Research - Heart
Pomegranate (Punica granatum L.) peel hydro alcoholic extract ameliorates cardiovascular risk factors in obese women with dyslipidemia: A double blind, randomized, placebo controlled pilot study
- Mahdiyeh Khadem Haghighiana, ,
- Maryam Rafrafa, , ,
- Abdolvahab Moghaddamb, ,
- Salar Hemmatic, ,
- Mohammad Asghari Jafarabadid, ,
- Bahram Pourghassem Gargarie,
IntroductionDyslipidemia is one of the most important risk factors for cardiovascular disease. Previous studies have shown that pomegranate and its polyphenols may have hypolipidemic effects. The objective of this study was to evaluate the effects of pomegranate peel extract on some cardiovascular risk factors in patients with dyslipidemia.
MethodsThirty eight obese women (30< body mass index (BMI) >35 kg/m2) with dyslipidemia were allocated into two groups receiving two 500 mg pomegranate peel extract (n = 19) or placebo (n = 19) daily for 8 weeks. Serum lipid profile (total cholesterol (TC), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), triglycerides (TG)), Blood Pressure(BP), serum high sensitive-C reactive protein (hs-CRP) and BMIwere measured.
ResultsPomegranate peel extract significantly decreased post treatment levels of serum TC (p = 0.014), LDL-C (p = 0.021), and TG (p = 0.036) and increased HDL-C (p = 0.020)compared to baseline. There was a significant decrease in Systolic Blood Pressure (SBP) levels and hs-CRP in pomegranate peel group whereas Diastolic Blood Pressure (DBP) levels and BMI remained unchanged after intervention. No significant changes were seen in terms of all post treatment values for the placebo group at the end of trial (p > 0.05). After adjusting for the baseline values, energy intake and weight changes, there were significant differences in post-treatment values between the two groups except in serum concentrations of HDL-C, DBP and BMI.
ConclusionsCurrent study showed a positive effect of pomegranate peel extract in improving cardiovascular risk factors in obese women with dyslipidemia.
Source : Sci-Hub via European Journal of Herbal Medicine
Link to Full Article
Dietary epicatechin intake and 25-y risk of cardiovascular mortality: the Zutphen Elderly Study1,2,3
- James I Dower4,5,
- Johanna M Geleijnse4,5,
- Peter CH Hollman4,5,*,
- Sabita S Soedamah-Muthu4, and
- Daan Kromhout4
Background: Prospective cohort studies have shown that the consumption of cocoa and tea is associated with lower risk of cardiovascular diseases (CVDs), and cocoa and tea have been shown to improve CVD risk factors in randomized controlled trials. Cocoa and tea are major dietary sources of the flavan-3-ol epicatechin.
Objective: We investigated the associations of dietary epicatechin intake with 25-y CVD mortality in elderly Dutch men.
Design: We used data from the Zutphen Elderly Study, which was a prospective cohort study of 774 men aged 65–84 y in 1985. Epicatechin intake was estimated 4 times in 15 y with the use of the crosscheck dietary history method. Time-dependent Cox proportional hazards models were used to investigate repeated measures of epicatechin intake in relation to 25-y CVD mortality.
Results: Mean intake of epicatechin was 15.2 ± 7.7 mg/d, and the major dietary sources were tea (51%), apples (28%), and cocoa (7%). During 25 y of follow-up, 329 men died from CVD, 148 died from coronary heart disease (CHD), and 72 men died from stroke. Risk of CHD mortality was 38% lower in men in the top tertile of epicatechin intake than in men in the bottom tertile of epicatechin intake (HR: 0.62; 95% CI: 0.39, 0.98). Epicatechin intake was also significantly associated with 46% lower risk of CVD mortality in men with prevalent CVD (HR: 0.54; 95% CI: 0.31, 0.96) but not in men who were free of CVD.
Conclusions: We show, for the first time to our knowledge, that epicatechin intake is inversely related to CHD mortality in elderly men and to CVD mortality in prevalent cases of CVD. More studies are needed before conclusions can be drawn.
Source : American Journal of Clinical Nutrition
Link to Full Article
Acute Effects of T’ai Chi Chuan Exercise on Blood Pressure and Heart Rate in Peripheral Artery Disease Patients
Filipe Fernandes Oliveira Dantas, PhD,1 Fa´ bio da Silva Santana, BS,2 Thiago Souza Rosas da Silva, BS,2 Gabriel Grizzo Cucato, PhD,3 Breno Quintella Farah, MS,4,5 and Raphael Mendes Ritti-Dias, PhD3
Objective: To investigate the acute effect of a t’ai chi chuan session on blood pressure and heart rate in patients with peripheral artery disease (PAD). Design: Randomized crossover intervention study.
Setting: Outpatient therapy center. Participants: Seven patients with PAD, aged 50–79 years, not using b-blockers, calcium-channel blockers, or nondihidropiridinic vasodilators. Intervention: T’ai chi chuan and control session (both sessions lasted 40 minutes).
Outcome measures: Systolic and diastolic blood pressure and heart rate, which were evaluated before and after the intervention (10, 30, and 50 minutes).
Results: T’ai chi chuan exercise acutely decreased systolic blood pressure at 30 minutes after exercise ( p = 0.042) and increased diastolic blood pressure at 50 minutes after exercise ( p = 0.041). Heart rate did not change after t’ai chi chuan exercise.
Conclusion: T’ai chi chuan acutely decreases systolic blood pressure in patients with PAD.
Source : The Journal Alternative and Complementary Medicine
Link to Full Article
Targeted metabolomic profiling of cardioprotective effect of Ginkgo biloba L. extract on myocardial ischemia in rats
Myocardial ischemia (MI) is one of the highest mortality diseases in the world. It is closely associated with metabolism disorders of endogenous substances. Ginkgo biloba L. extract (GBE) is a popular herbal medicine used for prevention and therapy of MI. But its regulation effect on the metabolism disorders caused by MI remains currently unknown.
Our metabolomic profiling study provided insight into endogenous metabolic disorders of MI and cardioprotective mechanisms of GBE.
The rats were preventive administrated of GBE (200 mg/kg, i.g.) for 4 weeks and then subcutaneous injected of isoproterenol to establish MI model. Heart marker enzymes and histopathological examination were adopted to evaluate MI model and effect of GBE. On this base, endogenous metabolites in rat plasma and heart were well profiled using the developed targeted metabolomic profiling platform to comprehensively analyze metabolic pathways and find biomarkers.
A targeted metabolomic profiling platform was developed and only 100 μl biological sample was used to quantify 808 metabolites covering the core network of lipid, energy, amino acid and nucleotide metabolism. Then using this platform, endogenous metabolites of rats undergoing MI model and GBE pre-treatment were well profiled. Orthogonal partial least squares discriminant analysis (OPLS-DA) was used to discriminate between groups and find biomarkers.
The metabolomic profiles of MI model rats pre-protected by GBE were significantly different from those of unprotected. 47 metabolites were found as potential biomarkers and indicated MI would lead to disturbed metabolism due to inflammation, oxidative stress and structural damage; while GBE could effectively restore fatty acid, sphingolipid, phosphoglyceride, glyceride, amino acid and energy metabolism, closely related to its antioxidant, PAF antagonist and hypolipidemic properties.
The cardioprotective effect of GBE can be achieved through the comprehensive regulation of multiple metabolic pathways.
Source : Journal Phytomedicine
Link to Full Article
Flavonoids Extraction from Propolis Attenuates Pathological Cardiac Hypertrophy through PI3K/AKT Signaling Pathway
Guang-wei Sun,1,2 Zhi-dong Qiu,3 Wei-nan Wang,3 Xin Sui,3 and Dian-jun Sui1,3
1China-Japan Union Hospital of Jilin University, Changchun 130033, China
2Chinese Traditional Medicine Institute of Ji Lin Province, Changchun 130021, China
3Changchun University of Chinese Medicine, Changchun 130117, China
Propolis, a traditional medicine, has been widely used for a thousand years as an anti-inflammatory and antioxidant drug. The flavonoid fraction is the main active component of propolis, which possesses a wide range of biological activities, including activities related to heart disease. However, the role of the flavonoids extraction from propolis (FP) in heart disease remains unknown. This study shows that FP could attenuate ISO-induced pathological cardiac hypertrophy (PCH) and heart failure in mice. The effect of the two fetal cardiac genes, atrial natriuretic factor (ANF) and β-myosin heavy chain (β-MHC), on PCH was reversed by FP. Echocardiography analysis revealed cardiac ventricular dilation and contractile dysfunction in ISO-treated mice. This finding is consistent with the increased heart weight and cardiac ANF protein levels, massive replacement fibrosis, and myocardial apoptosis. However, pretreatment of mice with FP could attenuate cardiac dysfunction and hypertrophy in vivo. Furthermore, the cardiac protection of FP was suppressed by the pan-PI3K inhibitor wortmannin. FP is a novel cardioprotective agent that can attenuate adverse cardiac dysfunction, hypertrophy, and associated disorder, such as fibrosis. The effects may be closely correlated with PI3K/AKT signaling. FP may be clinically used to inhibit PCH progression and heart failure.
Source : Evidence Based Complementary and Alternative Medicine
Link to Full Article
Effect of Crataegus Usage in Cardiovascular Disease Prevention: An Evidence-Based Approach
Jie Wang, Xingjiang Xiong, and Bo Feng
Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
Hawthorn (Crataegus oxyacantha) is a widely used Chinese herb for treatment of gastrointestinal ailments and heart problems and consumed as food. In North America, the role of treatment for heart problems dates back to 1800. Currently, evidence is accumulating from various in vivo and in vitro studies that hawthorn extracts exert a wide range of cardiovascular pharmacological properties, including antioxidant activity, positive inotropic effect, anti-inflammatory effect, anticardiac remodeling effect, antiplatelet aggregation effect, vasodilating effect, endothelial protective effect, reduction of smooth muscle cell migration and proliferation, protective effect against ischemia/reperfusion injury, antiarrhythmic effect, lipid-lowering effect and decrease of arterial blood pressure effect. On the other hand, reviews of placebo-controlled trials have reported both subjective and objective improvement in patients with mild forms of heart failure (NYHA I–III), hypertension, and hyperlipidemia. This paper discussed the underlying pharmacology mechanisms in potential cardioprotective effects and elucidated the clinical applications of Crataegus and its various extracts.
Source : Evidence Based Complementary and Alternative Medicine
Link to Full Article
Hawthorn Extract Reduces Inflammatory Cell Adhesion Molecules in Patients with Stable Angina
Jalaly L, Sharifi G, Faramarzi M, et al. Comparison of the effects of Crataegus oxyacantha extract, aerobic exercise and their combination on the serum levels of ICAM-1 and E-selectin in patients with stable angina pectoris. Daru. December 19, 2015;23:54. doi: 10.1186/s40199-015-0137-2.
Stable angina (angina pectoris) refers to heart pain caused by a lack of oxygen availability, and is preceded by inflammation and atherosclerosis. Cell adhesion molecules (CAMs) facilitate the inflammation process with white blood cell recruitment, and can negatively affect cellular and tissue function. Previous studies have shown English hawthorn (Crataegus laevigata syn. C. oxyacantha, Rosaceae), and other species of Crataegus, to be useful in treating symptoms of heart failure.1 This randomized, double-blind, placebo-controlled trial investigated the impact of hawthorn consumption, combined with aerobic exercise (also shown to reduce CAMs), on intercellular adhesion molecule-1 (ICAM-1) and E-selectin. These CAMs have been shown to be important in the pathology of cardiovascular disease.
English hawthorn leaf and flower extract (EPO Istituto Farmochimico Fitoterapico S.r.l.; Milan, Italy) was used for this study. The product Cratagol (provided by Goldaru; Isfahan, Iran), consisting of 240 mg of extract per tablet standardized to 4-6 mg of vitexin-2-ramnozide, was used. These tablets also contained microcrystalline cellulose, corn (Zea mays, Poaceae) starch, talc, and magnesium stearate. Placebo tablets (Goldaru) consisted of lactose with identical coating. Two tablets were administered per day with water, prior to meals, for 12 weeks.
Patients diagnosed with stable angina were recruited from the Imam Ali Clinic in Shahrekord, Iran. Patients were included if they had received angina testing between 1-12 months prior to the study, < 50% atherosclerosis, treatment within 3 months prior to the study, and if they were 45-65 years old. Those with severe heart failure, "lack of accessibility," or who were taking medications, including digoxin, cisapride, anticoagulants, or antiarrhythmics, were not included. In total, 80 patients were randomly assigned to 1 of 4 groups with 20 patients in each (11 men and 9 women) as follows: (1) exercise with placebo, (2) hawthorn extract alone, (3) exercise and hawthorn extract together, and (4) control (no exercise, hawthorn extract, or placebo). At baseline, there were no differences in age, sex, weight, or body mass index among groups. Exercise, nutrition, smoking and drinking habits, and angina symptoms were monitored.
Throughout the study, all patients received 50 mg/day of Methoral, 80 mg/day of aspirin, and nitroglycerine as needed for pain. Exercise consisted of a treadmill protocol of 40-60% of heart rate reserve and an 11-13 rating of perceived exertion using the Borg scale (this scale ranges from 6 to 20, where 20 indicates maximal exertion). The exercise protocol was done for 20-30 minutes twice per week for 12 weeks. If patients had chest pain, asthma, dizziness, fatigue, or decreased systolic blood pressure by > 10 mmHg, exercise was halted. Fasting blood was collected at baseline (24 hours prior to the study) and at the end of the study. Enzyme-linked immunosorbent assay (ELISA) kits were used to measure serum concentrations of ICAM-1 and E-selectin.
None of the patients dropped out. At baseline, ICAM-1 and E-selectin were not different among groups. At the end of the study, ICAM-1 significantly decreased compared to baseline concentrations in the exercise group (65.5 ± 39.7 ng/ml vs. 20.8 ± 2.7 ng/ml, P=0.001), hawthorn extract group (61.3 ± 38.1 ng/ml vs. 23.1 ± 3.7 ng/ml, P=0.001), and the exercise and hawthorn extract combined group (90 ± 53.5 ng/ml vs. 21.9 ± 3.9 ng/ml, P=0.001). No significant differences were noted in the control group. Also, as compared to baseline, E-selectin concentrations were significantly decreased in the exercise group (3.2 ± 1.5 ng/ml vs. 1.8 ± 1 ng/ml, P=0.001), hawthorn extract group (3.4 ± 1.9 ng/ml vs. 2.2 ± 1.3 ng/ml, P=0.003), and the exercise and hawthorn extract combined group (3.5 ± 1.3 ng/ml vs. 1.8 ± 0.7 ng/ml, P=0.001). No differences were seen in the control group.
The ICAM-1 serum concentrations of those in the exercise and hawthorn extract combined group were significantly lower than those taking hawthorn extract alone (P=0.021) and the control group (P<0.05), but not the exercise-only group. Also, E-selectin concentrations were lower in the combination group than in the hawthorn extract-only group and the control group (P=0.021 and P<0.05, respectively), but not the exercise-only group. No adverse side effects were noted.
In summary, this study shows that both English hawthorn extract and exercise were effective in attenuating the concentration of ICAM-1 and E-selectin. This may be due to the alleviation of downstream inflammation markers or general bioactivity associated with the antioxidant potential of hawthorn. It is curious that the control group in this study did not receive the placebo; this somewhat confounds the results. However, English hawthorn extract may be an effective adjuvant treatment, with or without exercise, for those suffering from stable angina.
--Amy C. Keller, PhD:
Source : American Botanical Council - HerbClip
Link to Source
Gualou Xiebai decoction inhibits cardiac dysfunction and inflammation in cardiac fibrosis rats
- Yong-fang DingEmail author,
- Yun-ru Peng,
- Hong Shen,
- Luan Shu and
- Ying-jie Wei
Gualou Xiebai Decoction (GXD) is a well-known traditional Chinese recipe. It has been used to treat cardiovascular disorders for nearly two thousand years. But there is a lack of reports on cardiac fibrosis and underlying mechanism.
Myocardial infarction was performed by ligation of left anterior descending coronary artery (LAD) in male Wistar rats. Rats with myocardial infarction were treated with GXD (1.14 g/kg, 4.53 g/kg) daily for 4 weeks. Cardiac function was evaluated by echocardiography. Hemodynamic parameters and infarct size were measured in each group. Myocardial enzymes were examined by biochemical tests. Inflammatory cytokines were assessed by ELISA, and interrelated proteins were detected by western blot.
