This article first appeared in the
April, 1997
issue of VRP's Nutritional News
by Al AdrianThe human heart and cardiovascular system are a complex and sophisticated network. After all, it must work non-stop, 24-hours a day for an average of 72.8 years. It's easy to see why healthy heart maintenance and proper cardiovascular care is so important. Without the right care, disease can set in.
Atherosclerosis, resulting in coronary artery disease and cerebro-vascular disease, is the leading killer of both men and women above the age of 50. Cardio Care is a new combination product designed to help prevent (or be beneficial for pre-existing) atherosclerotic conditions of all kindsparticularly, coronary artery disease. This complex formula works best when combined with a good multivitamin such as Extend Plus, and an omega-3 fatty acid supplement (like Ethyl EPA). Cardio Care is comprised of ten key ingredients. This combination of nutrients will provide a comprehensive bio-chemical strategy which should significantly reduce the risk of occlusive heart disease. This multifactorial approach includes nutrients which have demonstrated ability to: [1] reduce atherosclerosis-promoting homocysteine levels; [2] reduce total cholesterol and elevate HDL ("good" cholesterol) levels; [3] decrease risk of blood clots; [4] improve myocardial bioenergetics; and [5] increase arterial vasodilation. Each of the ten nutritional factors in Cardio Care has been investigated for its effects on the cardiovascular system, and all have been provided in effective amounts.
How Cardio-Care Works
I. Reduces Atherogenic Homocysteine Levels
Elevated blood homocysteine levels (homocysteine is a by-product of methionine metabolism) have been identified as a risk factor for heart attacks that may be even more significant than elevated blood cholesterol levels.(1) Cystathionine synthase, the enzyme which converts atherogenic homocysteine to cystathionine, is a vitamin B-6 dependent enzyme. Supplementation with pyridoxine (B-6) has been found to improve abnormal homocysteine metabolism in subjects with homocysteinuria.(2) Six Cardio Care capsules (recommended daily dose) provide twenty milligrams of vitamin B-6, and when combined with any of our multivitamin formulations (or other multivitamin formulas) provides 40-220 mg of pyridoxine, depending on the multivitamin used.Supplementation of folic acid alone produced a 41.7% decrease in homocysteine levels, indicating that a functional folic acid deficiency may be a common cause of hyperhomocysteinemia (see the article "Fabulous Folate" in VRP's Nutritional News, Apr-June 95). This result would be expected to be obtained with supplementation of just the Extend Core (VRP's basic 3-a-day multivitamin) which contains 20 mg of vitamin B-6, 800 mcg of folic acid, and 60 mcg of vitamin B-12. A study conducted in 1994 at the University of Pretoria,(3) South Africa, recently showed that very modest supplementation of vitamin B-6 (10 mg), folic acid (650 mcg), and vitamin B-12 (400 mcg) reduced plasma serum homocysteine levels by 49.8% in men with hyperhomo-cysteinemia. Researchers at the Free University Hospital in Amsterdam(3) conducted a similar experiment with young patients presenting with arteriosclerosis and obtained excellent results. This study found that fasting and postload hyper-homocysteinemia were normalized in slightly more than 90% of patients with daily doses of 250 mg of vitamin B-6 and 5 mg of folic acid. Six of the nonresponders were continued on the vitamin regimen for an additional 6 weeks which proved successful in three. The other three were given betaine (as in VRP's MethylCaps) and normalized.
