Factors contributing to coronary heart disease.
Cardiovascular system maintenance is essential for health, vitality and the
well-being of both body and mind. Our
cardiovascular health is continually threatened by cholesterol,
triglycerides, hypertension (high blood pressure) and an unhealthy lifestyle.
All of these factors may contribute to coronary heart disease (CHD). CHD, which
can lead to a heart attack and possibly stroke, is the leading cause of death in
the United States and is usually a major cause of disability. CHD occurs when
the arteries that supply the heart with blood become hardened by calcification
and narrowed by an accumulation of excessive deposits of cholesterol and fat
called plaque. When a clot forms due to unstable plaque, blood flow through the
artery becomes blocked, resulting in a heart attack with varying degrees of
severity. Almost 700,000 people die of CHD in the United States each year. That
accounts for about 29% of all deaths in this country.
Reducing the threat of CHD by addressing risk factors.
Fortunately, the threat of CHD can be reduced or prevented by addressing
various risk factors. Lifestyle modification is a very effective starting point
for improving cardiovascular health. For instance, elimination of obesity by
adopting a sensible diet and a reasonable exercise program together with the
discontinuation of cigarette smoking and/or the use of other forms of tobacco
are of primary importance. Syndrome X, or metabolic syndrome leading to
diabetes, may have a genetic component, but many of the signs and symptoms
should be addressed and reversed immediately. Diabetes has a major negative
impact on the cardiovasculature, and this disease must be avoided at all cost.
High blood cholesterol and triglycerides are major risk factors for
High blood cholesterol and triglycerides are major risk factors for
cardiovascular disease. Genetic predisposition may account for high cholesterol
levels in some individuals, but for the majority, an unhealthy lifestyle and/or
eating habits are the key risk factors. Reducing LDL (“bad” cholesterol) and
elevating HDL (“good” cholesterol) levels are two major goals in achieving
cardiovascular health. A third player in the blood–lipid arena prompts me to
describe a cardiovascular trio as “the good, the bad and the ugly.”
LDL: the "bad" cholesterol, and HDL: the "good" cholesterol.
LDL is regarded as the “bad” cholesterol. However, LDL is very important in
delivering cholesterol to most cells in the body where it is used in a variety
of ways ranging from building cellular membranes to acting as a precursor to the
sex hormones. If too much LDL is delivered to the arterial walls,
atherosclerotic plaque accumulation can occur, which eventually leads to CHD.
HDL is “good” because it actually removes cholesterol from the arteries and
transports it to the liver for disposal. HDL also functions as an antioxidant
that can diminish arterial inflammation. The main reason why this cholesterol
derivative is “good” seems to involve the preponderance of the cardio-protective
protein, apolipoprotein A-1 (APO A-1), on the surface of HDL. APO A-1 traps
lipids and holds them tightly for transport to the liver (1). However, in some
situations, a high level of HDL does not seem to decrease the risk of developing
heart disease. Modifications of the HDL molecule by pro-oxidants such as
malondialdehyde or MDA (in the body MDA is a product of lipid peroxidation)
involve a decrease in the activity of an HDL surface enzyme called PON-1
(Paraoxonase). The lowering of PON-1 activity has been shown to be directly
responsible for a reduced capacity of HDL to export cholesterol from arterial
plaque as well as a decrease in endothelial nitric oxide (NO) production in
those with developing CHD. It has been shown recently that supplements
containing yerba mate, pomegranate, quercetin and resveratrol contribute to an
increase in PON-1 activity. These supplement ingredients may preserve the
beneficial action of HDL. Another factor to keep in mind about LDL and HDL is
particle size and density. Large, buoyant LDL is much less dangerous than
smaller, dense LDL particles. Likewise, large HDL offers greater protection than
smaller HDL particles (2).
Triglycerides: the "ugly lipids".
Now that we have discussed the “good” and the “bad,” it’s time to focus on
the “ugly.” In my opinion, the “ugly lipids” are the triglycerides (TG). I say
this because triglycerides, once thought to be relatively innocuous, are now
viewed as a major risk factor in CHD development. Triglycerides are actually
incorporated into developing arterial plaque. The current thinking is that TG
elevation is predominantly due to excessive simple sugar intake. A simplistic
view of this is when a lot of simple sugars are consumed, not all of these
sugars can be converted to energy because there is usually a fairly low demand
for producing large amounts of energy at any given time. The excess sugar not
used for energy production is converted in the cell to TG or fat. In the
bloodstream, much of the TG will be deposited in adipose (fat) cells, but some
will be directed to form dangerous atherosclerotic plaque.