Cardiac function was significantly improved in GXD-treatment rats after myocardial infarction (MI), which was accompanied with decreased infarct size. Administration of GXD to myocardial fibrosis rats significantly ameliorated the activities of AST, LDH and CK-MB in serum. The increase in inflammatory factors (TNF-α, IL-1β) were markedly reduced upon GXD treatment. Furthermore, the inflammatory mediators (NF-κB p65, TNF-α, MCP-1) were down-regulated by GXD in the myocardial fibrosis rats.
Treatment with GXD improved cardiac function induced by myocardial fibrosis by inhibiting expression of inflammatory mediators associated with NF-κB.
Source : BMC Evidence Based Complementary and Alternative Medicine
Link to Full Article
Selenium status and cardiovascular diseases: meta-analysis of prospective observational studies and randomized controlled trials
X Zhang1,4, C Liu2,4, J Guo3 and Y Song
Selenium was thought to have a role in cardiovascular disease (CVD) owing to its antioxidant properties; however, evidence from observational studies and randomized controlled trials (RCTs) has been inconsistent and controversial. We thus conducted a meta-analysis to assess the discrepancies between observational and randomized trial evidence.
We searched MEDLINE and EMBASE for eligible prospective studies regarding the relationship between selenium and CVD up to 15 December 2013 and finally included 16 prospective observational studies and 16 RCTs. Random effects model was used to estimate the pooled relative risk (RR). Generalized least-squares trend test and restricted cubic spline model were performed to assess a linear and a nonlinear dose–response relationship.
Our meta-analysis of prospective studies showed a nonlinear relationship of CVD risk with blood selenium concentrations across a range of 30–165 μg/l and a significant benefit of CVD within a narrow selenium range of 55–145 μg/l. Our meta-analyses of RCTs showed that oral selenium supplements (median dose: 200 μg/day) for 2 weeks to 144 months significantly raised the blood selenium concentrations by 56.4 μg/l (95% confidence interval (CI): 40.9, 72.0 μg/l), whereas oral selenium supplements (median: 100 μg/day) for 6 to 114 months caused no effect on CVD (RR=0.91; 95% CI: 0.74, 1.10).
Our meta-analysis in prospective studies demonstrated a significant inverse association between selenium status and CVD risk within a narrow selenium range and a null effect of selenium supplementation on CVD was observed in RCTs. These findings indicate the importance of considering selenium status, dose and safety in health assessment and future study design.
Source : European Journal of Clinical Nutrition
Link to Abstract
Wen-Xin Decoction ameliorates vascular endothelium dysfunction via the PI3K/AKT/eNOS pathway in experimental atherosclerosis in rats
- Tongda Li†,
- Dongmei Li†,
- Hui Xu,
- Huamin Zhang,
- Danli Tang and
- Hongxin Cao
Nitric oxide (NO) is the most powerful vasodilator that inhibits leukocyte adhesion, platelet aggregation, and vascular smooth muscle cell proliferation. However, excessive NO can cause lipid peroxidation and direct endothelial cell damage. Therefore, investigation of the role of NO in artherosclerosis development is important. Wen-Xin Decoction (WXD) has been shown to relieve myocardial ischemia reperfusion injury and prevent leukocyte adhesion and invasion; in addition, it can accelerate angiogenesis and prevent platelet activation and aggregation. In this study, we focused on the NO pathway to further clarify the protective effects of WXD on the vascular endothelium in rat models of artherosclerosis.
Wistar rats were randomly divided into a normal group (n = 10) and a model group (n = 75). Rat models of atherosclerosis were generated by intraperitoneal vitamin D3 (3 months) injections and administration of a high-fat diet (3 months with vitamin D3 and 2 months alone). The model rats were randomly divided into five groups (n = 15 each): model (saline), atorvastatin (4.8 mg/kg/d atorvastatin), high-dose WXD (9 g/kg/d), medium-dose WXD (4.5 g/kg/d), and low-dose WXD (2.25 g/kg/d) groups. Each group received continuous drug or saline administration (suspended liquid gavage) for 30 days, following which all animals were sacrificed. The ultrastructure and histopathological changes of vascular endothelial cells and the expression of PI3K/AKT/eNOS and iNOS in the thoracic aorta tissue were analyzed.
WXD increased NO levels, modulated the NO/ET-1 ratio, and promoted repair of the injured vascular endothelium in a dose-dependent manner. At a high dose, WXD regulated the NO/ET-1 ratio as effectively as atorvastatin; furthermore, it increased NO levels within the physiological range to prevent endothelial damage caused by excessive NO expression. Real-time polymerase chain reaction and Western blot analysis showed that WXD significantly upregulated the mRNA and protein expressions of PI3K, AKT, and eNOS mRNA and significantly increased AKT and eNOS phosphorylation.
ConclusionsOur results suggest that WXD protects and maintains the integrity of the vascular endothelium by activating the PI3K/AKT/eNOS pathway, decreasing iNOS expression, and promoting the release of physiological NO levels.
Source : BMC Complementary and Alternative Medicine
Link to Full Article
Comparative Efficacy of Tongxinluo Capsule and Beta-Blockers in Treating Angina Pectoris: Meta-Analysis of Randomized Controlled Trials
Objective: There have been no systematic reviews, let alone meta-analyses, of randomized controlled trials (RCTs) comparing tongxinluo capsule (TXL) and beta-blockers in treating angina pectoris. This study aimed to evaluate the efficacy of TXL and beta-blockers in treating angina pectoris by a meta-analysis of eligible RCTs.
Methods: The RCTs comparing TXL with beta-blockers (including metoprolol) in treating angina pectoris were searched and retrieved from databases including PubMed, Chinese National Knowledge Infrastructure, and WanFang Data. Eligible RCTs were selected according to prespecified criteria. Meta-analysis was performed on the odds ratios (OR) of symptomatic and electrocardiographic (ECG) improvements after treatment. Subgroup analysis, sensitivity analysis, meta-regression, and publication biases analysis were conducted to evaluate the robustness of the results.
Results: Seventy-three RCTs published between 2000 and 2014 with 7424 participants were eligible. Overall ORs comparing TXL with beta-blockers were 3.40 (95% confidence interval [CI], 2.97–3.89; p<0.0001) for symptomatic improvement and 2.63 (95% CI, 2.29–3.02; p<0.0001) for ECG improvement. Subgroup analysis and sensitivity analysis found no statistically significant dependence of overall ORs on specific study characteristics except efficacy criteria. Meta-regression found no significant except sample sizes for data on symptomatic improvement. Publication biases were statistically significant.
Conclusion: TXL seems to be more effective than beta-blockers in treating angina pectoris, on the basis of the eligible RCTs. Further RCTs are warranted to reduce publication bias and verify efficacy.
Source : Journal Alternative and Complementary Medicine
Link to Abstract
Re: High Levels of Olive Oil Consumption Associated with Decreased Risk of Coronary Artery Disease
Dimitriou M, Rallidis LS, Theodoraki EV, Kalafati IP, Kolovou G, Dedoussis GV. Exclusive olive oil consumption has a protective effect on coronary artery disease; overview of the THISEAS study. Public Health Nutr. July 2015:1-7. [epub ahead of print]. doi: 10.1017/S1368980015002244.
Coronary artery disease (CAD) is the most common condition associated with cardiovascular disease (CVD) and is the result of narrowing of the coronary arteries. CAD can lead to angina, myocardial infarction, and heart failure. The Seven Countries Study was one of the first to establish that dyslipidemia, hypertension, obesity, and environmental factors, including diet, activity level, stress, and smoking, affect the risk of developing CVD. Other studies have shown that the Mediterranean diet can provide a cardiovascular protective effect. The Mediterranean diet is characterized by high intake of fruits, vegetables, whole grains, chicken, fish, and olive (Olea europaea, Oleaceae) oil. Each of these components is likely to contribute to the reduction in CVD risk in some way. Studies have shown that olive oil can improve lipid profile, reduce oxidation of low-density lipoprotein cholesterol (LDL-C), and improve endothelial function. The Hellenic study of Interactions between Single-nucleotide polymorphisms and Eating and Atherosclerosis Susceptibility (THISEAS) is a case-controlled study that was conducted in Greece between 2006 and 2010. This report describes the relationship between the risk of developing CAD and socioeconomic status, anthropometrics, lifestyle choices, and biochemical markers.
Patients with CAD were recruited from hospitals, Centers of Open Protection for the Elderly, and municipalities in and around Athens, Greece. Outpatients or in-patients who did not have CAD and were not patients in a cardiology clinic were also recruited as controls. In addition, healthy subjects were recruited from the Centers of Open Protection for the Elderly and municipalities in and around Athens, Greece. An attempt was made to recruit twice as many control patients as case patients. The case patients had acute coronary syndrome or CAD with > 50% stenosis in at least 1 of the main coronary blood vessels. Patients were excluded if they had acute renal or hepatic disease.
Blood was collected after a 12-hour fast and measured for glucose, total cholesterol, triglycerides, LDL-C, and high-density lipoprotein cholesterol (HDL-C). Education level, marital status, socioeconomic status, physical activity level, smoking status, body weight and height, body mass index (BMI), and blood pressure were measured. Diet was evaluated using a 172-picture food frequency questionnaire that asked what food was consumed, how often, and in what proportions. Because it is common for diet to be modified after CAD diagnosis, information on diet was collected only from case patients who had been recently diagnosed with CAD. This resulted in dietary analysis of 60.4% of the case patients. Adherence to the Mediterranean diet and olive oil consumption were measured using the MedDietScore and additional questionnaires on fat consumption, respectively. Patients were also asked to note any prescription medications taken.
Of the 2565 patients enrolled in the study, 1221 were case patients, and 1344 were control patients. Of the 1221 case patients, 499 underwent dietary analysis, while 832 of the control patients underwent dietary analysis. The case patients were significantly older, were more likely to smoke or have smoked in the past, and had a lower level of education and income than the control patients (P<0.001 for all). In addition, the case patients had significantly higher cholesterol levels and blood pressure, were more likely to have diabetes, and more likely to be taking lipid-lowering medication (P<0.001 for all). The control patients had higher total cholesterol, HDL-C, and LDL-C than the case patients (P<0.001 for all). This is likely because many of the case patients were taking medications to control dyslipidemia. The case patients also had higher fasting blood glucose levels than the control patients (P<0.001). The control patients had significantly lower daily caloric intake but a significantly higher fat and olive oil intake than case patients (P<0.001). Lastly, olive oil consumption was associated with a decrease in risk of developing CAD. This decrease was as much as 48% in those that consumed olive oil exclusively.
A reduced risk of developing CAD was associated with higher levels of education, higher socioeconomic status, higher activity levels, not smoking cigarettes, lower BMI, and higher intake of olive oil. Most of these correlations have been confirmed with other studies, including the Minnesota Heart Survey and the ATTICA study. A decreased risk of developing CAD with increased olive oil consumption has been found in several other studies. In two studies, subjects in the highest olive oil consumption group had a reduced risk of developing CAD. In the Three-City Study, there was a reduced risk of stroke in the group with the highest olive oil consumption. However, according to the authors, this is the first study to control for confounding dietary influence on CAD rates and investigate the effect of exclusive olive oil consumption. Olive oil effects are thought to be mediated through changes in oxidative stress, inflammation, lipid peroxidation, and lipid profile. Limitations of the study, acknowledged by the authors, include recall bias of past diet and the unknown probability that control patients would be diagnosed with CAD soon after the study ended. The authors conclude that higher or exclusive olive oil consumption could be an important addition to nutritional protocols to prevent CAD.
―Cheryl McCutchan, PhD
Source : American Botanical Council
Link to Source
Decreased risk of acute myocardial infarction in stroke patients receiving acupuncture treatment: a nationwide matched retrospective cohort study
Sun-Fa Chuang1†, Chun-Chuan Shih2†, Chun-Chieh Yeh34, Hsin-Long Lane2, Chin-Chuan Tsai25, Ta-Liang Chen678, Jaung-Geng Lin9, Tainsong Chen1† and Chien-Chang Liao6789*†
Background Whether acupuncture protects stroke patients from acute myocardial infarction (AMI) has not been studied previously. The purpose of this study was to investigate the risk of AMI among stroke patients receiving acupuncture treatment.
Methods Taiwan’s National Health Insurance Research Database was used to conduct a retrospective cohort study of 23475 stroke patients aged 40–79 years receiving acupuncture treatment and 46950 propensity score-matched stroke patients not receiving acupuncture treatment who served as controls from 2000 to 2004. Both stroke cohorts were followed until the end of 2009 and were adjusted for immortal time to measure the incidence and adjusted hazard ratios (HRs) with 95 % confidence intervals (CIs) for new-onset AMI in multivariate Cox proportional hazard models.
Results Stroke patients who received acupuncture treatment (9.2 per 1000 person-years) exhibited a lower incidence of AMI compared with those who did not receive acupuncture treatment (10.8 per 1000 person-years), with an HR of 0.86 (95 % CI, 0.80–0.93) after adjusting for age, sex, low income, coexisting medical conditions and medications. The relationship between acupuncture treatment and AMI risk was investigated in female stroke patients (HR, 0.85; 95 % CI, 0.76–0.95), male stroke patients (HR, 0.87; 95 % CI, 0.80–0.95), patients from 50 to 59 years of age (HR, 0.75; 95 % CI, 0.63–0.90), patients from 60 to 69 years of age (HR, 0.85; 95 % CI, 0.75–0.95), patients suffering from ischemic stroke (HR, 0.87; 95 % CI, 0.79–0.95), and patients suffering from hemorrhagic stroke (HR, 0.62; 95 % CI, 0.44–0.88).
Conclusions We raised the possibility that acupuncture may be effective in lowering the risk of AMI in stroke patients aged 50–69 in this study, which was limited by a lack of information regarding stroke severity and acupuncture points. Our results suggest that prospective randomized trials are needed to establish the efficacy of acupuncture in preventing AMI.
Source : BMC Complementary and Alternatve Medicine
Link to Full Article
Effects of the Olive Tree Leaf Constituents on Myocardial Oxidative Damage and Atherosclerosis
Panagiotis Efentakis1, Efstathios K. Iliodromitis2, Emmanuel Mikros1, Anastasia Papachristodoulou1, Nikolaos Dagres2, Alexios-Leandros Skaltsounis3, Ioanna Andreadou1
The olive (Olea europaea) leaf is considered an important traditional herbal medicine utilized against infectious diseases, and for the treatment of diabetes and hypertension. Moreover, olive leaf constituents have been related to cardioprotection, probably due to their association with cellular redox modulating effects. The pathogenesis of certain common diseases, including those of the cardiovascular system, involves oxidative stress and tissue inflammation. Olive polyphenolic compounds, such as oleuropein, hydroxytyrosol, or tyrosol, possess antioxidant, anti-inflammatory, antiatherosclerotic, anti-ischemic, and hypolipidemic effects on the myocardium as demonstrated by various in vitro and in vivo studies. In this review article, we summarize the current knowledge on the role of the olive leaf constituents in the prevention of cardiac dysfunction and highlight future perspectives in their use as cardioprotective agents in therapeutics.
In conclusion, oleuropein seems to be a promising molecule that may be used as a cardioprotective agent. However, the underlying signaling cascades of its cardioprotective effects remain to be elucidated.
Conclusively, O. europaea L. leaf constituents possess proven beneficial results on myocardial oxidative stress and atherosclerosis.