II. Prevents Life-Threatening Blood Clots
In addition to reducing homocysteine levels, vitamin B-6 may also reduce coagulation and inhibit platelet activation(4) thus favorably influencing the vasoelastic properties of blood and helping to prevent blood clotsa major cause of heart attacks and strokes. The 500 mg of bovine cartilage extract (90% chondroitin sulfate) in the formula also acts as a mild form of heparin (anticoagulant) and as an anti-inflammatory substance. In 1973, chondroitin sulfate was found by a group of Japanese investigators(5) to significantly reduce mortality rates in a group of 120 coronary heart patients. A similar study by Enrick6 in the journal Angiology confirmed the benefits of chondroitin sulfate supplementation.III. Prevents LDL Oxidation & Raises Protective HDL Levels
The recommended daily dose of Cardio Care also provides 200 iu of vitamin E (provided in the natural D-alpha form), 60 mg of Coenzyme Q10 (CoQ10), and 200 mg of a premium Hawthorn Extract. Each of these ingredients provides protection from LDL oxidation which is thought to play a primary role in the etiology of atherosclerosis.The average American diet provides only 9-12 iu of vitamin E per day (RDI-30 iu), and many studies(7,8,9,10) now confirm the wisdom of daily supplementation of at least 200 iu per day. Cardio Care (plus supplementation with one of our multivitamins) will provide 400-1000 iu of vitamin E in the premium natural D-form, which has been found to have 2-5 times the bio -availability of the synthetic DL-form. This level of supplementation with vitamin E should substantially reduce LDL oxidation,(9) will most likely increase the HDL to LDL cholesterol ratio, and may inhibit platelet adhesiveness as well.(11)
IV. Improves Myocardial Energetics
CoQ10 has produced significant clinical improvement in many patients suffering from angina, cardiomyopathy, hypertension, and cancer. CoQ10 has been well-recognized since its discovery by Dr. F. Crane in 1957 (although Dr. Karl Folkers has contributed more to our knowledge of CoQ10) as essential to energy production in all mammalian cells. CoQ10 plays a pivotal role as a redox agent in electron-transport in mitochondria. We now know that CoQ10 is found in the LDL fraction of plasma where it plays a role in the prevention of LDL oxidation. Furthermore, reduced CoQ10 serum levels have been found in patients with athero-sclerosis.(12) It has been hypothesized that perhaps a low ratio of CoQ10 to LDL cholesterol is a more precise indicator of the risk of atherosclerosis than is a low ratio of HDL to total cholesterol. Clinically, CoQ10 administration has been found to reduce the frequency of angina attacks and improve cardiac function(13) and blood vasoelastic parameters.(14) CoQ10 should be considered essential for everyone with any form of myopathy, hypertension, or atherosclerosis. Additionally, those who are presently being treated with drugs of the HMG coenzyme A reductase inhibitor class (such as Simvastatin, Lovastatin, Zocor, Mevacor, etc.), should also supplement with CoQ10, as these drugs interfere with the synthesis of both cholesterol and CoQ10. Eventual depletion of CoQ10 by these drugs could have very serious consequences.(15) For more information on CoQ10, read our very informative article "Coenzyme Q:The Ubiquitous Quinone" which first appeared in the fall 1993 issue of VRP Nutrition News.V. Provides Nature's Most Powerful Heart-Healing Factor
Hawthorn (Crataegus oxycantha-rose family) is a particularly rich source of a huge variety of bioflavonoids.(16) Bioflavonoidsformerly known as vitamin Pare well known for their protective effects on blood vessels. Hawthorn is an especially significant source of antioxidant anthocyanidins (as are grape seed extracts-OPCs) and cardiotonic amines. Hawthorn's benefits are impressive:(16) [1] dilates coronary blood vessels and consequently improves blood supply; [2] improves contraction strength of myocardium resulting in greater ejection volume (positive inotropic effect); [3] has ACE-inhibitory effects and is a mild diuretic; [4] stabilizes collagen; [5] prevents arrhythmias; [6] prevents cardiac spasms; and [7] reduces thromboxane synthesis. Furthermore, Wegrowski found that Hawthorn actually decreased the size of atherosclerotic plaques in rabbits!18 Due to its great complexity and extraordinary variety of heart-healthy compounds, perhaps no other herbal extract has such potential for the treatment of heart disease and vascular occlusive diseases as Hawthorn Extract.Hawthorn berries and their extracts are approved in Germany for the treatment of a variety of cardiac maladies. It is sold throughout Europe as a pharmaceutical drug under the names Cardplant, Crataegol, Esbericard, Oxacant and several others. This extract is supplied in Cardio Care at a dose (200 mg) thought to produce clinical improvement, although daily doses of up to 900 mg or more have been used. Additionally, this formula contains antioxidant polyphenols as OPCs and bioflavonoids as components of the Hawthorn Extract. Some of these compounds are known to chelate copper and thus reduce its absorption. Hawthorn and its extract are exceedingly safe, but they do potentiate the effects of digitalis.(16) Patients who take digitalis should take Hawthorn only under the supervision of a physician.