Ingredients that help promote cardiovascular health
In addition to yerba mate, pomegranate, quercetin and resveratrol mentioned
above, the following ingredients are heart-healthful and help promote
cardiovascular health as well:
- Omega-3 fatty acid-rich fish oils dramatically lower TG serum levels.
- Phytosterols found abundantly in food plant sources such as peanuts, wheat
germ and olive oil interfere with the absorption of cholesterol from the gut
- Red yeast rice (RYR) acts in much the same way as the prescription medications called the statins. Cardiovascular benefit here is due to active compounds from RYR inhibiting the production of cholesterol in the liver (5).
- The menaquinones are often referred to as Vitamin K2 and they have been shown to reduce the incidence of CHD. Scientists believe that consumption of Vitamin K2 results in less calcification of arterial plaque and a reduction of plaque instability. These observations have been coupled with a lower CHD mortality (6).
- Coenzyme Q10 (Co-Q10) is a vitamin-like compound present in all cells but is most concentrated in the heart, liver, kidney and pancreas (7). Cellular Co-Q10 levels have been shown to be low in patients with cardiovascular diseases. Excellent documentation shows that Co-Q10 supplementation is heart-healthy in cases of hypertension and congestive heart failure, and that is has been shown to reduce heart attack risk (8).
- Arginine is an amino acid necessary for protein synthesis and also serves as a substrate for the enzyme nitric oxide synthase (NOS). When arginine interacts with NOS in the endothelial lining of arteries, nitric oxide is produced, which causes vasodilatation (9). The result of arterial dilation is a reduction of blood pressure together with an improvement of blood flow. These effects are nearly always viewed as being heart-healthy.
1 in 3 adults in the US have high blood pressure, or Hypertension.
Even though blood lipid levels are a major focus of cardiovascular health
discussions, it must be kept in mind that approximately one in three adults in
the U.S. has high blood pressure or hypertension. Unfortunately, hypertension is
often referred to as a “silent killer” because most people really do not know
they have it until significant disease symptoms appear. If untreated,
hypertension increases the risk of CHD and stroke. Extracts of grape seed and
arginine-based products may lower elevated blood pressure and can be useful to
those who want to achieve and maintain cardiovascular health. It is important to
realize that if blood pressure is excessively high and cannot be controlled
through the use of supplements, then a physician should be consulted.
about NSP's Heart Health Supplements
Created by Dr. William J. Keller
- Tailleux A, Duriez P, Fruchart JC, Clavey V. Apolipoprotein A-II, HDL
metabolism and atherosclerosis. Atherosclerosis. 2002 Sep;164(1):1-13.
R, Silva RA, Jerome WG, Kontush A, Chapman MJ, Curtiss LK, Hodges TJ, Davidson
WS. Apolipoprotein A-I structural organization in high-density lipoproteins
isolated from human plasma. Nat Struct Mol Biol. 2011 Apr;18(4):416-22.
- Becker M, Staab D, Von Bergmann K. Treatment of severe familial
hypercholesterolemia in childhood with sitosterol and sitostanol. J Pediatr 1993
- Pelletier X, Belbraouet S, Mirabel D, Mordret F, Perrin JL,
Pages X, Debry G. A diet moderately enriched in phytosterols lowers plasma
cholesterol concentrations in normocholesterolemic humans. Ann Nutr Metab
- Heber D, Yip I, Ashley JM, Elashoff DA, Elashoff RM, Go VL.
Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary
supplement. Am J Clin Nutr. 1999 Feb;69(2):231-6.
- Geleijnse JM, Vermeer C,
Grobbee DE, Schurgers LJ, Knapen MH, Van der Meer IM, Hofman A, Witteman JC.
Dietary intake of menaquinone is associated with a reduced risk of coronary
heart disease: the Rotterdam Study. J Nutr. 2004 Nov;134(11):3100-5.
JM, Gregory PJ, Batz F, Hitchens K, et al. Pharmacist’s Letter/Prescriber’s
Letter Natural Medicines Comprehensive Database. 8th ed. Stockton, CA:
Therapeutic Research Faculty; 2006:pg 351.
- Jellin JM, Gregory PJ, Batz F,
Hitchens K, et al. Pharmacist’s Letter/Prescriber’s Letter Natural Medicines
Comprehensive Database. 8th ed. Stockton, CA: Therapeutic Research Faculty;
- Jellin JM, Gregory PJ, Batz F, Hitchens K, et al. Pharmacist’s
Letter/Prescriber’s Letter Natural Medicines Comprehensive Database. 8th ed.
Stockton, CA: Therapeutic Research Faculty; 2010:pg 1029.