Source : Planta Medica
Link to Full Article
Exercise attenuates inflammation and limits scar thinning after myocardial infarction in mice Sarah-Lena Puhl,1 Andreas Müller,2 Michael Wagner,1 Yvan Devaux,3 Michael Böhm,1 Daniel R. Wagner,4 and Christoph Maack1
Although exercise mediates beneficial effects in patients after myocardial infarction (MI), the underlying mechanisms as well as the question of whether an early start of exercise after MI is safe or even beneficial are incompletely resolved. The present study analyzed the effects of exercise before and reinitiated early after MI on cardiac remodeling and function. Male C57BL/6N mice were housed sedentary or with the opportunity to voluntarily exercise for 6 wk before MI induction (ligation of the left anterior descending coronary artery) or sham operation. After a 5-day exercise-free phase after MI, mice were allowed to reexercise for another 4 wk. Exercise before MI induced adaptive hypertrophy with moderate increases in heart weight, cardiomyocyte diameter, and left ventricular (LV) end-diastolic volume, but without fibrosis. In sedentary mice, MI induced eccentric LV hypertrophy with massive fibrosis but maintained systolic LV function. While in exercised mice gross LV end-diastolic volumes and systolic function did not differ from sedentary mice after MI, LV collagen content and thinning of the infarcted area were reduced. This was associated with ameliorated activation of inflammation, mediated by TNF-, IL-1, and IL-6, as well as reduced activation of matrix metalloproteinase 9. In contrast, no differences in the activation patterns of various MAPKs or adenosine receptor expressions were observed 5 wk after MI in sedentary or exercised mice. In conclusion, continuous exercise training before and with an early reonset after MI ameliorates adverse LV remodeling by attenuating inflammation, fibrosis, and scar thinning. Therefore, an early reonset of exercise after MI can be encouraged.
Source : Am J Physiol Heart Circ Physiol.
Link to Full Article
Epicatechin and Quercetin Affects Some Biomarkers of Endothelial Dysfunction and Inflammation in (Pre)Hypertensive Adults: A Randomized Double-Blind, Placebo-Controlled, Crossover Trial1,2
James I Dower3,4, Johanna M Geleijnse3,4, Lieke Gijsbers3,4,Casper Schalkwijk3,5, Daan Kromhout4, and Peter C Hollman3,4,*
Background: Consumption of flavonoid-rich foods such as cocoa and tea may reduce cardiovascular disease risk. The flavonoids epicatechin (in cocoa and tea) and quercetin (in tea) probably play a role by reducing endothelial dysfunction and inflammation, 2 main determinants of atherosclerosis.
Objective: We studied the effects of supplementation of pure epicatechin and quercetin on biomarkers of endothelial dysfunction and inflammation.
Methods: Thirty-seven apparently healthy (pre)hypertensive men and women (40–80 y) participated in a randomized, double-blind, placebo-controlled crossover trial. Participants ingested (-)-epicatechin (100 mg/d), quercetin-3-glucoside (160 mg/d), or placebo capsules for a period of 4 wk, in random order. Plasma biomarkers of endothelial dysfunction and inflammation were measured at the start and end of each 4-wk intervention period. The differences in changes over time between the intervention and placebo periods (Δintervention − Δplacebo) were calculated and tested with a linear mixed model for repeated measures.
Results: Epicatechin changed Δepicatechin − Δplacebo for soluble endothelial selectin (sE-selectin) by −7.7 ng/mL (95% CI: −14.5, −0.83; P = 0.03) but did not significantly change this difference (−0.30; 95% CI: −0.61, 0.01; P = 0.06) for thez score for endothelial dysfunction. Quercetin changed Δquercetin − Δplacebo for sE-selectin by −7.4 ng/mL (95% CI: −14.3, −0.56; P = 0.03), that for IL-1β by −0.23 pg/mL (95% CI: −0.40, −0.06; P = 0.009), and that for the z score for inflammation by −0.33 (95% CI: −0.60, −0.05; P = 0.02).
Conclusions: In (pre)hypertensive men and women, epicatechin may contribute to the cardioprotective effects of cocoa and tea through improvements in endothelial function. Quercetin may contribute to the cardioprotective effects of tea possibly by improving endothelial function and reducing inflammation.
Source : Journal Nutrition
Link to Abstract
Olive Oil Polyphenols Decrease LDL Concentrations and LDL Atherogenicity in Men in a Randomized Controlled Trial1,2,3
Álvaro Hernáez4,8,9, Alan T Remaley11, Marta Farràs4,8,12,Sara Fernández-Castillejo13, Isaac Subirana5,7, Helmut Schröder4,7,Mireia Fernández-Mampel4, Daniel Muñoz-Aguayo4,8, Maureen Sampson11,Rosa Solà8, Magí Farré6,14, Rafael de la Torre6,15,María-Carmen López-Sabater10, Kristiina Nyyssönen16,Hans-Joachim F Zunft17, María-Isabel Covas4,8, and Montserrat Fitó4,8,*
Background: Olive oil polyphenols have shown protective effects on cardiovascular risk factors. Their consumption decreased oxidative stress biomarkers and improved some features of the lipid profile. However, their effects on LDL concentrations in plasma and LDL atherogenicity have not yet been elucidated.
Objective: Our objective was to assess whether the consumption of olive oil polyphenols could decrease LDL concentrations [measured as apolipoprotein B-100 (apo B-100) concentrations and the total number of LDL particles] and atherogenicity (the number of small LDL particles and LDL oxidizability) in humans.
Methods: The study was a randomized, cross-over controlled trial in 25 healthy European men, aged 20–59 y, in the context of the EUROLIVE (Effect of Olive Oil Consumption on Oxidative Damage in European Populations) study. Volunteers ingested 25 mL/d raw low-polyphenol-content olive oil (LPCOO; 366 mg/kg) or high-polyphenol-content olive oil (HPCOO; 2.7 mg/kg) for 3 wk. Interventions were preceded by 2-wk washout periods. Effects of olive oil polyphenols on plasma LDL concentrations and atherogenicity were determined in the sample of 25 men. Effects on lipoprotein lipase (LPL) gene expression were assessed in another sample of 18 men from the EUROLIVE study.
Results: Plasma apo B-100 concentrations and the number of total and small LDL particles decreased (mean ± SD: by 5.94% ± 16.6%, 11.9% ± 12.0%, and 15.3% ± 35.1%, respectively) from baseline after the HPCOO intervention. These changes differed significantly from those after the LPCOO intervention, which showed significant increases of 6.39% ± 16.6%, 4.73% ± 22.0%, and 13.6% ± 36.4% from baseline (P < 0.03). LDL oxidation lag time increased by 5.0% ± 10.3% from baseline after the HPCOO intervention, which was significant only relative to preintervention values (P = 0.038). LPL gene expression tended to increase by 26% from baseline after the HPCOO intervention (P = 0.08) and did not change after the LPCOO intervention.
Conclusion: The consumption of olive oil polyphenols decreased plasma LDL concentrations and LDL atherogenicity in healthy young men.
Source : Journal Nutrition
Link to Abstract
Research Review Supports Cardioprotective Role of Cocoa
Berends LM, van der Velpen V, Cassidy A. Flavan-3-ols, theobromine, and the effects of cocoa and chocolate on cardiometabolic risk factors. Curr Opin Lipidol. 2015;26(1):10-19.
Potential cardiovascular health benefits are attributed to cocoa (Theobroma cacao, Malvaceae) and chocolate through their bioactive constituents, including polyphenols, stearic acid, and methylxanthines. This review summarizes the recent research on the cardiometabolic effects of cocoa and chocolate and focuses on two key bioactive constituents: flavan-3-ols and theobromine. The main flavan-3-ols in chocolate are (–)-epicatechin, (+)-catechin, and some of their oligomers, known as procyanidins. Theobromine is another bioactive constituent of chocolate with potential beneficial health effects. The role of chocolate in cardiovascular disease (CVD) has been studied in both observational studies for cardiovascular endpoints and in randomized, controlled trials (RCTs) for cardiometabolic markers.
In a meta-analysis of six cohort studies and one cross-sectional study, a higher chocolate intake was associated with a reduced risk for cardiometabolic disorders.1 The greatest reductions were seen for CVD (37%) and stroke (29%) in three studies. In one study, a reduction in diabetes was observed; no effects of chocolate intake on heart failure were observed. A meta-analysis of observational data showed an overall relative risk reduction of 19% for stroke when comparing the highest and lowest categories of chocolate intake.2 Two other meta-analyses supported the association between chocolate intake and reduced risk for CVD.
Three meta-analyses of RCTs reviewed the impact of cocoa and chocolate consumption on cardiometabolic health from short-duration studies (≤18 weeks). One reported a 2.77 mmHg decrease in systolic blood pressure (SBP) and a 2.20 mmHg decrease in diastolic blood pressure (DBP) after cocoa intake.3 Two of the meta-analyses reported improved levels of both high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) with cocoa consumption. In another study, daily cocoa intake significantly improved HDL-C, glucose, and several inflammatory biomarkers, but did not affect blood pressure, LDL-C, or triglyceride concentrations.4
The authors conclude that data from available RCTs on cardiometabolic markers "largely support the findings on CVD outcomes in observational studies; the short duration studies support potentially clinically relevant effects of cocoa and chocolate on vascular function and insulin resistance." Additional longer-term trials are needed.
According to the authors, the most recent prospective cohort studies on flavan-3-ol intake and cardiovascular health report no association with coronary heart disease (CHD) mortality, CHD incidence, or stroke risk. One study of 98,469 men and women over seven years, however, reported that higher flavan-3-ol intake was associated with a 17% decrease in CVD mortality.5 Another study of 1,063 women over five years reported a 66% decrease for atherosclerotic vascular disease mortality associated with flavanol intake.6 A third study of 7,172 subjects followed for more than four years reported a 60% decrease in CVD events and mortality.7
Three systematic reviews sought to determine the effective dose of flavan-3-ols. In one, a nonlinear dose-response effect with a maximal effect was observed at a total polyphenol intake of 500 mg. In another, intakes of epicatechin > 50 mg resulted in greater effects on SBP and DBP; flow-mediated dilatation (FMD) improved at all levels of epicatechin intake.
The authors conclude that "flavan-3-ols may mediate the beneficial effects of cocoa and chocolate. However, in addition to elucidating the effective doses, it remains to be established whether the flavan-3-ol monomers, their phase-II-conjugated metabolites, the procyanidins or their gut metabolites are driving any cardiometabolic effects."
Theobromine may be responsible for mediating the observed beneficial effects of cocoa and chocolate on lipoprotein levels, suggests a short-term RCT in which daily consumption of theobromine (850 mg) for four weeks significantly increased HDL-C concentrations.8 In another RCT, with a lower daily consumption of theobromine (476 mg daily for four weeks), no changes were reported in HDL-C levels.9 In some studies, high-dose theobromine consumption was associated with gastrointestinal complaints, and acute stimulatory effects on heart rate were observed following consumption of 500-1000 mg theobromine.
The authors suggest further studies should investigate how theobromine affects HDL-C functionality and cardiovascular health, along with the effects at dietary-relevant levels, and its potential synergistic effects with other bioactive compounds in chocolate.
The authors conclude, "Evidence for a cardioprotective role of chocolate consumption is apparent from the population-based studies and short-term RCTs, and currently provides greater support for the flavan-3-ol content rather than theobromine. However, interpretation of findings is difficult because of considerable variability between studies and it is unclear whether they work individually or in synergy."
Source : American Botanical Council
Link to Source
Dark Chocolate Consumption for One Month Improves Vascular Function in Young, Healthy Subjects
Pereira T, Maldonado J, Laranjeiro M, et al. Central arterial hemodynamic effects of dark chocolate ingestion in young healthy people: a randomized and controlled trial. Cardiol Res Pract. 2014;2014:945951. doi: 10.1155/2014/945951.
Ischaemic heart disease and stroke are the most important causes of mortality worldwide. Studies have shown that the severity of endothelial dysfunction relates to the risk for an initial or recurrent cardiovascular event.1Endothelial dysfunction plays a critical role in the development of atherosclerosis, leading to decreased arterial compliance. Nutrition is thought to affect endothelial function. Foods rich in flavanols have been investigated for their role in preventing cardiovascular disease. Cocoa (Theobroma cacao, Malvaceae) and chocolate products have a high flavanol concentration and antioxidant capacity. The authors conducted a randomized, controlled trial to determine whether daily ingestion of a small amount of cocoa-rich chocolate (>70%) improves the vascular function in young, healthy subjects.
Between November 2012 and February 2013, 60 clinically healthy subjects (20 men and 40 women), all undergraduate students at the Superior Polytechnic Institute of Coimbra, Portugal, were enrolled in the study. They were randomly allocated to the control group (CG) or the intervention group (IG). The 30 subjects in the CG were aged between 18 and 24 years; those in the IG, between 18 and 23 years.
The first study evaluation was done at baseline, after which the subjects in the IG ingested 10 g daily of dark chocolate with more than 75% cocoa for 1 month. [Note: Source of chocolate and other information regarding chocolate contents were not provided.] The CG had no intervention. A second evaluation was conducted 1 week after the end of the 1-month intervention period.
Among the clinical evaluations conducted were aortic pulse wave velocity (PWV), central pulse wave analysis (PWA), brachial artery flow-mediated dilation (FMD), augmentation index (AiX), distensibility index (ASI), blood pressure (BP), heart rate (HR), and clinical observation.
Baseline group characteristics were similar. The authors report no significant changes during the trial in body mass index, HR, or brachial BP in either group, although a consistent trend for reduced BP was seen in the IG.
Statistically significant decreases in PWV (P=0.02) and ASI (P<0.01) were seen in the IG, but not in the CG. A similar finding was also observed for the AiX, an indirect measure of arterial stiffness. At baseline, no significant differences in FMD were noted between the 2 groups; however, the FMD improved considerably after 1 month in the IG (P<0.001), with no significant changes in the CG. When pooling the mean within-group individual differences for each group, the authors reported a reduction in all variables after the 1-month intervention in the IG, with statistically significant effects for ASI (P<0.001) and PWV (P=0.010). Brachial and central BP levels also decreased in the IG.
To summarize, vascular function significantly improved in young, healthy subjects who consumed 10 g dark chocolate for 1 month.
The probable mechanism for improved PWV, ASI, and AiX after cocoa consumption may be the parietal relaxation of the large arteries, as well as a dilation of small- and medium-sized peripheral arteries and arterioles, say the authors. The "finding of improved FMD strongly suggests endothelium-dependent vascular relaxation as the motive for the vasomotor benefit found," leading to lower PWV, ASI, and AiX, and a trend toward reduced BP, write the authors.
"We can suggest flavanol-containing cocoa as a promising and powerful option for cardiovascular primary prevention."
Source : American Botanical Council - HerbClip
Link to Source
Fiber consumption and all-cause, cardiovascular, and cancer mortalities: A systematic review and meta-analysis of cohort studies
Lihua Liu1, Shan Wang2 and Jianchao Liu3
1 Institute of Hospital Management, Chinese PLA General Hospital, Beijing, P. R. China
2 Department of Epidemiology and Biostatistics, School of Basic Medical Sciences, Peking Union Medical College/Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences Beijing, P. R. China
3 Office of Hospital Informatization, Institute of Hospital Management, Chinese PLA General Hospital, Beijing, P. R. China
The present meta-analysis aimed to investigate fiber consumption and all-cause mortality, and cause-specific mortality. MEDLINE and web of science database were searched for cohort studies published from inception to August 2014. Studies were included if they provided a hazard ratio (HR) and corresponding 95% CI for mortality in relation to fiber consumption.We found that, compared with those who consumed lowest fiber, for individuals who ate highest fiber, mortality rate was lower by 23% (HR, 0.77; 95% CI, 0.72–0.81) for CVD, by 17% (HR, 0.83; 95% CI, 0.74–0.91) for cancer, by 23% (HR, 0.77; 95% CI, 0.73–0.81) for all-cause mortality. For each 10 g/day increase in fiber intake, the pooled HR was estimated to be 0.89 (95% CI, 0.86–0.93) for all-cause mortality, 0.80 (95% CI, 0.72–0.88) for CHD mortality, and 0.66 (95% CI, 0.40–0.92) for IHD mortality, 0.91 (95% CI, 0.88–0.94) for cancer. Dietary fiber and CVD mortality showed a strong dose–response relation. Apparently, fiber consumption is inversely associated with all-cause mortality and CVD, IHD, cancer mortality.
Source : Molecular Nutrition and Food Research
Link to Full Article
Sulforaphane suppresses cardiac hypertrophy by inhibiting GATA4/GATA6 expression and MAPK signaling pathways
Hae Jin Kee, Gwi Ran Kim, In Kyeom Kim, Myung Ho Jeong
Sulforaphane (SFN) is a naturally occurring isothiocynate compound found in cruciferous vegetables. Here, we report the effect of SFN on cardiac hypertrophy and propose an underlying mechanism.
Methods and results
SFN suppresses cardiomyocyte hypertrophy induced by hypertrophic stimuli in vitro and in vivo. SFN suppresses the expression of fetal genes, including atrial natriuretic peptide, brain natriuretic peptide, and beta myosin heavy chain. We used an siRNA technique and atrial natriuretic peptide promoter with mutated GATA binding sites to demonstrate that SFN mediates cardiac hypertrophy by modulating transcription factors GATA4/6.