VI. Restores & Stabilizes Normal Heart Rhythm
Cardio Care also contains the amino acid taurine. Taurine has been extensively researched in Japan. It is a small, nonessential, membrane-stabilizing sulfur -containing amino acid antioxidant. Taurine is found in high concentrations in muscle tissue, colostrum and mother's milk, but not in cow's milk. It is also found in high concentrations in mollusks. Taurine is known to have antiarrhythmic, inotropic (improves cardiac contractility) and hypotensive effects, it also reduces platelet aggregation. Many of taurine's functions mirror those of magnesium; consequently, it has been used in the treatment of congestive heart failure. Consumption of a daily dose of Cardio Care plus one of VRP's multivitamins will provide a daily dose range of 675 to 1600 mg of taurine, depending on the multivitamin chosen.VII. Improves Cardiac Blood Flow
Cardio Care contains 1,000 mg of the amino acid arginine per dose. Arginine is used by many alternative physicians for the treatment of cardiovascular disease as it produces significant vasodilation. This specific effect of arginine on the heart has been investigated and reported in The Lancet in 1991. Arginine was found to restore impaired endothelium dilation of coronary microcirculation(19) in eight hypercholesterolemic patients. The beneficial effect of arginine on coronary vessels is due to the production of nitrous oxide (NO), commonly referred to as endothelial derived relaxing factor, or EDRF for short.In addition, it is well known that vegetarians, as compared to omnivores, suffer much lower rates of cardiovascular disease. This is due in part to the relatively greater amounts of arginine in vegetable protein. The addition of arginine favorably influences the lysine-to-arginine ratio in the diet,(20) artificially providing the consumer of Cardio Care more of a vegetarian-like amino acid profile. Arginine has also been investigated for its effects on immunity, fertility, growth hormone production, tumor regression, wound healing, and reduction of hyperammonemia in patients with liver failure. Some care must be taken, however, when providing arginine to Type II diabetics, herpes sufferers, and perhaps even those with Parkinson's disease.
VIII. Restores Essential Mineral Balance
No heart-friendly formula would be complete without substantial amounts of the minerals magnesium, potassium, and copper. The heart is particularly vulnerable to deficiencies of these minerals, and experimentally produced necrosis and fibrosis have been routinely produced in animals fed diets deficient in copper, magnesium, and potassium. The minerals magnesium and potassium are presented in their well-absorbed aspartate forms in Cardio Care. Magnesium aspartate (300 mg of magnesium as magnesium aspartate, 75% of the RDI) is particularly useful in this formula as it is known to lower cholesterol levels, provide anti-fatigue effects, and activate cellular metabolism.(21) Cardio Care, therefore, has protective effects above and beyond the metabolic and disease prevention effects of added dietary magnesium.100% of the RDI of copper is included, since it is an integral part of two essential antioxidants superoxide dismutase (SOD) and ceruloplasmin which are copper-dependent. Copper-induced cardiac enlargement and other pathologies induced by copper deficiency are well documented. Furthermore, a study published in 1994 in the journal of Free Radical Biology & Medicine(22) makes it clear that the heart is more susceptible to copper -deficiency induced antioxidant stress than other organs. Like magnesium, copper is also essential for the proper functioning of several enzymes involved in energy production. Another reason for adding extra copper is the addition of the previously-mentioned antioxidant polyphenols and bioflavonoids which are known to chelate copper and thus reduce its absorption.(23) Consumption of one of VRP's multivitamins plus Cardio Care will provide supplemental copper in the dose range of 4-5 mg per day.
Cardio Care delivers nutrients necessary to help support a healthy heart and arteries. This state-of-the-art formula provides ten key factors known to help prevent a variety of atherosclerotic conditions. All of these specially-selected nutritional components have been clinically tested for efficacy and safety and are manufactured under stringent, pharmaceutical-grade conditions.
