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Conquering a Disease of the Heart
by Somlynn Rorie
Reprinted from HSR Health Supplement Retailer
Cardiovascular disease affects millions of people each year. According to the latest statistics in the 2001 Heart and Stroke Statistical Update, published by the American Heart Association (AHA), cardiovascular disease (CVD) claimed 949,619 lives in the United States in 1998. It has also been reported that more than 60 million Americans have one or more types of CVD, including high blood pressure, coronary heart disease (CHD), heart failure, stroke or congenital cardiovascular defects.
(National Health and Nutrition Examination Survey III (NHANES III), CDC/NCHS and the AHA, 1988-94).
While genetics play a large role in heart disease, modem lifestyles can also increase the risk. Secondhand smoke, inactive lifestyles and poor diet can take a toll on heart health. In one published paper, co-author Lyn Patrick, N.D., estimated that by the year 2020, cardiovascular disease would be responsible for 36 percent of all deaths and the leading cause of death in the world (Altern MedRev, 6,3:248-71, 2001). The authors hypothesized that the rise in cardiovascular death might be due to a worldwide increase in smoking. "An estimated 21 million smokers in developed countries (with one-third of the world's population) have died as a result of tobacco use in the last decade," they wrote, adding that obesity (30 percent of U.S. adults are obese) and diabetes (80 percent of diabetics die of CVD) are also prominent factors. However, preventive measures such as controlling high blood pressure, balancing cholesterol levels and taking heart-friendly supplements may potantially keep the heart healthy and ward off more serious conditions for those at risk.
High Blood Pressure
High blood pressure is a common heart condition found in the adult population. It is so prevalent that one in five Americans is diagnosed with it (NHANES III, CDC/NCHS, 1988-94). Two other conditions--atherosclerosis, a build-up of fatty deposits or plaque on blood vessel walls, and arteriosclerosis, a loss of elasticity in the artery walls---contribute to hypertension (high blood pressure) and degeneration of the heart muscle. Researchers have hypothesized that high blood pressure is a result of fatty deposits and loss of elasticity, which causes blood vessels to narrow and raise pressure. As the pressure increases, it adds stress on the arteries and creates a rapid build-up of plaque, which may "break loose," leading to strokes, heart attacks and other ischemic conditions such as angina, poor kidney function and reduced eyesight. The most serious heart conditions, such as a heart attack, can occur when a clot, a spasm or an accumulation of plaque blocks blood flow to the heart. A stroke can also result, which is caused when a clot interrupts blood flow to the brain or when blood vessels burst. In a study funded by the National Heart, Lung and Blood Institute (NHLBI), published in the November 2001 New England Journal of Medicine (345:1291-7, 2001), researchers further confirmed that high blood pressure significantly increased the risk of heart attack, stroke and heart failure. They also found that those with high blood pressure have a 1.5 to 2.5 times greater risk of suffering from a cardiovascular condition in 10 years vs. those with optimal blood pressure levels. "This study underscores that, when it comes to blood pressure, any elevation over normal puts people at a significant cardiovascular risk," said NHLBI Director Claude Lenfant. "While more research is needed on this topic, it's advisable that high to normal blood pressure be treated." He added that for most individuals, treatment can consist of such lifestyle changes as following a healthy diet, lowering dietary intake of saturated fat and cholesterol, choosing foods low in salt and other forms of sodium, losing extra weight, becoming physically active and limiting alcoholic beverages.
Cholesterol
Total Cholesterol: Desirable cholesterol is below 200; borderline high is
between 200 and 239; high is 240 and above.