These results suggest that SFN has the potential to prevent cardiac hypertrophy by downregulating GATA4/6 and mitogen-activated protein kinase signaling pathways.
Source : Molecular Nutrition and Food Research
Link to Abstract
Blueberries Decrease Cardiovascular Risk Factors in Obese Men and Women with Metabolic Syndrome
1,2,3Arpita Basu,4,* Mei Du,6 Misti J. Leyva,5 Karah Sanchez,4 Nancy M. Betts,4 Mingyuan Wu,6 Christopher E. Aston,5and Timothy J. Lyons5,6
Among all fruits, berries have shown substantial cardio-protective benefits due to their high polyphenol content. However, investigation of their efficacy in improving features of metabolic syndrome and related cardiovascular risk factors in obesity is limited. We examined the effects of blueberry supplementation on features of metabolic syndrome, lipid peroxidation, and inflammation in obese men and women. Forty-eight participants with metabolic syndrome [4 males and 44 females; BMI: 37.8 ± 2.3 kg/m2; age: 50.0 ± 3.0 y (mean ± SE)] consumed freeze-dried blueberry beverage (50 g freeze-dried blueberries, #126 350 g fresh blueberries) or equivalent amounts of fluids (controls, 960 mL water) daily for 8 wk in a randomized controlled trial. Anthropometric and blood pressure measurements, assessment of dietary intakes, and fasting blood draws were conducted at screening and at wk 4 and 8 of the study. The decreases in systolic and diastolic blood pressures were greater in the blueberry-supplemented group (− 6 and − 4%, respectively) than in controls (− 1.5 and − 1.2%) (P lt 0.05), whereas the serum glucose concentration and lipid profiles were not affected. The decreases in plasma oxidized LDL and serum malondialdehyde and hydroxynonenal concentrations were greater in the blueberry group (− 28 and − 17%, respectively) than in the control group (− 9 and − 9%) (P lt 0.01). Our study shows blueberries may improve selected features of metabolic syndrome and related cardiovascular risk factors at dietary achievable doses.
Source : The Journal of Nutrition
Link to full Article
The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials
- 1Department of Health Policy, Harvard University, MA, USA
- 2Center for Health Decision Science, Harvard School of Public Health, MA, USA
- 3Department of Epidemiology, Erasmus MC, the Netherlands
- 4Department of Radiology, Erasmus MC, the Netherlands
- 5Division of General Medicine and Primary Care, Harvard Medical School, MA, USA
- 6Department of Health Policy and Management, Harvard School of Public Health, MA, USA
- MG Myriam Hunink, Departments of Radiology and Epidemiology, Room Na 2818, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
AbstractBackground Yoga, a popular mind-body practice, may produce changes in cardiovascular disease (CVD) and metabolic syndrome risk factors.
Design This was a systematic review and random-effects meta-analysis of randomized controlled trials (RCTs).
Methods Electronic searches of MEDLINE, EMBASE, CINAHL, PsycINFO, and The Cochrane Central Register of Controlled Trials were performed for systematic reviews and RCTs through December 2013. Studies were included if they were English, peer-reviewed, focused on asana-based yoga in adults, and reported relevant outcomes. Two reviewers independently selected articles and assessed quality using Cochrane’s Risk of Bias tool.
Results Out of 1404 records, 37 RCTs were included in the systematic review and 32 in the meta-analysis. Compared to non-exercise controls, yoga showed significant improvement for body mass index (−0.77 kg/m2 (95% confidence interval −1.09 to −0.44)), systolic blood pressure (−5.21 mmHg (−8.01 to −2.42)), low-density lipoprotein cholesterol (−12.14 mg/dl (−21.80 to −2.48)), and high-density lipoprotein cholesterol (3.20 mg/dl (1.86 to 4.54)). Significant changes were seen in body weight (−2.32 kg (−4.33 to −0.37)), diastolic blood pressure (−4.98 mmHg (−7.17 to −2.80)), total cholesterol (−18.48 mg/dl (−29.16 to −7.80)), triglycerides (−25.89 mg/dl (−36.19 to −15.60), and heart rate (−5.27 beats/min (−9.55 to −1.00)), but not fasting blood glucose (−5.91 mg/dl (−16.32 to 4.50)) nor glycosylated hemoglobin (−0.06% Hb (−0.24 to 0.11)). No significant difference was found between yoga and exercise. One study found an impact on smoking abstinence.
Conclusions There is promising evidence of yoga on improving cardio-metabolic health. Findings are limited by small trial sample sizes, heterogeneity, and moderate quality of RCTs.
Source : EU Journal of Preventative Cardiology
Link to Full Article.
Bad Marriage, Broken Heart? Age and Gender Differences in the Link between Marital Quality and Cardiovascular Risks among Older Adults
- 1Department of Sociology, Michigan State University, East Lansing, MI, USA
- 2Department of Sociology & NORC, University of Chicago, Chicago, IL, USA
- Hui Liu, Department of Sociology, Michigan State University, Berkey Hall, 509 E. Circle Drive 316, East Lansing, MI, 48824, USA. E-mail: firstname.lastname@example.org
AbstractWorking from a life course perspective, we develop hypotheses about age and gender differences in the link between marital quality and cardiovascular risk and test them using data from the first two waves of the National Social Life, Health, and Aging Project. The analytic sample includes 459 married women and 739 married men (aged 57–85 in the first wave) who were interviewed in both waves. We apply Heckman-type corrections for selection bias due to mortality and marriage. Cardiovascular risk is measured as hypertension, rapid heart rate, C-reactive protein, and general cardiovascular events. Results suggest that changes in marital quality and cardiovascular risk are more closely related for older married people than for their younger counterparts and that the link between marital quality and cardiovascular risk is more pronounced among women than among men at older ages. These findings fit with the gendered life course perspective and cumulative disadvantage framework.
Source : Journal of Health and Social Behaviour
Link to Abstract
Curcumin Attenuates Angiotensin II-Induced Abdominal Aortic Aneurysm by Inhibition of Inflammatory Response and ERK Signaling Pathways
QingQing Hao,1,2,3 Xu Chen,1,2 XiaoYu Wang,1,2 Bo Dong,1,2,4 and ChuanHua Yang4
1Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, China
2The Key Laboratory of Cardiovascular Remodeling and Function Research, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China
3Department of Pathophysiology, Fenyang College Shanxi Medical University, Fenyang, Shanxi 032200, China
4Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, China
Background and Objectives. Curcumin has long been used to treat age-related diseases, such as atherosclerosis and coronary heart disease. In this study, we explored the effects of curcumin on the development of abdominal aortic aneurysm (AAA).
Methods. ApoE−/− mice were randomly divided into 3 groups: AngII group, AngII + curcumin (AngII + Cur) group (100 mg/kg/d), and the control group. Miniosmotic pumps were implanted subcutaneously in ApoE−/− mice to deliver AngII for 28 days. After 4-week treatment, abdominal aortas with AAA were obtained for H&E staining, immunohistochemistry, and Western blotting.
Results. The results showed that curcumin treatment significantly decreased the occurrence of AAA. The levels of macrophage infiltration, monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factors-α (TNF-α) were significantly lower in AngII + Cur group than those in AngII group (all ). The level of superoxide dismutase (SOD) was significantly higher in AngII + Cur group than those in AngII group . The ERK1/2 phosphorylation in AngII + Cur group was significantly lower than that in AngII group . Conclusions. These results suggested that curcumin can inhibit the AngII-induced AAA in ApoE−/− mice, whose mechanisms include the curcumin anti-inflammation, antioxidative stress, and downregulation of ERK signaling pathway.
Source : Evidence Based Complementary and Alternative Medicine
Link to Full Article
Spices and Herbs May Improve Cardiovascular Risk Factors
West, Sheila G. PhD; Skulas-Ray, Ann C. PhD
Sheila G. West, PhD, is professor of biobehavioral health and nutritional sciences at The Pennsylvania State University, University Park.
Ann C. Skulas-Ray, PhD, is a research associate in the department of nutritional sciences at The Pennsylvania State University, University Park.
Traditional risk factors for cardiovascular disease (CVD) include high blood low-density lipoprotein (LDL) cholesterol, low high-density lipoprotein (HDL) cholesterol, high blood pressure, smoking, and diabetes. Family history and inflammatory factors also affect CVD risk. Diet therapy for treating and managing patients with CVD and for reducing risk among healthy individuals focuses on consuming a diet containing vegetables and fruits; eating whole-grain breads and cereals; choosing poultry, fish, nuts, legumes, and low-fat dairy foods; and limiting the intake of saturated fat, trans-fat, sweets, sugar-sweetened beverages, and red meats.1 Because spices and herbs are rich in potentially bioactive compounds, clinical studies have examined their effects on blood insulin, blood lipids, and inflammation.
Spices and herbs are rich in compounds that may reduce inflammation and improve blood factors associated with increased CVD risk. However, the body of literature regarding their effects is small, and the clinical findings are not always consistent. The vascular effects of spices and herbs and their efficacy and safety relative to traditional drug therapy represent an exciting area for future research given the public health significance of CVD.
Source : Nutrition Today
Link to Full Article
Positive Associations of Dispositional Mindfulness with Cardiovascular Health: the New England Family Study
- Eric B. Loucks,
- Willoughby B. Britton,
- Chanelle J. Howe,
- Charles B. Eaton,
- Stephen L. Buka
Mindfulness (the ability to attend nonjudgmentally to one’s own physical and mental processes) is receiving substantial interest as a potential determinant of health. However, little is known whether mindfulness is associated with cardiovascular health.
The aim of this study is to evaluate whether dispositional mindfulness is associated with cardiovascular health.
Study participants (n = 382) were from the New England Family Study, born in Providence, RI, USA, with mean age 47 years. Dispositional mindfulness was assessed using the Mindful Attention Awareness Scale (MAAS). Cardiovascular health was assessed based on American Heart Association criteria. Cross-sectional multivariable-adjusted log binomial regression analyses were performed.
Analyses demonstrated that those with high vs. low MAAS had prevalence ratio (PR) for good cardiovascular health of 1.83 (95 % confidence interval (CI) 1.07, 3.13), adjusted for age, gender, and race/ethnicity. There were significant associations of high vs. low mindfulness with nonsmoking (PR = 1.37, 95 % CI 1.06, 1.76), body mass index <25 kg/m2 (PR = 2.17, 95 % CI 1.16, 4.07), fasting glucose <100 mg/dL (PR = 1.47, 95 % CI 1.06, 2.04), and high physical activity (PR = 1.56, 95 % CI 1.04, 2.35), but not blood pressure, total cholesterol, or fruit/vegetable consumption. Exploratory mediation analyses suggested that sense of control and depressive symptomatology may be mediators.
This study demonstrated preliminary cross-sectional evidence that dispositional mindfulness is positively associated with cardiovascular health, with the associations particularly driven by smoking, body mass index, fasting glucose, and physical activity. If in future research mindfulness-based practices are found to consistently improve cardiovascular disease risk factors, such interventions may have potential to strengthen effects of cardiovascular health promotion programs.
Source : International Journal of Behavioral Medicine
Link to Abstract
A metabonomic study of cardioprotection of ginsenosides, schizandrin, and ophiopogonin D against acute myocardial infarction in rats
Miaomiao Jiang1, Liyuan Kang1, Yi Wang2, Xiaoping Zhao3, Xuan Liu1, Lei Xu1 and Zheng Li1*
Background Metabonomics is a useful tool for studying mechanisms of drug treatment using systematic metabolite profiles. Ginsenosides Rg1 and Rb1, ophiopogonin D, and schizandrin are the main bioactive components of a traditional Chinese formula (Sheng-Mai San) widely used for the treatment of coronary heart disease. It remains unknown the effect of individual bioactive component and how the multi-components in combination affect the treating acute myocardial infarction (AMI).
Methods Rats were divided into 7 groups and dosed consecutively for 7 days with mono and combined-therapy administrations. Serum samples were analyzed by proton nuclear magnetic resonance (1H NMR) spectroscopy. Partial least squares discriminate analysis (PLS-DA) was employed to distinguish the metabolic profile of rats in different groups and identify potential biomarkers.
Results Score plots of PLS-DA exhibited that combined-therapy groups were significantly different from AMI group, whereas no differences were observed for mono-therapy groups. We found that AMI caused comprehensive metabolic changes involving stimulation of glycolysis, suppression of fatty acid oxidation, together with disturbed metabolism of arachidonic acid, linoleate, leukotriene, glycerophospholipid, phosphatidylinositol phosphate, and some amino acids. β-hydroxybutyrate, cholines and glucose were regulated by mono-therapy of schizandrin and ginsenosides respectively. Besides these metabolites, combined-therapy ameliorated more of the AMI-induced metabolic changes including glycerol, and O-acetyl glycoprotein. A remarkable reduction of lactate suggested the therapeutic effect of combined-therapy through improving myocardial energy metabolism.
Conclusions This study provided novel metabonomic insights on the mechanism of synergistic cardioprotection of combined-therapy with ginsenosides, schizandrin, and ophiopogonin D, and demonstrated the potential of discovering new drugs by combining bioactive components from traditional Chinese formula.
Source : BMC Complementary and Alternative Medicine
Link to Full Article
Unconvincing Study Links Cannabis Use to Cardiovascular Complications
by Ashley Lindstrom
On April 23, 2014, the Journal of the American Heart Association (JAHA) published an article titled “Cannabis Use: Signal of Increasing Risk of Cardiovascular Disorders.”1
The authors of the JAHA article worked with the French Addictovigilance Network (FAN) to analyze cases in which cardiovascular complications were reported to the network alongside cannabis (Cannabis sativa, Cannabaceae) use for the years 2006 through 2010. (FAN was “created in the 1990s with the aim of achieving reliable surveillance of abuse and pharmacodependence cases related to drug abuse.”1) According to the study, healthcare providers in France have a “legal obligation to report to their regional addictovigilance center all serious cases defined as one of the following criteria of seriousness: leading to temporary or permanent functional incapacity or disability, to inpatient hospitalization or prolongation of existing hospitalization, to congenital anomalies, or to an immediate vital risk or death.”1
During the five years investigated, a total of 9,936 reports were filed with FAN for all drugs. Of those, 1,979 cases were cannabis related. From there, only 35 involved cardiovascular complications and cannabis use, nine of which were fatal. (As a result, based on these somewhat limited data, part of the authors’ conclusion is that a death rate of 25.6% exists in cases of cardiovascular complications related to cannabis.1) Inclusion criteria were adequate documentation with outcome chronology; however, cases with insufficient patient management and toxicological information also were admitted, as noted below. Research was funded by the French InterMinisterial Mission for the Fight Against Drugs and Addiction and the French Drug Agency.1
The various shortcomings of the study — many of which will be elucidated herein — signal the need for critical analysis of the data and even skepticism toward the validity of the authors’ conclusions.
As noted by the JAHA authors, cardiovascular diseases (CVDs) are the world’s leading causes of death. Well-known risk factors include age, tobacco and/or alcohol use, obesity, physical inactivity, and high blood pressure and/or cholesterol. According to the World Health Organization, behavioral risk factors such as tobacco and/or alcohol use, poor diet, and physical inactivity are to blame for 80% of incidences of coronary heart disease and cerebrovascular disease.2 Other concerns include genetics (familial history of CVD), sex (pre-menopausal women have a lower risk), secondhand-smoke exposure, kidney disease, low birth weight, and intake of substances such as caffeine or pharmaceuticals such as sildenafil (the active ingredient in Viagra®).
Cannabis has been posited as a potential trigger for coronary events. According to a 2002 Journal of Clinical Pharmacology article, “THC [tetrahydrocannabinol] acutely causes a substantial increase in heart rate (as high as 50%-60%) that is dose dependent and is generally associated with a modest increase in blood pressure, whether smoked in marijuana cigarettes or administered intravenously. Maximal heart rate increase occurs 10-15 minutes after peak plasma THC concentration.”3 Tolerance develops to the acute effects.2
Conversely, in several recent studies4-6 cannabinoids have exhibited potential cardioprotective properties, according to Jahan Marcu, PhD, multidisciplinary scientific advisory board vice-chair of Americans for Safe Access, a medical cannabis patient advocacy organization (email, May 4, 2014). “Cannabis-based medicine and cannabinoids are being developed to treat ischemia and other pathologies due to heart attacks,” said Dr. Marcu. “Cannabinoids protect the heart from damage, stimulate repair mechanisms of cardiac tissues, and are being developed to reduce brain damage from heart attacks.”
