 Previously I've explored the potent anti-hypertensive effect of dietary flaxseed in hypertensive patients. This was a double-blind or randomized placebo-controlled trial where they disguised ground flaxseed in baked goods versus like flax-free placebo muffins and got an extraordinary drop in high blood pressures. As you can imagine, the flaxseed industry was overjoyed, praising the impressive findings as was I. After all, high blood pressure is the single largest risk factor for death on the planet Earth. Yes, we give people medications, lots and lots of medications, but most people don't take them, as in 9 out of 10 people take less than 80% of their prescribed blood pressure pills, just 8%. It's not difficult to understand why patients are asked to follow an inconvenient, potentially costly regimen, which will likely have detrimental effect on their health-related quality of life, to treat it mostly asymptomatic condition, so they may feel worse instead of better due to the side effects. The answer then is to give them more drugs to counteract the effects of the first drugs, like giving men Viagra to counter the erectile dysfunction caused by their blood pressure pills. How about using a dietary strategy instead, especially if it can just be as effective? And indeed, the drop in blood pressures they got in the flax seed study was greater than the average decreased observed with a standard dose of anti-hypertensive drugs. And flax seeds are cheaper, too, compared to even single medications that most patients are on multiple drugs, and has good side effects beyond their anti-hypertensive actions, but not all good. Taking tablespoons of flax seed a day is a lot of fiber for people who have been living off of cheeseburgers and milkshakes their whole lives, and can take a little while for your gut bacteria to adjust to the new bounty. So, people who start out with low-fiber diets may want to take it slow at first. Not all studies have shown significant blood pressure lowering effects. There have been over a dozen trials by now, involving more than a thousand subjects, and though yes, put them all together, and overall there were significant reductions in both cystoc and diastolic blood pressures, the upper and lower numbers. Following supplementation with various flax seed products, none were as dramatic as that six-month trial. The longer trials tended to show better results, and some of the trials just used flax seed oil, or some kind of flax seed extract. And the thought is that the whole is greater than the sum of its parts. Each of the components of interest within flax seed, the omega-3s, the cancer-fighting lignans, all the soluble fiber and plant proteins all contribute toward the blood pressure reduction. Okay, but how? Why? What's the mechanism? Some common blood pressure medications, like Norvask or Procardia, work by reducing the ability of the heart to contract, or slowing the heart down. And so it's possible that's how flax seeds work, too. But no, dietary flax seed reduces blood pressure without cardiac involvement, but rather through changes in plasma oxylipins. What are oxylipins? Oxylipins are a group of fatty acid metabolites involved in inflammation, and as a result have been implicated in many pro-inflammatory conditions, including cardiovascular disease and aging. The best characterized oxylipins in relation to cardiovascular disease are derived from the long chain omega-6 fatty acids, known as arachidonic acid found preformed in animal products, particularly chicken and eggs, and can be made inside the body from junky omega-6 rich oils, such as cotton seed oil. But elevated levels of pro-inflammatory oxylipins in older subjects are normalized by flax seed consumption. See, that's how we think flax seed consumption reduces blood pressure in patients with hypertension, by inhibiting the enzyme that makes these pro-inflammatory oxylipins. I'll spare you from the acronym overload, but basically eating flax seeds inhibits the activity of the enzyme that makes these pro-inflammatory oxylipins, leukotoxin diols, which in turn may lower blood pressure. Identifying the molecular mechanisms adds confidence to the antihypertensive actions of dietary flax seed, but that's not all oxylipins do. Oxylipins may play a role in the aging process, but we may be able to beneficially disrupt these biological changes associated with inflammation and aging with nutritional intervention like flax seed. Older adults around age 50 have higher levels of these arachidonic acid-derived oxylipins compared to younger adults around age 20. These elevated concentrations of pro-inflammatory oxylipins in the older age group may help explain the higher levels of inflammation in older versus younger individuals. I mean, as we get older, right we're more likely to be stricken with inflammatory conditions like arthritis. So this elevation of pro-inflammatory oxylipins may predispose individuals to chronic disease conditions. But what if you took these older adults and gave them muffins, ground flax seed-containing muffins? Four weeks later, their levels dropped to here, right? Down to like 20-year-old levels. Demonstrating that a potential therapeutic strategy to correct the deleterious pro-inflammatory oxylipin profile is via dietary supplementation with flax.