The Natural Way to a Healthy Heart

Remarkably, most cases of premature heart disease are preventable with a combination of good nutrition, regular exercise, the use of herbal and nutritional supplements, weight management and by avoiding habits such as smoking that increase the the risk of heart disease.

By Tori Hudson
Source: Bioriginal Publishing
Date Published: January 2001

Cardiovascular disease is the leading cause of death in both men and women in the United States. Remarkably, most cases of premature heart disease are preventable with a combination of good nutrition, regular exercise, the use of herbal and nutritional supplements, weight management, and by avoiding habits such as smoking that increase the risk of heart disease.

Two of the most significant risk factors for heart disease are elevated blood cholesterol levels and high blood pressure. Efforts to reduce "bad" blood cholesterol (LDL) levels and reduce blood pressure can have dramatic impact in reducing the risk of heart disease. And, it all starts with diet and exercise. Adding nutritional supplements to a balanced regime can provide further benefits, reducing or even eliminating the need for pharmaceutical drugs.

A heart-healthy diet and lifestyle
The modern lifestyle includes many pitfalls that affect heart health. Lifestyle modifications for prevention and management of heart disease include:

• Lose weight if overweight.
• Increase aerobic activity.
• Limit alcohol intake to no more than .5 oz ethanol; 12 oz beer; 5 oz wine; 1 oz 100 proof whiskey per day. (However, there are many good health reasons to consider avoiding alcohol altogether.)
• Reduce sodium to no more than 2.4 grams of sodium or 6 grams of sodium chloride per day.
• Maintain adequate intake of dietary potassium, calcium, and magnesium.
• Stop smoking.
• Reduce caffeine intake.
• Reduce stress.
• Reduce intake of sugar and simple carbohydrates.
• Increase fiber intake with foods such as oats, whole grains, legumes, and flax seeds.
• Increase consumption of soy.
• Increase the amount of fruits and vegetables in the diet.
• Reduce saturated fats in the diet – eat less animal fat, lard, butter, and fried foods.
• Replace saturated fats in the diet with mono and polyunsaturated fats– eat more vegetable oils, fatty fish, nuts, seeds, and avocadoes.
• Avoid hydrogenated and partially hydrogenated fats – for example, hard margarine.
• Avoid trans-fatty acids – found in high amounts of fast food and fried foods.

Heart-healthy fats
In October 2000, the American Heart Association released new dietary recommendations advising that everyone eat two 3-oz. servings of fatty fish a week – for example, salmon or sardines. These fish contain high amounts of omega-3 essential fatty acids (EFAs), which are polyunsaturated fats that are as important as other essential vitamins and minerals. Because of their benefits to the heart, omega-3s have become known as "heart-healthy fats" or, simply, "good fats".

Omega-3s have many cardioprotective effects. Fish oils are probably best known for their ability to reduce triglycerides.1 Less known is the effect fish oils have on reducing blood pressure in those with hypertension.2 Another mechanism by which fish oils may be helpful is their ability to prevent thrombosis (blood clots). Early studies of Greenland native peoples (Inuit) highlighted their lower rate of death due to heart disease. Their diet high in fish oils has resulted in lower blood cholesterol, lower triglycerides, lower LDL (low density lipoproteins), increased HDL (high density lipoproteins), and lower rates of heart disease. These findings have been repeated in other ongoing studies.

Omega-3 fatty acids have also been shown to decrease platelet aggregation (therefore preventing blood clots), help to keep the blood thin, decrease LDL cholesterol ("bad" cholesterol), lower serum triglycerides, lower blood pressure, and may increase HDL ("good" cholesterol).

The most efficient way to consume more beneficial fish fats is to use supplementation of fish oils containing the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Flax oil, natureÕs richest plant source of omega-3 fatty acids, is the vegetable alternative to fish oil.