While the possibility exists that individuals with cardiovascular risks could be adversely affected by cannabis intake, a study of 65,171 subjects over the course of 49 years showed no significant difference in mortality rate between cannabis users and non-users.7
The mean age of the JAHA subjects was 34.3; 30 of the patients were men; 21 of the patients were tobacco smokers; and no associated substances were declared in 11 cases. (As previously stated, both men and tobacco smokers are at a higher risk for CVD.) Seven patients had a familial cardiovascular history and nine had personal cardiovascular history, adding up to 16 — a total of 46% of the subjects.1
In seven of the nine fatal case reports, patients had either already collapsed or were found dead and more than likely would not have been able to contribute relevant details to their medical files — including vital information about associated substances for which they may not have been tested. No case descriptions or toxicology information were presented for the other two fatalities. Fatal cases for which patient management information was not available totaled five.
Patients’ exposure to cannabis was broken down into three categories: actual, recent, and regular/daily. In eight of the nine fatal cases, exposure was actual, defined as “one or more uses in the past 12 months,” while recent refers to one to nine uses in the past 30 days. In the article, several case descriptions seem to disagree with reported exposure. In one fatal 2009 case, exposure was classified as actual when the case description reports the presence of cannabinoids “at a dose compatible with recent intoxication.” The case description for a 2010 case states that the deceased was under the influence of cannabis, but exposure is listed as actual. Another fatal 2010 case classifies exposure as actual, though the case description notes “[c]hronic exposure to cannabis.”
Many other cardiac risk factors are not mentioned among the data and do not seem to be considered by the authors, including the subjects’ physical inactivity, kidney disease, history of substance abuse, stress level, exposure to secondhand smoke, blood lipid disorder(s), caffeine intake (usually not considered a cardiac risk factor), et al.
Several sources for this article highlighted the fact that cannabis is most frequently smoked along with tobacco in France (a country with a relatively high per-capita tobacco-smoking population8), thereby cautioning that the cases in which cannabis is the sole “associated substance” in this article should be considered with a considerable degree of skepticism where toxicology testing does not confirm that a subject was in fact tobacco-free.
“There’s a tendency for folks who are of the…drugs-are-bad kind of mindset that leads to a gross over-interpretation and a tendency to not just cherry-pick…but to just completely turn things inside out,” said William Dolphin, publications director of Americans for Safe Access (personal communication, May 2, 2014). “This study comes [from people] who are looking at negative outcomes, and fair enough — that’s the lens that they’re interpreting it through,” said Dolphin, adding, “You tend to find what you look for and there are all kinds of that kind of observational bias that get through to the media and then the media take it and amplify it.”
“Now, the caveat to all of that — and it’s a serious concern — is that the elevated heart rate, the vasodilation can be problematic for some people,” explained Dolphin. “If you’ve got a heart problem, you shouldn’t be using Viagra, you shouldn’t be engaging in really strenuous exercise, and maybe you shouldn’t be going near the cannabis — IF you know it creates that effect in you.”
Skewed and poor-quality cannabis studies, whether their outcomes are positive or negative, highlight the need for research of high methodological quality in this area. Despite a long history of relatively safe use, legitimate concerns regarding the effects of cannabis and its many unique compounds demand robust and critical study, particularly as more people have access to legal medicinal and recreational cannabis. In the United States, the erroneous view that cannabis is a highly dangerous substance with no redeeming medicinal value perpetuates its frequently-criticized Drug Enforcement Agency Schedule I classification, which in turn makes it more difficult to attain approval for medical research. That the American Heart Association allowed such an inadequate cannabis study to be published under its auspices is troubling. When correlation is spun as causation and resultant media coverage is uncritical and misleading, scientific and public health progress is hindered.
Source : American Botanical Council - Herbalgram
Link to Source
The Usefulness of Xuefu Zhuyu Tang for Patients with Angina Pectoris: A Meta-Analysis and Systematic Review
Guo-zhong Yi,1 Yu-qin Qiu,2 Ya Xiao,2,3 and Li-xia Yuan2
1The First College of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
2College of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
3Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
Objective. To evaluate the efficacy of Xuefu Zhuyu Tang (XFZYT) for treating angina pectoris (AP). Methods. Six databases were searched (up to December, 2013). Eligible randomized controlled trials (RCTs) evaluating the efficiency of XFZYT plus traditional antianginal medications (TAMs) compared with TAMs alone in patients with AP were included. The outcomes were relief of anginal symptoms (RAS) and improvement of electrocardiogram (ECG) and blood high-density lipoprotein cholesterol (HDL-C) level. Result. Finally 14 RCTs were included. There were evidences that XFZYT combined with TAMs was more effective in improving RAS (RR = 1.29; 95% CI = [1.20, 1.38]), ECG (RR = 1.37; 95% CI = [1.22, 1.54]), and blood HDL-C level (MD = 0.29 mmol/L; 95% CI = [0.23, 0.35]) compared with TAMs alone. Our meta-analysis also showed the pooled number needed to treat (NNT) of the group with stable angina pectoris (SAP) was smaller in improving RAS (4.2 versus 5.7) and ECG (3.1 versus 5.5) compared with the group with both SAP and unstable angina pectoris (UAP). Conclusion. Combination therapy with XFZYT and TAMs is more effective in treating AP compared with TAMs alone. And XFZYT may be a more suitable choice for the treatment of SAP. However, the findings should be interpreted with caution due to the mediocre methodological quality of the included RCTs.
Source : Evidence Based Complementary and Alternative Medicine Journal
Link to Full Article
Homocysteine, vitamin B12 and folate levels in premature coronary artery disease
Saeed Sadeghian1*, Faramarz Fallahi2, Mojtaba Salarifar3, Gholamreza Davoodi1, Mehran Mahmoodian4, Nader Fallah5, Soodabeh Darvish4, Abbasali Karimi6 and Tehran Heart Center
1 Assistant Professor of Cardiology, Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
2 Assistant Professor of Cardiology, Shahed University, Tehran, Iran
3 Assistant Professor of Interventional Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
4 Researcher, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
5 Regular member of board, Department of Biostatistics, Shahed University, Tehran, Iran
6 Associated Professor of cardiac surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Background Hyperhomocysteinemia is known as an independent risk factor of atherosclerosis, but the probable role of hyperhomocysteinemia in premature Coronary Artery Disease (CAD) is not well studied. The aim of this study was to assess the role of hyperhomocysteinemia, folate and Vitamin B12 deficiency in the development of premature CAD.
Methods We performed an analytical case-control study on 294 individuals under 45 years (225 males and 69 females) who were admitted for selective coronary angiography to two centers in Tehran.
Results After considering the exclusion criteria, a total number of 225 individuals were enrolled of which 43.1% had CAD. The mean age of participants was 39.9 +/- 4.3 years (40.1 +/- 4.2 years in males and 39.4 +/- 4.8 years in females). Compared to the control group, the level of homocysteine measured in the plasma of the male participants was significantly high (14.9 +/- 1.2 versus 20.3 +/- 1.9 micromol/lit, P = 0.01). However there was no significant difference in homocysteine level of females with and without CAD (11.8 +/- 1.3 versus 11.5 ± 1.1 micromol/lit, P = 0.87). Mean plasma level of folic acid and vitamin B12 in the study group were 6.3 +/- 0.2 and 282.5 +/- 9.1 respectively. Based on these findings, 10.7% of the study group had folate deficiency while 26.6% had Vitamin B12 deficiency. Logistic regression analysis for evaluating independent CAD risk factors showed hyperhomocysteinemia as an independent risk factor for premature CAD in males (OR = 2.54 0.95% CI 1.23 to 5.22, P = 0.01). Study for the underlying causes of hyperhomocysteinemia showed that male gender and Vitamin B12 deficiency had significant influence on incidence of hyperhomocysteinemia.
Conclusion We may conclude that hyperhomocysteinemia is an independent risk factor for CAD in young patients (bellow 45 years old) – especially in men -and vitamin B12 deficiency is a preventable cause of hyperhomocysteinemia.
Source : BMC Cardiovascular Disorders
Link to Full Article
Protective Effects of Panax Notoginseng Saponins on Cardiovascular Diseases: A Comprehensive Overview of Experimental Studies
Xiaochen Yang,1 Xingjiang Xiong,1 Heran Wang,2 and Jie Wang1
1Department of Cardiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange, Xicheng District, Beijing 100053, China
2Cancer Research Institute, Central South University, Changsha, Hunan 410078, China
Panax notoginseng saponins (PNS) are one of the most important compounds derived from roots of the herb Panax notoginseng which are traditionally used as a hemostatic medicine to control internal and external bleeding in China for thousands of years. To date, at least twenty saponins were identified and some of them including notoginsenoside R1, ginsenoside Rb1, and ginsenoside Rg1 were researched frequently in the area of cardiovascular protection. However, the protective effects of PNS on cardiovascular diseases based on experimental studies and its underlying mechanisms have not been reviewed systematically. This paper reviewed the pharmacology of PNS and its monomers Rb1, Rg1, and R1 in the treatment for cardiovascular diseases.
...We could suggest that PNS is an important herbal medicine for cardiovascular protection; nevertheless, it could also be used as an antihypertensive agent on the basis of our clinical experience. It has been proved that PNS has an effect on reversing ventricular hypertrophy, protecting target organs, improving blood vessel function, and other auxiliary vasodilator effects. Therefore, further in vivo researches are needed to explore and verify the potential effect to provide precise guidance for clinical use and new drug discovery. ....
Source : Evidence Based Complementary and Alternative Medicine
Link to Full Article
Nut consumption and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis1,2,3,4
Background: Epidemiologic studies have shown inverse associations between nut consumption and diabetes, cardiovascular disease (CVD), and all-cause mortality, but results have not been consistent.
Objective: We assessed the relation between nut intake and incidence of type 2 diabetes, CVD, and all-cause mortality.
Design: We searched PubMed and EMBASE for all prospective cohort studies published up to March 2013 with RRs and 95% CIs for outcomes of interest. A random-effects model was used to pool risk estimates across studies.
Results: In 31 reports from 18 prospective studies, there were 12,655 type 2 diabetes, 8862 CVD, 6623 ischemic heart disease (IHD), 6487 stroke, and 48,818 mortality cases. The RR for each incremental serving per day of nut intake was 0.80 (95% CI: 0.69, 0.94) for type 2 diabetes without adjustment for body mass index; with adjustment, the association was attenuated [RR: 1.03; 95% CI: 0.91, 1.16; NS]. In the multivariable-adjusted model, pooled RRs (95% CIs) for each serving per day of nut consumption were 0.72 (0.64, 0.81) for IHD, 0.71 (0.59, 0.85) for CVD, and 0.83 (0.76, 0.91) for all-cause mortality. Pooled RRs (95% CIs) for the comparison of extreme quantiles of nut intake were 1.00 (0.84, 1.19; NS) for type 2 diabetes, 0.66 (0.55, 0.78) for IHD, 0.70 (0.60, 0.81) for CVD, 0.91 (0.81, 1.02; NS) for stroke, and 0.85 (0.79, 0.91) for all-cause mortality.
Conclusions: Our meta-analysis indicates that nut intake is inversely associated with IHD, overall CVD, and all-cause mortality but not significantly associated with diabetes and stroke. The inverse association between the consumption of nuts and diabetes was attenuated after adjustment for body mass index. These findings support recommendations to include nuts as part of a healthy dietary pattern for the prevention of chronic diseases
Source : The American Journal of Clinical Nutrition
Link to Full Article
Selected Activities of Citrus Maxima Merr. Fruits on Human Endothelial Cells: Enhancing Cell Migration and Delaying Cellular Aging
by Paiwan Buachan, Linda Chularojmontri and Suvara K. Wattanapitayakul
Endothelial injury and damage as well as accumulated reactive oxygen species (ROS) in aging play a significant role in the development of cardiovascular disease (CVD). Recent studies show an association of high citrus fruit intake with a lower risk of CVD and stroke but the mechanisms involved are not fully understood. This study investigated the effects of pummelo (Citrus maxima Merr. var. Tubtim Siam, CM) fruit extract on human umbilical vein endothelial cell (HUVECs) migration and aging. The freeze-dried powder of fruit extract was characterized for antioxidant capacity (FRAP assay) and certain natural antioxidants, including ascorbic acid, gallic acid, hesperidin, and naringin (HPLC). Short-term (48 h) co-cultivation of HUVECs with CM enhanced cell migration as evaluated by a scratch wound assay and Boyden chamber assay. A long-term treatment with CM for 35 days significantly increased HUVEC proliferation capability as indicated by population doubling level (PDL). CM also delayed the onset of aging phenotype shown by senescence-associated β-galactosidase (SA-β-gal) staining. Furthermore, CM was able to attenuate increased ROS levels in aged cells when determined by 2′,7′-dichlorodihydrofluorescein diacetate (DCDHF) while eNOS mRNA expression was increased but the eNOS protein level was not changed. Thus, further in vivo and clinical studies are warranted to support the use of pummelo as a functional fruit for endothelial health and CVD risk reduction
Source : Journal Nutrients
Link to Full Article
Salvia miltiorrhiza (Danshen) injection ameliorates iron overload-induced cardiac damage in mice
.Zhang JP1, Zhang YY, Zhang Y, Gao YG, Ma JJ, Wang N, Wang JY, Xie Y, Zhang FH, Chu L.
The traditional Chinese medicinal herb Danshen (Salvia miltiorrhiza), first recorded in the "Shen Nong's Herbal Classic", has long been used to treat cardiovascular conditions, although the mechanism(s) underlying its effects remain unclear. Here, an iron dextran injection (50 mg · kg⁻¹ per day) was delivered intraperitoneally to establish a mouse model for investigating the ameliorative effects of Danshen injection (low dose at 3 g · kg⁻¹ per day or high dose at 6 g · kg⁻¹ per day) on iron overload-induced cardiac damage. The iron-chelating agent deferoxamine (100 mg · kg⁻¹ per day) was administered as a positive control. The main constituents of Danshen injection, salvianic acid A (danshensu), protocatechuic aldehyde, and salvianolic acid B, were quantified at concentrations of 2.15, 0.44, and 1.01 mg · mL⁻¹, respectively, using HPLC with UV detection. Danshen injection significantly lowered cardiac iron deposition and the concentration of the lipid oxidation product malondialdehyde, as well as improved cardiac superoxide dismutase and glutathione peroxidase levels in iron-overloaded mice. Serum levels of creatine kinase, creatine kinase isoenzyme, and lactate dehydrogenase in the iron-overloaded mice were significantly elevated (up to ~ 160 %), whereas their activities were downregulated by Danshen injection by 25 ~ 35 % at the high dose and by ~ 20 % at the low dose. Morphological changes of cardiac tissue analyzed by hematoxylin and eosin staining indicated that lesions induced by iron overload could be ameliorated by Danshen injection dose-dependently. Altogether, these results illustrated that the protective effects of Danshen injection were at least in part due to decreased iron deposition and inhibition of lipid peroxidation.
Source : Planta Medica
Link to Abstract
Effect of Aerobic Training on Heart Rate Recovery in Patients with Established Heart Disease; a Systematic Review
Johan A. Snoek mail, Sietske van Berkel, Nico van Meeteren, Frank J. G. Backx, Hein A. M. Daanen Abstract
Background Although a delayed decrease in heart rate during the first minute after graded exercise has been identified as a powerful predictor of overall mortality in cardiac patients, the potential to influence this risk factor by aerobic training remains to be proven.
Objective The aim was to study the relationship between aerobic training and Heart Rate Recovery (HRR) in patients with established heart disease.
Methods (Quasi) randomized clinical trials on aerobic exercise training in adults with established heart disease were identified through electronic database and reference screening. Two reviewers extracted data and assessed the risk of bias and therapeutic validity. Methodological validity was evaluated using an adapted version of the Cochrane Collaboration’s tool for assessing risk of bias and the therapeutic validity of the interventions was assessed with a nine-itemed, expert-based rating scale (CONTENT). Scores range from 0 to 9 (score ≥ 6 reflecting therapeutic validity).
