Effects of Olive Oil on Blood Pressure: Epidemiological, Clinical, and Mechanistic Evidence

Abstract

The increasing access to antihypertensive medications has improved longevity and quality of life in hypertensive patients. Nevertheless, hypertension still remains a major risk factor for stroke and myocardial infarction, suggesting the need to implement management of pre- and hypertensive patients. In addition to antihypertensive medications, lifestyle changes, including healthier dietary patterns, such as the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet, have been shown to favorably affect blood pressure and are now recommended as integrative tools in hypertension management. An analysis of the effects of nutritional components of the Mediterranean diet(s) on blood pressure has therefore become mandatory. After a literature review of the impact of Mediterranean diet(s) on cardiovascular risk factors, we here analyze the effects of olive oil and its major components on blood pressure in healthy and cardiovascular disease individuals and examine underlying mechanisms of action. Both experimental and human studies agree in showing anti-hypertensive effects of olive oil. We conclude that due to its high oleic acid and antioxidant polyphenol content, the consumption of olive oil may be advised as the optimal fat choice in the management protocols for hypertension in both healthy and cardiovascular disease patients.

Keywords: hypertension; monounsaturated fatty acids; olive oil; polyphenols..

Figure 1

(a) The bubble map visualizes the medical subject headings (MeSH) keywords selected from papers published and retrieved in PubMed under the search terms term “cardiovascular disease risk factors” and “Mediterranean diet” and “olive oil”. The bubble size indicates the frequency of occurrence of the words, while the bubble color represents the cluster of belonging. Two bubbles are in closer proximity if the two words had more frequent co-occurrence. (b) The map highlights MeSH terms directly connected to Mediterranean diet. Analysis was performed by the bibliometric mapping tool VOSviewer.

Figure 2

(a) Black-figured Greek amphora showing a scene of olive-gathering. A naked youth seated in a tree shakes down olives with sticks. Two bearded figures beat the trees with sticks, and a naked youth collects the fallen olives in a basket. The amphora dates back to 520 BC. British Museum, London. (b) Greeks and Romans used OO to clean their bodies after exercise. They smeared OO on the body so that it might collect dirt and sweat and then scraped it off using a metal instrument called a strigil. The red figure on the cup (skyphos) depicts a nude athlete holding a strigil. The skyphos dates back to 410 BC, Archaeological Museum, Milan. (c) Lekythos, vase used as a container of olive oil for body care of athletes. This lekythos dates back to 500 BC. Archaeological Museum, Bologna.

Figure 3

Main bioactive compounds in extra-virgin olive oil (EVOO).

Figure 4

A model describing interactions of OO components—oleic acid and antioxidant polyphenols—within the pathogenic process leading to hypertension. Ang, angiotensin; FFA, free fatty acids; ROS, reactive oxygen species; BP, blood pressure; M:L ratio, media to lumen ratio; ACEs, angiotensin converting enzymes; ECE, endothelin converting enzyme; bET1, big endothelin-1; AT1; Angiotensin II receptor type 1; ETA, Endothelin receptor type A; ETB, Endothelin receptor type B; MMPs, metalloproteinases; NO, nitric oxide; eNOS, endothelial nitric oxide synthase; EC, endothelial cell; VSMC, vascular smooth muscle cell; GTP, guanosine-5′-triphosphate; cGMP, cyclic guanosine monophosphate.