Ph.D., an associate professor in the division of general internal medicine at the Johns Hopkins University School of Medicine and leader of the study published in the American Journal of Clinical Nutrition. Roughly 30 percent of adults in the United States have high blood pressure, or hypertension, an important risk factor for heart disease and stroke. Successful treatment may include drugs, exercise, weight loss, and dietary changes such as reducing salt intake. Some experts believe that large amounts of vitamin C, an essential micronutrient found primarily in fruits and vegetables, could lower pressure as well, but randomized, controlled dietary intervention studies — the gold standard of nutrition research — have produced mixed results. Miller and his colleagues reviewed and analyzed data from 29 randomized, controlled, previously published clinical trials that reported systolic and/or diastolic blood pressure values and also compared vitamin C intake to a placebo. What they found is that taking an average of 500 milligrams of vitamin C daily — about five times the recommended daily requirement — reduced blood pressure by 3.84 millimeters of mercury in the short term. Among those diagnosed with hypertension, the drop was nearly 5 millimeters of mercury. By comparison, Miller says, patients who take blood pressure medication such as ACE inhibitors or diuretics (so-called “water pills”) can expect a roughly 10 millimeter of mercury reduction in blood pressure. Five hundred milligrams of vitamin C is the amount in about six cups of orange juice. The recommended daily intake of vitamin C for adults is 90 milligrams. “Although our review found only a moderate impact on blood pressure, if the entire U.S. population lowered blood pressure by 3 milliliters of mercury, there would be a lot fewer strokes,” Miller says. Miller cautions, however, that none of the studies his team reviewed show that vitamin C directly prevents or reduces rates of cardiovascular disease, including stroke. Scientists have focused on vitamin C’s potential role in blood pressure reduction because of the nutrient’s biological and physiological effects. For example, vitamin C may act as a diuretic, causing the kidneys to remove more sodium and water from the body, which helps to relax the blood vessel walls, thereby lowering blood pressure. Nutritional supplements are a $28 billion-a-year industry, and marketing claims, newspaper stories and testimonials often make them hard to resist, Miller says. People often view supplements as a “natural alternative” and preferable to drugs for high blood pressure or other ailments, he adds, despite mounting evidence that many supplements don’t work and in some cases may cause harm. “People love to take vitamins regardless of the evidence or lack of it,” Miller says. “We’re trying to raise the bar and provide evidence-based guidance about whether supplements help or actually do harm.” With respect to vitamin C, he says, the jury is still out. Other study authors from Johns Hopkins include Stephen P. Juraschek, an M.D., Ph.D. candidate; Eliseo Guallar, M.D., Dr.Ph.; and Lawrence J. Appel, M.D., M.P.H.

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What are the symptoms of low vitamin C?

Symptoms include fatigue, depression, and connective tissue defects (eg, gingivitis, petechiae, rash, internal bleeding, impaired wound healing). In infants and children, bone growth may be impaired.

Usually clinical (based on skin or gingival findings and risk factors)

Diagnosis of vitamin C deficiency is usually made clinically in a patient who has skin or gingival signs and is at risk of vitamin C deficiency. Laboratory confirmation may be available. Complete blood count is done, often detecting anemia. Bleeding, coagulation, and prothrombin times are normal. Skeletal x-rays can help diagnose childhood (but not adult) scurvy. Changes are most evident at the ends of long bones, particularly at the knee. Early changes resemble atrophy. Loss of trabeculae results in a ground-glass appearance. The cortex thins. A line of calcified, irregular cartilage (white line of Fraenkel) may be visible at the metaphysis. A zone of rarefaction or a linear fracture proximal and parallel to the white line may be visible as only a triangular defect at the bone’s lateral margin but is specific. The epiphysis may be compressed. Healing subperiosteal hemorrhages may elevate and calcify the periosteum. Laboratory diagnosis, which requires measuring blood ascorbic acid, is sometimes done at academic centers. Levels of < 0.6 mg/dL (< 34 mcmol/L) are considered marginal; levels of < 0.2 mg/dL (< 11 mcmol/L) indicate vitamin C deficiency. Measurement of ascorbic acid levels in the white blood cell-platelet layer of centrifuged blood is not widely available or standardized.

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