References:
1. McCully K.S., Wilson R.B. "Homocysteine theory of arteriosclerosis" Atherosclerosis 1975, 22, pp. 215-227.
2. Ubbink J.B., Vermaak W.J., et. al. "Vitamin requirements for the treatment of hyperhomocysteinemia in humans" Journal of Nutrition Oct., 1994, 124:10, pp. 1927-1933
3. Van den Berg M., Franken D.G., Boers G.H., Blom H.J., Jakobs C., Stehouwer C.D., Rauwerda J.A. "Combined vitamin B-6 plus folic acid therapy in young patients with arteriosclerosis and hyperhomocysteinemia" Journal Vascular Surgery Dec., 1994; 20:6, pp. 933-940.
4. "Is vitamin B-6 an antithrombotic agent?" American Journal of Cardiology 63:513-16, 1989.
5. Nakazawa K. and Murata K. "The therapeutic effect of chondroitin polysulphate in elderly atherosclerotic patients" Journal of Internal Medical Research 1978, 6:3, pp.217-225.
6. Morrison L.M. and Enrick L. "Coronary heart disease: Reduction of death rate by chondroitin sulfate A" Angiology 1973, vol. # 24, pp. 269-287
7. Stampfer M.J., Hennekens C.H., et al. "Vitamin E consumption and the risk of coronary disease in women" New England Journal of Medicine May 93, 328:20 pp 1444-1449.
8. Rimm E.B., Stampfer M.J., et al. "Vitamin E consumption and the risk of coronary heart disease in men" New England Journal of Medicine May 93, 328:20 pp 1450-1456.
9. Hennig B. and Boissonneault G.A. "The Roles of vitamin E and oxidized lipids in atherosclerosis" International Clinical Nutrition Review July 1988, 8:3 pp. 134 -139
10. Palinski W., Rosenfeld M., Herttuala Y., et al. "Low density lipoprotein undergoes oxidative modification in vivo" Proceedings of the National Academy of Sciences, USA 1989 86:1372-1376
11. Steiner M. "Influence of vitamin E on platelet function in humans" Journal of American College of Nutrition 1991, 10:5 pp.466-473.
12. Hanaki Y., Sugiyama S., Ozawa T. "Ratio of low-density lipoprotein cholesterol to ubiquinone as a coronary risk factor" New England Journal of Medicine 1991, 325 (11):814-15.
13. Kamikawa T. et al. "Effects of coenzyme Q 10 on exercise tolerance in chronic stable angina pectoris" American Journal of Cardiology 1985, 56:247.
14. Kato T. et al. "Reduction of blood viscosity by treatment with coenzyme Q 10 in patients with ischemic heart disease" Int J Clin Pharmacol Ther Toxicol 1990, 28(3):123-6.
15. Gissen A.S. "Coenzyme Q" Nutritional News Sept.-Nov., 1993.
16. Djumlija L.C. "Crataegus oxycantha" Australian Journal of Medicinal Herbalism 1994 Vol 6 (2): 37-42.
17. Vibes J., Lasserre B., Gleye J., & Declume C. "Inhibition of thromboxane A2 biosynthesis in vitro by the main components of Crataegus oxycantha (Hawthorn) flower heads" Prostaglandins Leukot Essent Fatty Acids 1994, 50:4 pp.173-5.
18. Wegrowski J., Robert A.M. & Mozcar M. "The effect of procyanidolic oligomers on the composition of normal and hypercholesterolemic rabbit aortas" Biochem Pharm 1984 33:3491-7.
19. Drexler H. et al. "Correction of endothelial dysfunction in coronary microcirculation of hypercholesterlaemic patients by L-arginine" Lancet 1991, 338:1546-50.
20. Sanchez A. Nutr Rep Int 1983, 28:497.
21. Gissen A.S. "Magnesium and Health" Nutritional News July,1993.
22. Chen Y., Saari J.T., Kang Y. J. "Weak antioxidant defenses make the heart a target for damage in copper-deficient rats" Free Radical Biology & Medicine 1994, Vol. 17, No.6:529-536.
23. Cook N.C. & Samman S. "Flavonoids-Chemistry, metabolism, cardioprotective effects, and dietary sources" Nutritional Biochemistry 1996, 7:66-76.
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