Another essential fatty acid with benefits for the heart is gamma linolenic acid (GLA), found in evening primrose oil, black currant oil, and borage oil. The majority of the research on GLA has been done using evening primrose oils, however both black currant and borage oil contain higher levels of GLA. Evening primrose oil appears to have positive effects on lipids showing a significant ability to decrease in LDL cholesterol. Blackcurrant seed oil, another rich source of GLA, has been shown in research to lower resting blood pressure, and cardiac measurements that demonstrate it can actually inhibit our reactions to stress.3 Borage seed oil, richer yet in GLA, adds the benefit that you need less of it to bring about positive effects.

The power of nutritional supplements
Other supplements that may be taken in combination with changes to diet and lifestyle are many and varied. Vitamin E is arguably the most significant nutrient in preventing the progression of atherosclerosis. By decreasing the susceptibility of LDL to oxidation, prevention of atherosclerosis is possible. The New England Journal of Medicine published a report showing that women who took at least 100 IU of vitamin E per day for several years had 40 percent decreased likelihood of having a coronary event when compared with non-vitamin E users. Doses of 400-1,000 IU per day provide cardiovascular benefit by inhibiting platelet aggregation, increasing HDL-cholesterol, and stimulating the breakdown of fibrin.

Several grams of niacin per day will lower total cholesterol and LDL cholesterol and raise HDL.4 Niacin has far exceeded lovastatin in increasing HDL cholesterol in a comparison study in 1994. The form inositol hexaniacinate is a form of niacin proven to be safe and not linked to serious side effects (such as elevated liver enzymes found in long term higher dose usage) and is therefore the recommended form used to lower cholesterol.

Coenzyme Q10 protects against atherosclerosis by preventing the oxidation of LDL. It also works together with vitamin E in preventing damage to lipids and to the vessels. In several studies, CoQ10 has been able to lower blood pressure in hypertensive patients after four to twelve weeks.5 Typical reductions are in the range of 10 percent for both systolic and diastolic blood pressure.

Recent research has focused on homocysteine and its role in heart disease. Results associate elevated plasma levels of this amino acid with significant increases in coronary artery disease, heart attacks, peripheral vascular disease, and cerebral vascular disease. A deficiency of folic acid, vitamin B6 or vitamin B12 will lead to an increase in the level of homocysteine. These three B vitamins either alone or in combination have demonstrated the ability to normalize homocysteine levels.6,7,8

Most population studies have indicated that individuals with hypertension consume less dietary calcium than individuals with a normal blood pressure. An increased calcium intake may lower blood pressure in some patients with hypertension, but the overall effect is considered modest. Several clinical studies have demonstrated that calcium supplementation does have the ability to lower blood pressure.9

At least 10 independent clinical studies show that patients with hypertension also tend to be deficient in magnesium. On the average, patients with long-term hypertension have at least a 15 percent deficit in total magnesium.10 Magnesium also improves cardiac performance by enhancing blood flow in the coronary arteries, prevents oxidation of lipoproteins and subsequent atherosclerosis.

In addition to increasing the potassium foods in our diet, several studies now show that potassium supplementation can reduce blood pressure. It has been shown that potassium supplementation can lower the systolic blood pressure an average of 12 points and diastolic blood pressure an average of 16 points.11 Potassium supplementation may be even more beneficial in people over age 65 who often do not respond well to anti-hypertensive drugs.

Combine with botanicals for a synergistic effect
Essential fatty acids and nutritional supplements may be combined with botanicals (herbal extracts) to achieve a synergistic effect. Following are some of the most effective botanical agents for supporting heart health:

Garlic is one of the key herbal ingredients that has shown remarkable benefits in the area of cardiovascular health. Garlic has the ability to lower cholesterol and triglycerides while also increasing HDL levels. Studies have shown that garlic can lower systolic pressure by 20-30 mm Hg and the diastolic pressure by 10-20 mm Hg.12 Hawthorn leaves, berries and blossoms contain flavonoids. The flavonoid, proanthocyanidin, found in hawthorne, is largely responsible for its cardiovascular activities.

Hawthorn preparations have been effective in lowering blood pressure and in improving heart function.13 Although its blood pressure lowering effects should be considered mild, hawthorn is a valuable heart medicine. It can prevent and treat atherosclerosis, lower cholesterol, prevent the oxidation of LDL, improve the blood supply to the heart by dilating the coronary arteries, increasing the force of contraction of the heart muscle and regulating cardiac rhythm.

