Hypertension remains a leading risk factor for stroke and heart disease. Health experts warn that certain supplements can worsen blood pressure, especially for those already managing the condition. A recent analysis from nutrition and cardiology professionals identifies five common ingredients—bitter orange, licorice root, caffeine-containing products, yohimbine, and ephedra—that may raise blood pressure or disrupt heart rhythms. In Thailand, where herbal traditions are widely practiced, these findings have particular relevance for everyday health decisions.
Supplements are often marketed as heart-friendly boosters, yet the line between benefit and harm can blur. Experts emphasize that some natural ingredients act as stimulants or upset fluid balance, increasing blood pressure even at modest doses. This nuanced view challenges the assumption that “natural equals safe.”
Bitter orange tops the list. Marketed for weight loss and athletic performance, its extract contains synephrine, a compound that can raise blood pressure and provoke irregular heart rhythms. A systematic review notes that extended use may increase systolic pressure by about 6 mmHg and diastolic pressure by about 4 mmHg. These incremental rises are linked to a greater risk of cardiovascular events over time.
Licorice root is familiar in Thai remedies and flavors, yet it contains glycyrrhizic acid, which promotes sodium retention and can elevate blood pressure with regular consumption. Even low doses may raise systolic pressure, according to recent findings. Glycyrrhizic acid can also deplete potassium, potentially causing muscle weakness and arrhythmias. Some supplement labels misstate potency, underscoring the importance of quality control.
Caffeine appears in tea, coffee, and energy products, and is common in supplements designed to boost alertness or physical performance. Even small amounts can raise both systolic and diastolic blood pressure, a concern for individuals with fragile cardiovascular health. Guarana, a caffeine-rich plant sometimes added to products, can magnify these stimulant effects.
Yohimbine, derived from the bark of the yohimbe tree, is found in supplements marketed for sexual function or performance. It is a potent stimulant that increases norepinephrine, constricting blood vessels and raising heart rate and blood pressure. This combination poses particular risk for those with hypertension.
Ephedra is linked to serious cardiovascular risks and has been banned in dietary supplements in several regions due to associations with heart attack, stroke, and sudden death. While ephedrine derivatives remain in some pharmaceutical products, experts urge careful consultation with healthcare providers before using any supplement containing these compounds, especially when taking antihypertensive medications.
In Thailand, where traditional remedies and modern supplements coexist, awareness is essential. Data from Thailand’s health authorities shows a substantial portion of the population uses complementary products, often without medical supervision. Urban centers see increased access to international supplements, which can complicate chronic disease management. This underscores the need for careful medical oversight and consumer education to prevent adverse interactions with prescribed treatments.
Hypertension often presents without symptoms, earning its reputation as a “silent killer.” Approximately one in three Thai adults may be affected, with many unaware of their condition. Dietary patterns high in salt, rising obesity, and reduced physical activity further increase risk. For those who use herbal or over-the-counter products alongside prescribed therapies, professional guidance is critical to avoid dangerous interactions.
Reputable medical organizations in the United States and Thailand emphasize lifestyle strategies to manage blood pressure: adopting a DASH-style eating pattern rich in fruits and vegetables, engaging in regular aerobic and strength exercise, maintaining a healthy weight, ensuring adequate sleep, and managing stress. These approaches remain the foundation of safe, effective hypertension care.
Practical guidance for Thai readers:
- Discuss all supplements—herbal and synthetic—with a healthcare provider, particularly if you have hypertension or take blood pressure medications.
- Be cautious with products labeled as “natural” but containing stimulants like bitter orange, caffeine products, yohimbine, or ephedra derivatives.
- Read labels carefully, choose whole-food-based nutrition where possible, and prioritize evidence-based therapies under medical supervision.
Policy and public health implications are clear. Strengthened regulation of supplement content and labeling, along with consumer education campaigns, can help reduce risk for people with hypertension. As Thailand modernizes and its population ages, balancing traditional practices with scientific safety becomes increasingly important.
Experts caution that individualization of treatment—considering genetic, dietary, and lifestyle factors—may optimize outcomes. For now, the safest path is collaboration with healthcare professionals when considering any supplement, especially for those managing blood pressure.
Action steps:
- Before starting any new supplement, consult your physician or a pharmacist.
- Prefer non-pharmacologic, whole-food approaches to heart health as a foundation.
- Seek trustworthy, regulated products and report any adverse effects promptly.
By integrating medical guidance with respectful regard for traditional practices, Thailand can safeguard heart health while preserving cultural heritage.