Most individuals diagnosed with cardiovascular disease also have elevated cholesterol levels. Low HDL cholesterol levels (known as the "good" cholesterol) and high LDL cholesterol (known as the "bad" cholesterol) are more specifically linked to cardiovascular disease than total cholesterol. HDL, for example, protects arteries by scavenging and sending excess cholesterol back to the liver where it is metabolized into hormones and bile acids. HDL also acts as a scavenger preventing plaques from adhering to vessel walls. Without these scavengers, or when the ratio of HDL to LDL is off, plaques can harden the arteries and cause atherosclerosis. Currently, there is no definitive method to raise HDL; however, exercise, a healthy diet and weight loss have been said to improve HDL levels. Recent scientific research has suggested a Mediterranean diet, rich in olive oil, may also have a beneficial impact on heart disease and cholesterol (Curr Atheroscler Rep, 3,6:437-45, 2001). In another study, researchers compared a Mediterranean diet with a standard Western diet in patients who had suffered a first myocardial infarction. After five years, there was a 76-percent reduction in cardiac events in the Mediterranean group (J Am Cardiol 28:1103-8, 1996). In a follow-up report, those who stayed on the diet continued to experience its health effects (Circulation, 99: 779-85, 1999). While dietary intervention continues to remain the initial choice for the prevention and treatment of CVD, the nature of dietary modification remains controversial, suggested researchers at the University of Massachusetts, Lowell (J Am Coil Nutr, (5 Supple):421S- 427S; discussion 440SJA2S, 2001). They noted that, "reducing calories from total fat, without decreasing saturated fat intake results in insignificant changes in LDL. Similarly, diet intervention that focuses solely on lowering dietary cholesterol and saturated fat intake not only decreases LDL, but also HDL and therefore may not improve the lipoprotein profile." The review suggests that soy protein, soluble fiber, soy lecithin and plant sterols, as well as polyphenols, isoflavones, folic acid and vitamins B6 and B12, may reduce the risk of CVD without changing levels of lipoprotein cholesterol.
In an attempt to promote a healthy LDL profile, NHLBI's National Cholesterol Education Program (NCEP) established new cholesterol guidelines. The guidelines define "normal" LDL levels as 100 mg/dl (milligrams per deciliter of blood serum), "borderline high" as 103 to 159 mg/dl, and "high" as 160 to 189 mg/dl. As a result of these guidelines, more people with borderline profiles may find physicians recommending cholesterol-lowering medication, in addition to lifestyle changes.
Several supplements have been touted to lower cholesterol. Niacin (vitamin B3) has been used since the 1950s to lower triglycerides, a type of fat in the blood associated with low levels of HDL. Folic acid (vitamin B9) is known to lower homocysteine (an amino acid) levels, which have been linked to risk of stroke (J Lab C/in Med, 133:572-82, 1999), as do vitamins B12, B6 and betaine. Since elevated homocysteine levels are associated with heart disease and increased atherosclerosis, these supplements are ideal for any heart-healthy plan.
One long-term favorite cholesterol-lowering supplement is garlic. A plethora of research was published this year showing that garlic can lower LDL and increase HDL. Evidence from these studies points to the fact that garlic may stabilize plasma lipids, enhance fibrinolytic activity, inhibit platelet aggregation and reduce blood pressure and glucose levels (J Nutr, 131 (3s):g77s-9s, 2001 ).
Antioxidant vitamins E and C, selenium and bioflavonoids also have potential benefits. These nutrients are said to protect the inner layer of veins and arteries from disease-producing agents. Antioxidants are important to the body in that they serve as natural guards against free radicals, which can contribute to many degenerative diseases, including CVD. Free radicals are atoms with an unpaired electron that can cause an adverse chemical event and set off a chain reaction. Antioxidants, in turn, can donate an electron to the free radical to combat oxidation.
Vitamin E is one of the most researched and controversial nutrients for reducing cholesterol. This fat-soluble vitamin can reduce the risk of coronary heart disease in a number of ways, including slowing and reducing the oxidation of cholesterol. But, some research published in 2001 showed no relationship between vitamin E supplementation and the prevention of cardiovascular mortality (Atherosclerosis, 159,1:193- 200, 2001; Nutrition, 17,10: 793-6, 2001)
Researchers have suggested more studies need to be conducted on the bioavailablity of vitamin E and that appropriate dosages may yield different results. W.H. Leong, vice president of Carotech Inc., further supported this stance, adding that there are eight forms of vitamin E--four forms of tocopherols and four forms of tocotrienols. "The idea that one single form of vitamin E--alpha tocopherol--out of eight fractions is a 'magic bullet' and assuming that the others are worthless denies the very fact that nature put seven other tocopherols and tocotrienols out there for a reason," Leong said. "We have unfortunately used technology to prematurely pinpoint a single compound. This has caused many of us to miss the boat as far as protection from vitamin E is concerned." Leong added.
Research Report Card
Following a heart-healthy diet can do a lot to reduce risk, but for many
people, it’s not enough. Heart-protecting drugs usually come with troublesome
side effects, such as fatigue and the possibility of liver disease. For some
risk factors, like homocysteine and low-density lipoprotein prescriptive drugs
are not available. The following is the short list of the hottest heart nutrients on the market today.