Results Of the 384 articles retrieved, 8 studies (449 patients) were included. Three of the included studies demonstrated adequate therapeutic validity and five demonstrated low risk of bias. Two studies showed both adequate therapeutic validity and a low risk of bias. For cardiac patients aerobic exercise training was associated with more improvement in HRR compared to usual care.
Conclusion The present systematic review shows a level 1A evidence that aerobic training increases HRR in patients with established heart disease.
Source : PLOS One
Link to Full Article
One-month strawberry-rich anthocyanin supplementation ameliorates cardiovascular risk, oxidative stress markers and platelet activation in humans
- José M. Alvarez-Suarez, Francesca Giampieri,, Sara Tulipani. Tiziana Casoli, Giuseppina Di Stefano, Ana M. González-Paramás, Celestino Santos-Buelga, Franco Busco, Josè L. Quiles, Mario D. Cordero, Stefano Bompadre, Bruno Mezzetti, Maurizio Battin
Strawberries are an important fruit in the Mediterranean diet because of their high content of essential nutrients and beneficial phytochemicals, which seem to exert beneficial effects in human health. Healthy volunteers were supplemented daily with 500 g of strawberries for 1 month. Plasma lipid profile, circulating and cellular markers of antioxidant status, oxidative stress and platelet function were evaluated at baseline, after 30 days of strawberry consumption and 15 days after the end of the study. A high concentration of vitamin C and anthocyanins was found in the fruits. Strawberry consumption beneficially influenced the lipid profile by significantly reducing total cholesterol, low-density lipoprotein cholesterol and triglycerides levels (−8.78%, −13.72% and −20.80%, respectively; P<.05) compared with baseline period, while high-density lipoprotein cholesterol remained unchanged. Strawberry supplementation also significant decreased serum malondialdehyde, urinary 8-OHdG and isoprostanes levels (−31.40%, −29.67%, −27.90%, respectively; P<.05). All the parameters returned to baseline values after the washout period. A significant increase in plasma total antioxidant capacity measured by both ferric reducing ability of plasma and oxygen radical absorbance capacity assays and vitamin C levels (+24.97%, +41.18%, +41.36%, respectively; P<.05) was observed after strawberry consumption. Moreover, the spontaneous and oxidative hemolysis were significant reduced (−31.7% and −39.03%, respectively; P<.05), compared to the baseline point, which remained stable after the washout period. Finally, strawberry intake significant decrease (P<.05) the number of activated platelets, compared to both baseline and washout values. Strawberries consumption improves plasma lipids profile, biomarkers of antioxidant status, antihemolytic defenses and platelet function in healthy subjects, encouraging further evaluation on a population with higher cardiovascular disease risk.
Source : The Journal of Nutritional Biochemistry
Link to Abstract
Complementary and Alternative Approaches Relieve the Burden of Atrial Fibrillation
By Mark L. Fuerst
Newer nonpharmacologic treatment options for atrial fibrillation (AF), including advances in radiofrequency catheter ablation and AF surgery, have led to substantial improvements in the treatment of the disease. However, AF can still cause disabling and bothersome symptoms that adversely affect a patient’s quality of life. One way to help manage the disease and improve quality of life may be to add adjunctive complementary and alternative therapies, such as yoga, meditation, acupuncture, therapeutic hypnosis, or tai chi into routine care.
Evidence that yoga may be beneficial comes from a recent small cohort study showing that the regular practice of yoga improves symptoms, arrhythmia burden, heart rate, blood pressure, anxiety and depression scores, and several domains of quality of life among patients with paroxysmal AF.1 Three months of yoga training reduced both symptomatic and asymptomatic AF episodes and improved quality-of-life parameters, including physical functioning, general health, vitality, social functioning, and mental health. This is not the first study to test the effects of yoga in the management of cardiovascular disease, but it is the first one to evaluate the role of yoga in AF.
The authors propose several possible physiologic explanations for their findings: an increase in parasympathetic tone; enhanced balance between the 2 autonomic nervous system components; reduced systemic inflammation and oxidative stress; and decreased progression of arrhythmia by preventing or attenuating atrial remodeling. They also suggest patients benefit from the emotionally supportive atmosphere at yoga centers and the caring relationships formed there, as well as changes in diet and lifestyle modification often associated with yoga practice.
Previous research has evaluated other noninvasive strategies, such as meditation, which has been associated with a significant reduction in the risk of all-cause mortality, myocardial infarction, or stroke in patients with documented coronary heart disease.2
Acupuncture has proven to be effective in decreasing AF recurrences after electrical cardioversion in persistent AF and also in reducing the burden of AF among patients with paroxysmal AF.3 In addition, therapeutic hypnosis can lead to a statistically significant lower incidence of AF after coronary artery bypass graft surgery.4
Many patients with AF also suffer from chronic heart failure. Researchers have shown that patients who completed 12 weeks of tai chi training demonstrated a significantly improved heart failure-related quality of life, greater exercise tolerance (walked farther on a 6-minute test), and had greater decreases in blood levels of B-type natriuretic protein when compared to a usual-care group.5 In a larger follow-up study, the investigators found tai chi led to clinically significant improvements in quality of life.
These researchers believe that tai chi is a safe, adaptable form of aerobic exercise, can reduce stress and improve psychological well-being, improves breathing efficiency, may improve the confidence to exercise and motivate healthy behavior, and is associated with higher levels of social support.5 Importantly, about 90% of the participants in the heart failure and tai chi studies regularly came to the classes and practiced tai chi at home as well, which suggests that tai chi can be safely incorporated into regular activities, even for patients with chronic heart disease.Other studies support including tai chi in the treatment of heart failure patients. A randomized controlled trial demonstrated that adding tai chi to endurance training for heart failure patients resulted in greater improvements in exercise tolerance (as assessed by the 6-minute walk test), systolic blood pressure, quality of life, and lower extremity strength, as compared to the control group.6
Although larger randomized controlled trials are needed to establish the relationship between adjunctive complementary and alternative therapies and AF, the current evidence suggests that these types of nonpharmacologic treatments may be safely incorporated into comprehensive management strategies for AF.
- Lakkireddy D, Atkins D, Pillarisetti J, et al. Effect of yoga on arrhythmia burden, anxiety, depression, and quality of life in paroxysmal atrial fibrillation: The YOGA My Heart Study. J Am Coll Cardiol. 2013 Jan 25. [Epub ahead of print]
- Schneider RH, Grim CE, Rainforth MV, et al. Stress reduction in the secondary prevention of cardiovascular disease: randomized, controlled trial of transcendental meditation and health education in blacks. Circ Cardiovasc Qual Outcomes. 2012;5:750-758.
- Lombardi F, Belletti S, Battezzati PM, et al. Acupuncture for paroxysmal and persistent atrial fibrillation: an effective non-pharmacological tool? World J Cardiol. 2012;4:60-65.
- Novoa R, Hammonds T. Clinical hypnosis for reduction of atrial fibrillation after coronary artery bypass graft surgery. Cleve Clin J Med. 2008;75(suppl 2):S44-S47.
- Yeh GY, Wood MJ, Lorell BH, et al. Effects of tai chi mind-body movement therapy on functional status and exercise capacity in patients with chronic heart failure: a randomized controlled trial. Am J Med. 2004;117:541-548.
- Caminiti G, Volterrani M, Marazzi G, et al. Tai chi enhances the effects of endurance training in the rehabilitation of elderly patients with chronic heart failure. Rehabil Res Pract. 2011;2011:761958
Link to Source
Inverse association between habitual polyphenol intake and incidence of cardiovascular events in the PREDIMED study
A. Tresserra-Rimbaua, b,E.B. Rimmc, d, e, A. Medina-Remóna, b, M.A. Martínez-Gonzálezb, f, R. de la Torreb, g, D. Corellab, h, J. Salas-Salvadób, i, E. Gómez-Graciab, j, J. Lapetrab, k, F. Arósb, l, M. Fiolb, m, E. Rosb, n,L. Serra-Majemb, o, X. Pintób, p, G.T. Saezb, q, J. Basorab, r, J.V. Sorlíb, s, J.A. Martínezb, t, E. Vinyolesb, u, V. Ruiz-Gutiérrezb, v, R. Estruchb, w, R.M. Lamuela-Raventósa, b, , ,
Background and aimsEpidemiologic and biological evidence supports an inverse association between polyphenol consumption and the risk of cardiovascular disease. However, no previous studies have prospectively evaluated the relationship between polyphenol intake and the incidence of cardiovascular disease (CVD) in such a comprehensive way. The aim was to evaluate the association between intakes of total polyphenol and polyphenol subgroups, and the risk of major cardiovascular events (myocardial infarction, stroke or death from cardiovascular causes) in the PREDIMED study.
Methods and resultsThe present work is an observational study within the PREDIMED trial. Over an average of 4.3 years of follow-up, there were 273 confirmed cases of CVD among the 7172 participants (96.3%) who completed a validated 137-item food frequency questionnaire (FFQ) at baseline. Polyphenol consumption was calculated by matching food consumption data from the FFQ with the Phenol-Explorer database on polyphenol content of each reported food. After multivariate adjustment, a 46% reduction in risk of CVD risk was observed comparing Q5 vs. Q1 of total polyphenol intake (HR = 0.54; 95% confidence interval [CI] = 0.33–0.91; P-trend = 0.04). The polyphenols with the strongest inverse associations were flavanols (HR = 0.40; CI 0.23–0.72; P-trend = 0.003), lignans (HR = 0.51; CI 0.30–0.86; P-trend = 0.007), and hydroxybenzoic acids (HR = 0.47; CI 0.26–0.86; P-trend 0.02).
ConclusionGreater intake of polyphenols, especially from lignans, flavanols, and hydroxybenzoic acids, was associated with decreased CVD risk. Clinical trials are needed to confirm this effect and establish accurate dietary recommendations. International Standard Randomized Controlled Trial Number: 35739639.
Source : Nutrition + Metabolism + Cardiovascular Disease
Link to Abstract
Mauritia flexuosa Presents In Vitro and In Vivo Antiplatelet and Antithrombotic Activities
Eduardo Fuentes,1,2 Wilson Rodríguez-Pérez,3 Luis Guzmán,1 Marcelo Alarcón,1 Simón Navarrete,1 Oscar Forero-Doria,4 and Iván Palomo1,2
1Department of Clinical Biochemistry and Immunohematology, Faculty of Health Sciences, Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES), Universidad de Talca, Talca, Chile
2Centro de Estudios en Alimentos Procesados (CEAP), CONICYT-Regional, Gore Maule, R09I2001 Talca, Chile
3Facultad de Ciencias Básicas, Universidad de la Amazonia, Florencia, Colombia
4Chemical Institute of Natural Resources, Universidad de Talca, Talca, Chile
Fruit from the palm Mauritia flexuosa is one of the most important species in Peru, Venezuela, Brazil, Colombia, Bolivia, and Guyana. The present study aimed to investigate the antiplatelet and antithrombotic activities of oil extracted from Mauritia flexuosa. The fatty acid contents were determined by gas chromatography—mass spectrometry. Oil extract of peel of Mauritia flexuosa was extracted by soxhlet extraction. The oil extract inhibited platelet secretion and aggregation induced by ADP, collagen, and TRAP-6 by a concentration-dependent way (0.1 to 1 mg/mL) without the participation of the adenylyl cyclase pathway and diminished platelet rolling and firm adhesion under flow conditions. Furthermore, the oil extract induced a marked increase in the rolling speed of leukocytes retained on the platelet surface, reflecting a reduction of rolling and less adhesion. At the concentrations used, the oil extract significantly decreased platelet release of sP-selectin, an atherosclerotic-related inflammatory mediator. Oil extract inhibited thrombus growth at the same concentration as that of aspirin, a classical reference drug. Finally, the data presented herein also demonstrate for the first time to our knowledge the protective effect of oil extracted from Mauritia flexuosa on platelet activation and thrombosis formation.
Source : Evidence Based Complementary and Alternative Medicine
Link to Full Article
Nut Consumption with Total and Cause-Specific Mortality
Ying Bao, M.D., Sc.D., Jiali Han, Ph.D., Frank B. Hu, M.D., Ph.D., Edward L. Giovannucci, M.D., Sc.D., Meir J. Stampfer, M.D., Dr.P.H., Walter C. Willett, M.D., Dr.P.H., and Charles S. Fuchs, M.D., M.P.H.
Increased nut consumption has been associated with a reduced risk of major chronic diseases, including cardiovascular disease and type 2 diabetes mellitus. However, the association between nut consumption and mortality remains unclear.
We examined the association between nut consumption and subsequent total and cause-specific mortality among 76,464 women in the Nurses' Health Study (1980–2010) and 42,498 men in the Health Professionals Follow-up Study (1986–2010). Participants with a history of cancer, heart disease, or stroke were excluded. Nut consumption was assessed at baseline and updated every 2 to 4 years.
During 3,038,853 person-years of follow-up, 16,200 women and 11,229 men died. Nut consumption was inversely associated with total mortality among both women and men, after adjustment for other known or suspected risk factors. The pooled multivariate hazard ratios for death among participants who ate nuts, as compared with those who did not, were 0.93 (95% confidence interval [CI], 0.90 to 0.96) for the consumption of nuts less than once per week, 0.89 (95% CI, 0.86 to 0.93) for once per week, 0.87 (95% CI, 0.83 to 0.90) for two to four times per week, 0.85 (95% CI, 0.79 to 0.91) for five or six times per week, and 0.80 (95% CI, 0.73 to 0.86) for seven or more times per week (P<0.001 for trend). Significant inverse associations were also observed between nut consumption and deaths due to cancer, heart disease, and respiratory disease.
In two large, independent cohorts of nurses and other health professionals, the frequency of nut consumption was inversely associated with total and cause-specific mortality, independently of other predictors of death. (Funded by the National Institutes of Health and the International Tree Nut Council Nutrition Research and Education Foundation.)
Source : The New England Journal of Medicine
Link to Full Article
Efficacy of Purple Passion Fruit Peel Extract in Lowering Cardiovascular Risk Factors in Type 2 Diabetic Subjects
- I. Naga Raju, MSc1
- K. Kodandarami Reddy, PhD2
- C. Krishna Kumari, MSc1
- E. Bhaskar Reddy, MSc1
- S. Dattatreya Rao, PhD3
- C. Damodar Reddy, PhD1
- Ronald Ross Watson, PhD4,5⇑
- 1Sugen Life Sciences Pvt Ltd, Tirupati, Andhra Pradesh, India
- 2Sri Venkateswara University, Tirupati, Andhra Pradesh, India
- 3Sri Venkateswara Ayurvedic College, Tirupati, Andhra Pradesh, India
- 4South West Scientific Editing and Consulting, Tucson, AZ, USA
- 5University of Arizona, Tucson, AZ, USA
The clinical efficacy of purple passion fruit peel extract (a flavonoid-rich dietary supplement) in reducing cardiovascular risk factors in adult type 2 diabetic subjects was investigated in a randomized, double-blind, placebo-controlled trial. Forty-one subjects were randomly assigned to receive a daily dose of purple passion fruit (220 mg) or a matched placebo for 16 weeks. Body mass index, blood pressure, fasting and postprandial blood glucose, glycated hemoglobin, and lipid profile were determined at baseline and at monthly intervals. A significant reduction in systolic blood pressure and fasting blood glucose was observed following administration of purple passion fruit (P < .05). Purple passion fruit was well tolerated, and no adverse events were reported. These data suggest that purple passion fruit supplementation for 16 weeks in type 2 diabetics results in a significant reduction in systolic blood pressure and fasting blood glucose, indicating that purple passion fruit is safe and well tolerated by diabetics.
Source : Journal Evidence Based Complementary and Alternative Medicine
Link to Abstract
Cardiovascular Protective Effects of Adjunctive Alternative Medicine (Salvia miltiorrhiza and Pueraria lobata )in High-Risk Hypertension
K. S. Woo,1,2,3Thomas W. C. Yip,4Ping Chook,1,2S. K. Kwong,5C. C. Szeto,2June K. Y. Li,4Alex W. Y. Yu,5William K. F. Cheng,1Thomas Y. K. Chan,2K. P. Fung,1,6andP.C.Leung1
1Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong
2Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
3Room 186, Science Centre South Block, School of Life Sciences, Biochemistry Programme,The Chinese University of Hong Kong, Hong Kong
4Department of Medicine, Yan Chai Hospital, Hong Kong
5Department of Medicine, Alice Ho Miu Ling Nethersole Hopsital, Hong Kong
6School of Medical Sciences, The Chinese University of Hong Kong, Hong Kong
Introduction. Hypertension in association with diabetes (DM), renal impairment (RI), and left ventricular hypertrophy (LVH)increases the risk of future cardiovascular events. We hypothesize, traditional herbal medicines Danshen and Gegen (D&G) have beneficial effects on atherogenesis in these high-risk hypertensive subjects.
