Certain dietary supplements can increase blood pressure or mask underlying health conditions, according to Houston-based cardiologist Patrick Kee. Because patients often do not disclose supplement use during consultations, doctors may prescribe unnecessary medication for hypertension when a simple change in supplement habits would suffice.
The impact of bitter orange on cardiovascular health
Cardiologists warn that supplements containing bitter orange (Citrus aurantium) can stimulate the nervous system and elevate blood pressure. The fruit contains a chemical compound called p-sinefrin, which acts on the body to constrict blood vessels and increase heart rate.
When the heart beats faster and forces blood through narrowed vessels, blood pressure rises suddenly, according to Kaple.
Did You Know? The American College of Cardiology reported as early as 2005 that bitter orange may contribute to high blood pressure that is difficult to control.
Risks for specific patient groups
The substances in bitter orange can be particularly dangerous for individuals with pre-existing heart, thyroid, kidney, or liver conditions, or those experiencing seizures or mental health issues. Kee warned that the risk is also higher for pregnant and breastfeeding women.
Patients taking monoamine oxidase inhibitors (MAOI) must be especially cautious. These medications include isocarboxazid, phenelzine, tranylcypromine, and selegiline. Combining bitter orange products with other stimulants like caffeine, ephedrine, or methylsynephrine can cause rapid, significant spikes in blood pressure.
Dietary sources and safe alternatives
While bitter orange is a common ingredient in weight loss and performance-enhancing supplements, it is also found in everyday items like jams, marmalades, and liqueurs. Interventional cardiologist Kevin Kheder notes that the concentration in these foods is usually too low to cause significant blood pressure spikes in most people.
“It is not the same as taking a concentrated dietary supplement. I am most concerned about products designed to have a stronger stimulant effect, not the casual consumption of bitter orange in food,” Kheder explained.
According to Kaple, consuming a cup of black coffee or green tea is a safer alternative for an energy boost before a workout than certain supplements, provided one does not have heart conditions that make them sensitive to caffeine.
Why doctors struggle to identify supplements as hypertension causes
Why is it difficult for doctors to identify supplements as a cause of high blood pressure?
Patients often fail to mention the supplements they consume during medical consultations. Without this information, doctors may incorrectly assume the patient requires pharmaceutical intervention for hypertension rather than a change in lifestyle habits.
What should consumers look for on product labels regarding bitter orange?
Products may list the ingredient by its Latin name, Citrus aurantium, or identify the active compound, synephrine. Consumers should check for these labels, especially on items marketed for weight loss, metabolism support, or athletic performance.
Is high blood pressure always a sign of chronic hypertension?
Not necessarily. Interventional cardiologist Kevin Kheder notes that blood pressure naturally fluctuates throughout the day due to stress or physical activity.
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