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Coenzyme Q10 (CoQ10) This is an essential nutrient in the body that has been studied extensively since it was first isolated from a cow's heart in 1957. In the early 70's, researchers documented that a deficiency in CoQ10 may be a predecessor for heart disease, and that cholesterol-lowering drugs such as simavastatin may reduce the amount of naturally occurring CoQ10 in a person's body. One recent study reported that CoQ10 may be able to help with chronic heart failure (CHF) management. The researchers, from Virginia Commonwealth University, recommended it as adjuvant therapy for CHF patients, not as a monotherapy
(Pharmacotherapy, 21,7:797-806, 2001).
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L-carnitine
This naturally occurring, vitamin-like substance is one that many people are lacking; carnitine deficiency is marked by such problems as obesity, fatigue, elevate triglycerides and heart problems. Long researched for its triglyceride-lowering benefits, the latest trial found that it may be helpful in open heart surgery recovery. In a trial on newborn rabbits, researchers from the Heart Institute of Japan found that carnitine supplementation may help with fatty acid metabolism after open heart surgery, a method that could be applied to infants (Ann Thorac Surg,
71,2:648-53, 2001), This alkaloid can be taken in amounts of 500 to 3,000 mg/d
for optimal results
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Plant sterols, stanols & sterolins Since the 1920s, plant sterots and stanols have been studied for their health benefits; in more recent times, the sterol glucose sterolin has been under investigation. These plant-based nutrients have been found to be highly beneficial in lowering LDL cholesterol levels. However, researchers from Maastricht University in The Netherlands reported that sterols and stanols might lower concentrations of plasma carotenoids (Curt Opin Lipido/11,6:571-6, 2000). The Food and Drug Administration (FDA) issued a stanol/sterot health claim pertaining to cholesterol health in 2001. FDA reported that studies found taking 1.3 g/d of plant sterols or 3.4 g/d of plant stanols may significantly lower cholesterol levels.
Beta-sitosterol and other plant sterols have a chemical structure similar to
that of cholesterol, which enables them to reduce the absorption of cholesterol
from the intestine. Several studies have found that plant sterols can lower
cholesterol levels by an average of 6 to 8 percent. Take sterol supplements 2 to
3 times a day, products labeled plant sterols, phytosterols, or beta-sitosterol
- Soy
This legume is chockfull of beneficial properties, including preventing LDL cholesterol from oxidizing. It is still unknown which compound--a mixture of isoflavones, a particular isoflavone, the soy protein or the entire soy food--best protects against heart disease. Recently, researchers from Emory University found that soy isoflavones may reduce the risk of heart disease by working in an anti-estrogen manner on estrogen receptors that, when awry, may promulgate the potential for heart disease (Endocrinology, 142,7:2946-52, 2001). Postmenopausal women who suffer from haywire estrogen have a higher-than-average risk for heart disease. However, researchers from UCLA found that taking soy phytoestrogens along with flavonoids and ascorbic acid reduced LDL oxidation in a significant manner (JAgric Food Chore, 49,1:308-14, 2001 ). FDA approved a heart-health claim for soy foods in late 1999, stating that 25 g/d may reduce the risk for heart disease.
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DHEA
This adrenal hormone may protect against ischemic heart disease, especially in men. Researchers at the New England Research Institutes found that low DHEA and DHEA sulfate levels may predict the risk for this heart condition (Am J Epidemiol, 153,1:79-89, 2001 ).
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Hawthorn Hawthorn fruit extract is hypothesized to be cardiovascular protective, hypotensive and hypocholesterolemic. Researchers from the Chinese University of Hong Kong reported that either the hawthorn itself provides enough antioxidant activity to keep LDL from oxidizing, or else it aids in maintaining vitamin E levels (another antioxidant) which in turn combats LDL oxidation (J Nutr Biochem, 12,3:144-52, 2001).
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Plant-Based Antioxidants:
Pycnogenol®, grapeseed
extract, Lycopene Researchers from the University of Arizona found that 200 mg/d of Pycogenol, or French maritime pine bark, may reduce platelet aggregation in smokers (integr Med, 2,2:73-7, 2000). According to researchers from Georgetown University, 100 mg of grapeseed extract combined with 200 mcg of chromium decreased total cholesterol and LDL levels significantly (JMed, 31,5-6:227.46, 2000). Low tycopene plasma levels, according to researchers from the University of Kuopio in Finland, may be associated with early atherosclerosis (Arterioscler Thromb Vasc Biol, 20,12:2677-81, 2000).