Subjects and Methods. 90 asymptomatic hypertensive subjects associated with LVH (63.3%), DM (62.2%), or RI (30%) were randomized to receive D&G herbal capsules 1gm/day,2gm/day, or identical placebo capsules in double-blind and parallel fashion for 12 months. Brachial flow-mediated dilation(endothelium-dependent dilation, FMD) and carotid intima-media thickness (IMT) were measured by ultrasound. All data were analyzed using the Statistical Package for Social Sciences in Windows 16.0.
Results.Their mean age was 55±8years, and 74.4% were male. After 12 months of adjunctive therapies and compared with baseline, there were no significant changes in blood pressure,heart rate, hematological, glucose, and creatinine profiles in both placebo and D&G groups. FMD improved significantly during D&G (𝑃=0.0001) and less so after placebo treatment (𝑃=0.001). There was a mild but significant decrease in carotid IMT after D&G (𝑃<0.001) but no significant changes after placebo. A trend of better improvement in FMD after higher versus lower D&G dosages was seen. D&G were well tolerated, with no significant adverse events or blood biochemistry changes.
Conclusion.D&G adjunctive treatment was well tolerated and significantly improved atherogenesis in high-risk hypertensive patients, with potential in primary atherosclerosis prevention
Source : Evidence Based Complementary and Alternative Medicine
Link to Full Article
Circulating and dietary magnesium and risk of cardiovascular disease: a systematic review and meta-analysis of prospective studies1,2,3
Liana C Del Gobbo, 2. Fumiaki Imamura, 3. Jason HY Wu, 3. Marcia C de Oliveira Otto,Stephanie E Chiuve, and Dariush Mozaffarian
- 1From the Departments of Nutrition (LCD, SEC, and DM) and Epidemiology (FI, JHYW, MCdOO, and DM), Harvard School of Public Health, Boston MA, and the Division of Preventive Medicine (SEC) and Division of Cardiovascular Medicine (DM), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (DM).
Background: Clinical hypomagnesemia and experimental restriction of dietary magnesium increase cardiac arrhythmias. However, whether or not circulating or dietary magnesium at usual concentrations or intakes influences the risk of cardiovascular disease (CVD), including fatal ischemic heart disease (IHD), is unclear.
Objective: We performed a systematic review and meta-analysis to investigate prospective associations of circulating and dietary magnesium with incidence of CVD, IHD, and fatal IHD.
Design: Multiple literature databases were systematically searched without language restriction through May 2012. Inclusion decisions and data extraction were performed in duplicate. Linear dose-response associations were assessed by using random-effects meta-regression. Potential nonlinear associations were evaluated by using restricted cubic splines.
Results: Of 2303 articles, 16 studies met the eligibility criteria; these studies comprised 313,041 individuals and 11,995 CVD, 7534 IHD, and 2686 fatal IHD events. Circulating magnesium (per 0.2 mmol/L increment) was associated with a 30% lower risk of CVD (RR: 0.70; 95% CI: 0.56, 0.88 per 0.2 mmol/L) and trends toward lower risks of IHD (RR: 0.83; 95% CI: 0.75, 1.05) and fatal IHD (RR: 0.61; 95% CI: 0.37, 1.00). Dietary magnesium (per 200-mg/d increment) was not significantly associated with CVD (RR: 0.89; 95% CI: 0.75, 1.05) but was associated with a 22% lower risk of IHD (RR: 0.78; 95% CI: 0.67, 0.92). The association of dietary magnesium with fatal IHD was nonlinear (P < 0.001), with an inverse association observed up to a threshold of ∼250 mg/d (RR: 0.73; 95% CI: 0.62, 0.86), compared with lower intakes.
Conclusion: Circulating and dietary magnesium are inversely associated with CVD risk, which supports the need for clinical trials to evaluate the potential role of magnesium in the prevention of CVD and IHD.
Source : The American Journal of Clinical Nutrition
Link to Abstract
Earthing (Grounding) the Human Body Reduces Blood Viscosity—a Major Factor in Cardiovascular Disease
Gaétan Chevalier, Stephen T. Sinatra, James L. Oschman, and Richard M. Delany.
1Developmental and Cell Biology Department, University of California at Irvine, Irvine, CA.
2Department of Medicine, University of Connecticut School of Medicine, Farmington, CT
.3Nature's Own Research Association, Dover, NH.4Personalized Preventive Medicine, Milton, MA.
Objectives: Emerging research is revealing that direct physical contact of the human body with the surface of the earth (grounding or earthing) has intriguing effects on human physiology and health, including beneficial effects on various cardiovascular risk factors. This study examined effects of 2 hours of grounding on the electrical charge (zeta potential) on red blood cells (RBCs) and the effects on the extent of RBC clumping.
Design/interventions: Subjects were grounded with conductive patches on the soles of their feet and palms of their hands. Wires connected the patches to a stainless-steel rod inserted in the earth outdoors. Small fingertip pinprick blood samples were placed on microscope slides and an electric field was applied to them. Electrophoretic mobility of the RBCs was determined by measuring terminal velocities of the cells in video recordings taken through a microscope. RBC aggregation was measured by counting the numbers of clustered cells in each sample.
Settings/location: Each subject sat in a comfortable reclining chair in a soundproof experiment room with the lights dimmed or off.
Subjects: Ten (10) healthy adult subjects were recruited by word-of-mouth.
Results: Earthing or grounding increased zeta potentials in all samples by an average of 2.70 and significantly reduced RBC aggregation.
Conclusions: Grounding increases the surface charge on RBCs and thereby reduces blood viscosity and clumping. Grounding appears to be one of the simplest and yet most profound interventions for helping reduce cardiovascular risk and cardiovascular events.
Source : The Journal of Alternative and Complementary Medicine. February 2013, 19(2): 102-110. doi:10.1089/acm.2011.0820.
Link to Full Article
Is Tongxinluo More Effective Than Isosorbide Dinitrate in Treating Angina Pectoris? A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Yongliang Jia, Feifei Bao, Fangyi Huang, and Siu-wai Leung
Tongxinluo (TXL), consisting of 12 Chinese Materia Medica items catalogued in the Chinese Pharmacopoeia, is commercially available in China, South Korea, and Russia. Hundreds of randomized clinical trials (RCTs) on TXL in treating cardiovascular diseases were conducted and published in China. This study provides a comprehensive Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)–compliant systematic review with sensitivity and subgroup analyses to evaluate the evidence about whether TXL is more effective than isosorbide dinitrate (ISDN) in treating ischemic heart disease, particularly angina pectoris.
RCTs published between 1996 and 2010 on TXL versus ISDN in treating angina pectoris for at least 4 weeks were retrieved from eight bibliographical databases (e.g., MEDLINE,® PubMed, Chinese National Knowledge Infrastructure, Cochrane Library, and WanFang Data). The quality of RCTs was assessed with the Jadad scale. Meta-analysis was performed to estimate the overall effects based on symptomatic and electrocardiographic (ECG) improvements. Subgroup analysis, sensitivity analysis, and meta-regression were conducted on the study characteristics of RCTs.
Twenty (20) RCTs with a total of 1936 participants were included after eligibility assessment. The Jadad score of all included studies was 2. The means of summary odds ratios (ORs) for comparing TXL and nitrates were 3.30 (95% confidence interval [CI] 2.37–4.58) by symptoms (n=20) and 2.38 (95% CI 1.846–3.09) by ECG (n=18). There was a significant correlation of ORs between symptoms and ECG (ρ=0.77 and p=0.00026). Subgroup analysis, sensitivity analysis, and meta-regression found no significant difference in overall effects among all study characteristics except the years of publication (p=0.0409).
The meta-analysis of 20 eligible RCTs demonstrates moderate evidence that TXL is more effective than ISDN for treating angina pectoris. This result warrants further RCTs of multicenters/countries, larger sample sizes, and higher quality.
Source : The Journal of Alternative and Complementary Medicine
Link to Full Article
Energy Drinks May Put Heart at Risk
Energy drinks may raise blood pressure and interfere with the heart's electrical system, increasing the risk of sudden cardiac death, a meta-analysis found.
In a pooled analysis of 93 people who consumed energy drinks, the QT interval – a segment of the heart's rhythm on an ECG – was significantly prolonged by 10 ms, according to Sachin A. Shah, PharmD, from the University of the Pacific in Stockton, Calif., and colleagues.
In another pooled analysis of 132 people, researchers found a significant increase in systolic blood pressure by 3.5 mmHg that was associated with the consumption of energy drinks, Shah reported at the American Heart Association Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 meeting in New Orleans.
Diastolic blood pressure and heart rate were not significantly increased but Shah and colleagues said that the QT prolongation and increase in systolic blood pressure were maintained in most subgroup sensitivity analyses.
"Doctors are generally concerned if patients experience an additional 30 ms in their QT interval from baseline," Shah said in a statement.
His co-author Ian Riddock, MD, from David Grant USAF Medical Center in Travis Air Force Base, Calif., added, "QT prolongation is associated with life-threatening arrhythmias. The finding that energy drinks could prolong the QT, in light of the reports of sudden cardiac death, warrants further investigation."
The seven pooled studies included healthy, young participants whose ages ranged from 18 to 45.
A previous review in the journal Pediatrics found that nearly half of the more than 5,000 caffeine overdoses reported in 2007 involved people under age 19. The review noted that up to half of the energy drinks on the market are consumed by adolescents and young adults.
The FDA has initiated several probes into energy drinks after reports of deaths were preliminarily linked to the drinks.
Drinks such as Monster, Red Bull, Rockstar, Full Throttle, and AMP have three times the amount of caffeine as colas. A 16-oz. can of Monster Energy, for example, contains 160 mg of caffeine, which is almost as much as five cans of soda.
Since 2005, the FDA has required drugs to be evaluated in a Thorough QT (TQT) study to determine their effect on the QT interval.
"The threshold level of regulatory concern is around 5 ms," according to the 20-page "Guidance for Industry" on how to conduct "Clinical Evaluation of QT/QTc Interval Prolongation," published by the FDA.
But the FDA can do nothing about the observed 10 ms increase in QT interval found by Shah and colleagues in this meta-analysis.
"Although the U.S. Food and Drug Administration limits caffeine content in soft drinks, which are categorized as food, there is no such regulation of energy drinks, which are classified as dietary supplements," the authors of the review in Pediatrics wrote.
Energy drinks capture 47% of the beverage market share internationally, Shah and colleagues noted. They said a general consensus on how to evaluate the health risks of energy drink consumption does not exist.
They therefore sought to determine the specific effect of energy drinks on "notable electrocardiographic and blood pressure parameters."
Researchers included data from seven previously published observational and interventional studies.
They said that further safety evaluation of energy drink consumption is warranted to guide public health policy.
Source : Medpage Yoday
Link to Source
Tongxinluo capsule for coronary heart disease: a systematic review
- Zhou Zhong-Ran,
- Tang Hai-Qin,
- Li Jie-Hua,
- Yang Lin-Lin,
- Hu Hao
Department of Geriatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
Objective To assess the effectiveness and safety of tongxinluo capsule for coronary heart disease.
Methods Trials were located electronic searches of the Cochrane Library (Issue 4, 2010), PubMed (1966 to April 2010), Wangfang (1984 to April 2010), CNKI (1979 to April 2010), VIP (1989 to April 2010), and CBM (1978 to April 2010). Randomised controlled trials (RCTs) and quasi-RCTs of tongxinluo capsule for coronary heart disease were included. Quality assessment and data extraction were conducted by two reviewers independently. Disagreement were resolved through discussion. All data were analysed using Review Manager 5.0.
Results 13 studies involving a total of 1 496 participants met the inclusion criteria. Meta analysis results showed that: compared with nitrate esters, tongxinluo capsule for the coronary heart disease group had superiority in many aspects such as amelioration according to curative effect: tongxinluo capsule is better than isosorbide dinitrate [RR 0.50 and 95% CI 0.36 to 0.70], than isosorbide mononitrate [RR 0.19 and 95% CI 0.12 to 0.30], total efficacy [RR 0.34 and 95% CI 0.26 to 0.44, p<0.00001], the two groups had significant difference; Effectiveness according to EKG: tongxinluo capsule is better than isosorbide denigrate [RR 0.55 and 95% CI 0.46 to 0.66], than isosorbide mononitrate [RR 0.58 and 95% CI 0.48 to 0.70], total efficacy [RR 0.56 and 95% CI 0.49 to 0.64, p<0.00001], the two groups had significant difference; the tongxinluo group has a lower rates of adverse effect than itrate esters group. Meta-analysis results showed that the incidence rates of adverse effect [RR 0.33 and 95% CI 0.20 to 0.53], p<0.00001], the two groups had significant difference.
Conclusion Now we have evidence to indicate that tongxinluo capsule can improve curative effect no worse than isosorbide dinitrate or isosorbide mononitrate, and have a lower rates of adverse effect. But more large scale multi center randomised trials are still needed.
Source : Journal Heart and Education in Heart
Link to Abstract
Anxiety, Depression Identify Heart Disease Patients at Increased Risk of Dying
Heart disease patients who have anxiety have twice the risk of dying from any cause compared to those without anxiety, according to new research in the Journal of the American Heart Association.
Patients with both anxiety and depression have triple the risk of dying, researchers said.
"Many studies have linked depression to an increased risk of death in heart disease patients," said Lana Watkins, Ph.D., lead author of the study and an associate professor in Psychiatry and Behavioral Sciences at Duke University Medical Center in Durham, N.C. "However, anxiety hasn't received as much attention."
Studies show that depression is about three times more common in heart attack patients. The American Heart Association recommends that heart patients be screened for depression and treated if necessary.
Depressed heart disease patients often also have anxiety, suggesting it may underlie the risk previously attributed solely to depression, Watkins said. "It's now time for anxiety to be considered as important as depression, and for it to be examined carefully."
In the study, 934 heart disease patients, average age 62, completed a questionnaire measuring their level of anxiety and depression immediately before or after a cardiac catheterization procedure at Duke University Medical Center. Patients had anxiety if they scored 8 or higher on a scale composed of seven common characteristics of anxiety, with each item rated from 0 to 3 (range of possible scores: 0-21). Depression was measured using a similar scale composed of seven symptoms of depression.
Researchers, after accounting for age, congestive heart failure, kidney disease and other factors that affect death risk, found:
- 90 of the 934 patients experienced anxiety only, 65 experienced depression only and 99 suffered anxiety and depression.
- Among 133 patients who died during three years of follow-up, 55 had anxiety, depression or both. The majority of deaths (93 of 133) were heart-related.
Anxiety and depression each influence risk of death in unique ways. Anxiety, for example, increases activity of the sympathetic (adrenaline-producing) nervous system that controls blood pressure.
"People who worry a lot are more likely to have difficulty sleeping and to develop high blood pressure," Watkins said.
The link between depression and mortality is more related to behavioral risk factors, she said. "Depression results in lack of adherence to medical advice and treatments, along with behaviors like smoking and being sedentary."
Future studies should test strategies to manage anxiety alone and with depression in heart disease patients, Watkins said.
"Anxiety reducing medications combined with stress management could improve outcome for patients with just anxiety, whereas patients with anxiety and depression may need a stronger intervention involving more frequent outpatient monitoring and incentives to improve adherence," she said.
Source : Science Daily
Link to Source
Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC-Oxford cohort study.
Crowe FL, Appleby PN, Travis RC, Key TJ
Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom.
BACKGROUND: Few previous prospective studies have examined differences in incident ischemic heart disease (IHD) risk between vegetarians and nonvegetarians.
OBJECTIVE: The objective was to examine the association of a vegetarian diet with risk of incident (nonfatal and fatal) IHD.
DESIGN: A total of 44,561 men and women living in England and Scotland who were enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Oxford study, of whom 34% consumed a vegetarian diet at baseline, were part of the analysis. Incident cases of IHD were identified through linkage with hospital records and death certificates. Serum lipids and blood pressure measurements were available for 1519 noncases, who were matched to IHD cases by sex and age. IHD risk by vegetarian status was estimated by using multivariate Cox proportional hazards models.