The mukul myrrh tree is native to India and is the source of gugulipid, the standardized extract obtained from this medicinal tree. Gugulipid has a significant ability to lower total cholesterol, triglycerides, and LDL cholesterol, and raise HDL cholesterol.14 Total cholesterol levels can drop from 14-27 percent within one to three months of therapy. LDL cholesterol will drop 25-35 percent and triglycerides from 22-30 percent. HDL levels usually increase by about 20 percent. The recommended dose is based on its guggulsterone content and is 25 mg guggulsterones per 500 mg tablet three times per day.

Flavonoids inhibit the peroxidation of lipids by acting as free radical scavengers. Quercitin specifically has been shown to inhibit LDL oxidation. Supplements of quercitin and bioflavonoids are obvious sources of flavonoids, but grape seed/leaf/skin extracts are a rich source of one of the most important groups of plant flavonoids –the proanthocyanidins. The cardiovascular protective action of these proanthocyanidins comes from their ability to reduce oxidation of fats, inhibit production of free radicals, prevent connective tissue damage, lower cholesterol and shrink the size of the cholesterol deposits in arteries. The implications for preventing atherosclerosis and its complications (heart attacks and strokes) are immense.

You can see that lifestyle changes, nutritional supplementation and the therapeutic use of botanical extracts can have a dramatic impact on reducing the risk of heart disease by sometimes even only mild to moderate impact on lipid levels and blood pressure. Whether it is altering blood lipids, lowering blood pressure, scavenging free radicals, inhibiting of platelet aggregation, or preventing atherosclerosis, the overall total effect of diet, exercise, lifestyle and selected natural medicines on the factors causing heart disease warrant adoption of these methods and provide confidence in our ability to change the course of our future.

Tori Hudson, ND, has more than 13 years of extensive clinical experience. She is also the author of The Women's Encyclopedia of Natural Medicine. Currently, Dr. Hudson is a professor of gynecology and operates "A Woman's Time" naturopathic women's health care clinic in Portland, Oregon.

References:

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2. Morris M, Sacks, Rosner B. Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation. 1993;88:523-533.

3. Deferne J, Leeds A. Resting blood pressure and cardiovascular reactivity to mental arithmetic in mild hypertensive males supplemented with blackcurrant seed oil. Journal of Human Hypertension 1996;10:531-537.

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5. Digiesi V, et al. Mechanism of action of coenzyme Q10 in essential hypertension. Current Therapies. 1992;51:668-672.

6. Wilcken DE, Dudman NP, Tyrrell PA. Homocysteinuria due to cystathionine beta-synthase deficiency Ð the effects of betaine treatment in pyridoxine-responsive patients. Metabolism 1985;12:1115-1121.

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8. Franken D, Boers G, Blom H, et al. Treatment of mild hyperhomocysteinaemia in vascular disease patients. Arteriosclerosis Thrombbosis Vascular Biology 1994;4:465-470.

9. Resnick L, Sealey J, Laragh J. Short and long-term oral calcium alters blood pressure in essential hypertension. Federationn Proceedings. 1083;42:300.

10. Altura B, Altura B. Magnesium in cardiovascular biology. Scientific American, Science and Medicine 1995; May/June:28-37.

11. Patki P, et al. Efficacy of potassium and magnesium in essential hypertension: a double-blind, placebo-controlled, crossover study. British Journal of Medicine 1990; 301:521-523.

12. Silagy C, Neil A. A meta-analysis of the effect of garlic on blood pressure. Journal of Hypertension 1994;12:463-468.

13. Petkov V. Plants with hypotensive, antiatheromatous and coronarodilatating action. American Journal of Chinese Medicine 1979; 7:197-236

14. Satyavati G. Gugulipid: a promising hypolipidaemic agent from gum guggul (Commiphora wightii). Econ Med Plant Res 1991;5:47-82.

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