Low-Density Lipoprotein (LDL) Cholesterol: Small, dense LDL globules are far
more likely to cause blood clots than are larger, less dense ones. And when a
person’s antioxidant intake is low, LDL oxidation increases, which appears to be
a key step in the development of heart disease. If total LDL is high, it may be
wise to have an additional blood test to find out which type predominates.
*Consumers should discuss supplementation of any of these products with their doctor to find a dose that is right for them.
Niacin: This form of vitamin B-3 has been known
since the 1950's to reduce cholesterol levels. Approved by the Food and Drug
Administration for lowering cholesterol, it is sold both by prescription and
over the counter. As effective as niacin is, it triggers the release of
histamine, which often will turn the skin beet red and tingly for about an hour.
If you keep taking niacin, the intense flushing episodes should eventually ease.
Vitamin E: Won’t lower LDL, but will
curb its tendency to promote heart disease. Contrary to common thinking, LDL is
not entirely bad – it’s needed to transport fat-soluble nutrients, such as
vitamin E and coenzyme Q10, throughout the bloodstream. Vitamin E and other fat
soluble antioxidants prevent LDL oxidation.
To lower LDL, reduce your intake of saturated fat (in fatty meats and dairy
products) and avoid processed foods containing trans fats such as most
shortenings, partially hydrogenated oils, and most cookies and crackers on the
market.
High-Density Lipoprotein (HDL) Cholesterol: HDL is widely considered the
“good” form of cholesterol, mainly because it helps transport the LDL or bad
cholesterol to the liver where the LDL is then processed for excretion. The
higher your HDL levels, the lower your risk of heart disease.
Ideal HDL levels are 55 mg./dL or higher for women and 45 mg/dL or higher for
men.
Fish Oil “Omega 3" Supplements: Contain
eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – both essential
dietary fats that boost HDL. They’re also potent blood thinners so they prevent
clotting, and they help to regulate heart rhythm.
To boost HDL, don’t skimp too much on fats, particularly heart-healthy fish
oils and olive oil. Low-fat diets, long recommended to reduce the risk of heart
disease, actually lower HDL levels. Cut back on refined carbs, which can
decrease HDL
Triglycerides: Triglycerides actually account for most fat found in the blood
and in body fat. A higher ratio of triglycerides to HDL has been associated with
a significant increase in heart attack risk.
Anything under 150 mg./dL is considered normal. Aim for 100 mg. or less.
Levels of 150 to 199 mg. are borderline high, and 200 mg. and above are
considered high.
Triglyceride levels are directly related to the quantity of refined
carbohydrates you eat, so reduce your intake of table sugar, white bread,
cookies and other sweets, refined pasta, and bagels, and focus instead on whole
grains.
Homocysteine: Homocysteine is normally a short-lived byproduct of protein
metabolism – it’s only when levels become elevated that they cause trouble. If
you eat lots of veggies, particularly those that contain folic acid such as
spinach, romaine lettuce, and other greens, there’s a good chance your
homocysteine is at healthy levels.
The American Heart Association considers normal levels to be from 5 to 15
micromoles per liter of blood. Ideal levels are under 7.
Three B Vitamins are particularly helpful in breaking down homocysteine:
folic acid, vitamin
B-6, and vitamin B-12
Glucose Tolerance
Beneficial Nutritional Supplements: Many supplements can help lower and
stabilize glucose and insulin levels, but if you already take glucose-regulating
drugs, be sure to work with your physician to adjust their dosage.
Alpha-Lipoic Acid: An antioxidant, is
widely used in Germany to treat peripheral neuropathy, a nerve disease caused by
diabetes. Studies have found that it can lower both glucose and insulin levels.
Chromium Picolinate: An essential
mineral, has been shown to lower glucose and cholesterol levels.
Cinnamon: Can lower fasting glucose, total cholesterol, and triglyceride
levels.
Ginseng Supplements: 1 to 3 grams of American
ginseng (Panax quinqufolius L.) significantly reduced the rise in blood sugar.
Silymarin: The antioxidant-rich extract of milk thistle, is well known for
increasing liver activity. Italian researchers found that 600 mg. of silymarin
daily reduced several key measures of glucose tolerance, including fasting
glucose and insulin, over the course of a year.
Vitamin Power is committed to supplying the
finest-quality nutritional supplements to be included in a person’s overall
health and dietary regimen.
Vitamin Power products are for the people who want the very best . . . and
know the difference.
IMPORTANT: These products are not intended to diagnose, treat, cure or prevent any disease.
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