Abstract

I read with interest the Editorial by Dr. Tziomalos et al [1]. The use of "alternative" treatments or functional foods/beverages for the treatment of arterial hypertension is getting increasingly prevalent. The paper is in this direction, supporting this trend. However, there are some issues that might be related to the use of such treatment modalities.

First, is it possible that the use of pomegranate juice (PJ), a functional beverage, will reduce the adherence of hypertensive to the antihypertensive drug treatment that they might need for the effective control of their blood pressure? It has been shown that the use of functional foods or dietary supplements may offer opportunities to reduce health risk factors and risk of diseases, both as monotherapy and in combination with prescription drugs. Nevertheless, the potential caveats or false claims of these products should not be overlooked [2]. Should we jeopardize the necessary drug treatment for a functional food?

Second, authors mention that one of the mechanisms of action of PJ is angiotensin converting enzyme (ACE) inhibition. In a short term (4 weeks) study, results showed that PJ reduced blood pressure (BP), however the fall in BP was not paralleled by changes in concentration of serum ACE [3].

Third, in the case that PJ indeed reduces ACE activity, would PJ administration be equally effective if coadministered with an ACE inhibitor or should we avoid such a co-administration?

Fourth, do authors consider that the use of PJ indeed improved CV health of hypertensives that they use it and if yes why?

It would be interesting and useful if these issues were sorted out.