Role of Zinc in Hypertension Management: Evidence‑Based Guidelines

Lifestyle Interventions for Blood Pressure Control

Hypertension Canada recommends a sodium intake of ≈ 2000 mg/day, weight loss for adults with BMI > 24.9 kg/m², adoption of the DASH dietary pattern rich in fruits and vegetables, 30–60 minutes of moderate‑intensity exercise on 4–7 days per week, limiting alcohol to ≤ 2 drinks per day, and stress‑management techniques to lower blood pressure. 1
American College of Cardiology (ACC) advises potassium supplementation of 3500–5000 mg/day to reduce blood pressure, except in patients with chronic kidney disease or those on potassium‑sparing medications. 3
Hypertension Canada explicitly advises against calcium or magnesium supplementation for the prevention or treatment of hypertension. 5

World Health Organization (WHO) recommends initiating antihypertensive drug therapy when clinic BP ≥ 140/90 mmHg, preferring combination regimens to improve adherence. First‑line agents include thiazide or thiazide‑like diuretics, ACE inhibitors, angiotensin‑receptor blockers, and long‑acting calcium‑channel blockers. 6
ACC sets target BP < 140/90 mmHg for patients without comorbidities and < 130/80 mmHg for those with established cardiovascular disease. 3

Clinical Nutrition Society recommends evaluating zinc status in high‑risk groups—chronic kidney disease (especially dialysis), inflammatory bowel disease, short‑bowel or malabsorption syndromes, chronic diarrhea, alcoholism, and prolonged parenteral nutrition. 9
For confirmed deficiency, Clinical Nutrition Society advises oral elemental zinc 0.5–1 mg/kg per day for 3–4 months, using zinc gluconate or zinc histidinate for better tolerability; intravenous zinc up to 12 mg/day may be required in patients with significant gastrointestinal losses. 9

Zinc supplementation should not replace proven antihypertensive therapies. The modest systolic BP reduction observed with zinc (~ 1.5 mmHg) is far inferior to reductions achieved by sodium restriction (5–6 mmHg), weight loss (5–20 mmHg), or first‑line antihypertensive drugs (10–15 mmHg). [1][10]