RESULTS: After an average follow-up of 11.6 y, there were 1235 IHD cases (1066 hospital admissions and 169 deaths). Compared with nonvegetarians, vegetarians had a lower mean BMI [in kg/m(2); -1.2 (95% CI: -1.3, -1.1)], non-HDL-cholesterol concentration [-0.45 (95% CI: -0.60, -0.30) mmol/L], and systolic blood pressure [-3.3 (95% CI: -5.9, -0.7) mm Hg]. Vegetarians had a 32% lower risk (HR: 0.68; 95% CI: 0.58, 0.81) of IHD than did nonvegetarians, which was only slightly attenuated after adjustment for BMI and did not differ materially by sex, age, BMI, smoking, or the presence of IHD risk factors.
CONCLUSION: Consuming a vegetarian diet was associated with lower IHD risk, a finding that is probably mediated by differences in non-HDL cholesterol, and systolic blood pressure.
Source : Am J Clin Nutr. 2013 Mar;97(3):597-603. doi: 10.3945/ajcn.112.044073
Link to Abstract as above
Dark Chocolate and Red Wine The Food of Love and Health
If you want to keep your true love's heart beating strong, Susan Ofria, clinical nutrition manager at Gottlieb Memorial Hospital, said the real food of love is dark chocolate and red wine. In moderation, red wine and dark chocolate are good health choices not just on Valentine’s Day, but for any occasion. "You are not even choosing between the lesser of two evils, red wine and dark chocolate have positive components that are actually good for your heart," said Ofria, a registered dietitian at the Loyola University Health System's Melrose Park campus.
Red wine and dark chocolate with a cocoa content of 70 percent or higher contain resveratrol, which has been found to lower blood sugar. Red wine is also a source of catechins, which could help improve "good" HDL cholesterol.
Ofria, who is also a nutrition educator, recommends the following list of heart-healthy ingredients for February, which is national heart month, and for good heart health all year.
Eight Ways to Say "I Love You" From Loyola Dietitian
Red Wine - "Pinots, shirahs, merlots -- all red wines are a good source of catechins and resveratrol to aid 'good' cholesterol."
Dark chocolate, 70 percent or higher cocoa content -- "Truffles, soufflés and even hot chocolate can be a good source of resveratrol and cocoa phenols (flavonoids) as long as dark chocolate with a high content of cocoa is used."
Salmon/tuna -- "Especially white, or albacore, tuna and salmon are excellent sources of omega-3 fatty acids, and canned salmon contains soft bones that give an added boost of calcium intake."
Flaxseeds -- "Choose either brown or golden yellow, and have them ground for a good source of omega-3 fatty acids, fiber, phytoestrogens."
Oatmeal -- "Cooked for a breakfast porridge or used in breads or desserts, oatmeal is a good source of soluble fiber, niacin, folate and potassium."
Black or kidney beans -- Good source of niacin, folate, magnesium, omega-3 fatty acids, calcium, soluble fiber.
Walnuts and almonds -- "Both walnuts and almonds contain omega-3 fatty acids, vitamin E, magnesium, fiber and heart-favorable mono- and polyunsaturated fats."
Blueberries/cranberries/raspberries/strawberries -- "Berries are a good source of beta carotene and lutein, anthocyanin, ellagic acid (a polyphenol), vitamin C, folate, potassium and fiber."
Source : Newswise
Link to Source
Yoga May Calm Afib
Patients with paroxysmal atrial fibrillation may see some relief from doing yoga, a small, proof-of-concept study suggested.
After 3 months of yoga training, patients had fewer symptoms and less atrial fibrillation measured on cardiac nonlooping event monitors compared with a pre-training control period, according to Dhanunjaya Lakkireddy, MD, of the University of Kansas Cardiovascular Research Institute in Kansas City, and colleagues.
Yoga was also associated with a continuation of declines in heart rate and both systolic and diastolic blood pressure observed during the control phase (P<0.001 for all), the researchers reported online in the Journal of the American College of Cardiology.
"These findings underscore the therapeutic value of a low-cost non-invasive therapy such as yoga to effectively complement the conventional treatment strategies in improving atrial fibrillation patient care," they wrote. "Given the high prevalence of [the condition] and costs of conventional therapy, the public health relevance of these findings is very pertinent."
Although yoga has been shown to have some beneficial effects on cardiovascular health, it had not been studied in patients with atrial fibrillation.
The Yoga My Heart Study was a single-center, before-and-after study of 49 patients with symptomatic paroxysmal atrial fibrillation. An initial 3-month observation period during which yoga was not performed was followed by 3 months of yoga training, which took place in 60-minute sessions twice a week. The participants were given educational DVDs and encouraged to practice at home.
The average age of the patients was 61, and atrial fibrillation had lasted an average of 5.3 years at baseline.
From the observation period to the end of the yoga period, there were reductions in events associated with both self-reported symptoms and findings of atrial fibrillation on the event monitors (average 2.1 versus 3.8), events associated with symptoms but no findings on the monitors (1.4 versus 2.9), and events associated with findings on the monitor but no symptoms (0.04 versus 0.12). All differences were statistically significant at P<0.001.
Eleven patients (22% of the cohort) had an atrial fibrillation episode during the control phase but not during the yoga phase.
In general, quality of life, depression, and anxiety did not change during the control phase, but all showed significant improvements following the yoga phase. Specifically, there were significant gains in the quality-of-life domains of physical functioning, general health, vitality, social functioning, and mental health (P<0.02 for all).
There were no major adverse effects of complications associated with yoga therapy.
The mechanisms underlying the apparent benefits of yoga therapy remain unclear, according to Lakkireddy and colleagues, who provided some possible explanations.
"Yoga may prevent the atrial fibrillation initiation and perpetuation through its pleiotropic effects such as: increasing the baseline parasympathetic tone, suppressing extreme fluctuations in the two autonomic nervous system components, and decreasing the progression of the arrhythmia by preventing or minimizing atrial remodeling," they wrote.
The improvement in quality of life, anxiety, and depression "is likely explained by yoga-related attenuation of neurohormonal response to triggers of stress," they added.
However, they wrote, "the benefit from the emotionally supportive atmosphere at yoga training centers, and the positive impact by the caring relationships, change in diet, and lifestyle modification associated with yoga practice on physiological parameters cannot be underestimated."
The researchers acknowledged some limitations of the study, including the lack of information on variations in autonomic tone, systemic inflammatory markers, and endothelial function, the possibility that atrial fibrillation episodes were underestimated because of the low sampling rates of the event recorders, and the inability to determine whether the initiation of atrial fibrillation episodes was vagally mediated.
Source : MedPage Today
Link to Source
Application of Curcumin to Heart Failure Therapy by Targeting Transcriptional Pathway in Cardiomyocytes
Yasufumi Katanasaka,a,b Yoichi Sunagawa,a,b Koji Hasegawa,b and Tatsuya Morimoto*
Heart failure is one of the leading causes of death throughout the world. During the development and deterioration processes of heart failure, cardiomyocytes undergo maladaptive hypertrophy by altering hypertrophy-related gene expression. The zinc finger protein GATA4 is one of the transcription factors involved in the regulation of cardiomyocyte hypertrophy. In response to hypertrophic stimuli such as the synaptic nervous and rennin-angiotensin systems, GATA4 forms a large complex with various functional proteins including an intrinsic histone acetyltransferase, p300, and the disruption of this complex results in the inhibition
of hypertrophic responses in cardiomyocytes. While such a transcriptional signal pathway is recognized as a critical event during cardiomyocyte hypertrophy, pharmacological heart failure therapy that targets this pathway has not been established. In order to develop novel heart failure therapy targeting the pathway in cardiomyocytes, we have studied the potential of curcumin, a p300 histone acetyltransferase inhibitor, as an agent for novel heart failure therapy. In this review, we describe a recent study on the cardiac transcriptional signal pathway, especially p300/GATA4 pathway, and a novel heart failure therapy using curcumin.
Source : Biol. Pharm. Bull. 36(1) 13–17 (2013)
Link to Full Study
Berries Ward Off MI in Women
Young and middle-age women whose diet included high levels of anthocyanins -- the flavonoids present in red and blue fruits such as strawberries and blueberries -- had a significantly reduced risk for myocardial infarction (MI), a large prospective study found.
Women whose anthocyanin intake was in the highest quintile had a 32% decrease in risk of MI during 18 years of follow-up (HR 0.68, 95% CI 0.49 to 0.96, P=0.03), according to Eric B. Rimm, ScD, of Harvard University, and colleagues.
And in a food-based analysis, women who consumed more than three servings of strawberries or blueberries each week showed a trend towards a lower MI risk, with a 34% decrease (HR 0.66, 95% CI 0.40 to 1.08, P=0.09) compared with women who rarely included these fruits in their diet, the researchers reported online in Circulation.
"Growing evidence supports the beneficial effects of dietary flavonoids on endothelial function and blood pressure, suggesting that flavonoids might be more likely than other dietary factors to lower the risk of [coronary heart disease] in predominantly young women," they observed.
A number of preclinical experiments have demonstrated cardioprotective effects of anthocyanins, including anti-inflammatory effects, plaque stabilization, and inhibition of the expression of growth factors.
While studies have suggested that MI risk is increased in young and middle-age women who smoke or use oral contraceptives, little is known about the influence of diet in this population, whose risk may differ from that in older women.
The younger women may have a greater likelihood of endothelial dysfunction and coronary vasospasm and less obstructive disease.
Because dietary flavonoids -- found in vegetables, fruits, wine, and tea -- are recognized as benefiting endothelial function, the researchers looked at outcomes for 93,600 women enrolled in the Nurses' Health Study II who reported their consumption of various foods and their lifestyle factors every 4 years.
At the time of enrollment, beginning in 1991, participants were ages 25 to 42.
During almost 2 decades of follow-up, there were 405 cases of MI, occurring at a median age of 48.9 years.
Review of the food frequency and lifestyle questionnaires revealed that women who consumed high levels of anthocyanins were less likely to smoke, were more physically active, and had lower fat and higher fiber intake.
The 32% reduction in MI risk was seen after adjustment for multiple factors including body mass index, physical activity, saturated fat intake, use of caffeine and alcohol, and family history of MI.
"This inverse association was independent of established dietary and nondietary [cardiovascular disease] risk," the researchers noted.
Even adding conditions such as hypertension, dyslipidemia, and diabetes to the analytical model did not significantly change the risk estimate (HR 0.70, 95% CI 0.50 to 0.97).
Comparison of risk among women in the highest and lowest 10% of anthocyanin intake showed a relative risk of 0.53 (95% CI 0.33 to 0.86) for the high-intake group, which suggested the presence of a dose-response relationship.
Intake of other types of flavonoids did not significantly lower the risk of MI. The researchers had hypothesized that high intake of flavan-3-ol also would be important, because they had previously identified cardiovascular benefits for one type of flavan-3-ol compound in a meta-analysis.
The lack of effect in the current analysis may have reflected the fact that in the early 1990s, when the study began, most food frequency questionnaires did not include dark chocolate, which is a primary source for flavan-3-ol, they noted.
Adjustment for additional dietary factors such as total fruit and vegetable consumption also did not alter the risk, which suggests "that the benefits are specific to a food constituent in anthocyanin-rich foods (including blueberries, strawberries, eggplants, blackberries, blackcurrants) and not necessarily to nonspecific benefits among participants who consume high intakes of fruits and vegetables."
However, the results of this study do not support the use of flavonoid dietary supplements, according to Michael Rinaldi, MD, of the Carolinas HealthCare System's Sanger Heart and Vascular Institute in Charlotte, N.C.
The study does suggest that a healthy diet that includes fruits and vegetables can be healthy, said Rinaldi, who was not involved in the study.
"On the other hand, if you're going to say that these flavonoid substances in the berries should be taken as supplements, that's not what the study has the power to say," he told MedPage Today in an interview.
Limitations of the study included a lack of information about the results of cardiac catheterization and the possibility of additional unmeasured confounding factors.
In addition, while the model adjusted for intake of a number of other potentially beneficial food components, there may have been other unidentified compounds in fruits that contribute to cardioprotection.
"In a population-based study like ours, it is impossible to disentangle the relative influence of all the constituents of fruits and vegetables," the researchers wrote.
Further research will be needed to identify cardiac biomarkers that could help explain mechanisms of action, to explore dose responses, and to evaluate longer-term clinical endpoints.
Source : Medpage Today
Link to Source
Effects of supplementation with n-3 polyunsaturated fatty acids on cognitive performance and cardiometabolic risk markers in healthy 51 to 72 years old subjects: a randomized controlled cross-over study
Higher plasma n-3 polyunsaturated fatty acids (PUFA) have been associated with a lower risk of age related cognitive decline, and to beneficially affect cardiometabolic risk factors. A relation exists between metabolic disorders such as diabetes type 2 and cognitive decline. Results regarding the potential effects of n-3 PUFA on risk factors in healthy subjects are divergent, and studies regarding the possible relation between cardiometabolic parameters and cognitive performance are scarce. The objective was to evaluate the effects of five weeks intake of long chain n-3 PUFA on cognitive performance in healthy individuals, and to
exploit the possible relation between outcomes in cognitive tests to cardiometabolic risk parameters.
Fish oil n-3 PUFA (3g daily) were consumed during 5weeks separated by a 5 week washout period in a cross-over placebo controlled study, including 40 healthy middle aged to elderly subjects. Cognitive performance was determined by tests measuring working memory (WM) and selective attention.
Supplementation with n-3 PUFA resulted in better performance in the WM-test compared with placebo (p < 0.05). In contrast to placebo, n-3 PUFA lowered plasma triacylglycerides (P < 0.05) and systolic blood pressure (p < 0.0001). Systolic blood pressure (p < 0.05), fglucose (p = 0.05), and s-TNF-α (p = 0.05), were inversely related to the performance in cognitive tests.
Intake of n-3 PUFA improved cognitive performance in healthy subjects after five weeks compared with placebo. In addition, inverse relations were obtained between cardiometabolic risk factors and cognitive performance, indicating a potential of dietary prevention strategies to delay onset of metabolic disorders and associated cognitive decline.
Source : Journal of Nutrition
Link to Full Article
Healthy Eating Beneficial Beyond Drug Therapy in Preventing a Second Heart Attack
A heart-healthy diet rich in fruits, vegetables and fish significantly reduces the chance of a second heart attack and stroke in people with cardiovascular disease, McMaster University researchers have found.A five-year study of almost 32,000 patients (average age 66.5 years) in 40 countries discovered those who ate a heart-healthy diet had a:
. 35 per cent reduction in risk for cardiovascular death
. 14 per cent reduction in risk for new heart attacks
. 28 per cent reduction in risk for congestive heart failure
. 19 per cent reduction in risk for stroke
“At times, patients don’t think they need to follow a healthy diet since their medications have already lowered their blood pressure and cholesterol – that is wrong,” said Mahshid Dehghan, the study’s lead author and nutritionist at McMaster University’s Population Health Research Institute (PHRI). “Dietary modification has benefits in addition to those seen with Aspirin, angiotensin modulators, lipid-lowering agents and beta blockers.”
The study is posted on-line today in the American Heart Association Rapid Access Journal.
Each year, at least 20 million people worldwide survive a heart attack or stroke. While drug treatments, such as Aspirin, substantially lower their risk of another heart attack, the McMaster study is the first to show a high quality diet also significantly lowers their risk.
For the study, researchers assessed the association between diet quality and the risk of cardiovascular disease using information collected from men and women who participated in two major McMaster-led global studies: ONTARGET, and TRANSCEND.
Participants with cardiovascular disease were asked how often they consumed milk, vegetables, fruits, grains, fish, nuts, meat and poultry over the past 12 months. They were also asked about lifestyle choices such as alcohol consumption, smoking and exercise. A healthy diet was indicated by a high intake of fruits, vegetables, whole grains and nuts as well as a high intake of fish compared to meat, poultry and eggs.
Researchers found a heart-healthy diet offered a “consistent benefit” over and above the benefits of taking medications to reduce the risk of heart attack and stroke.
Globally, healthy eating was associated with a lower risk of cardiovascular disease by more than 20 per cent in all regions of the world, which were grouped based on their food habit. According to income, similar results were found in middle and high income countries in different regions of the world.
The researchers believe this is the first study to report on the protective impact of healthy eating for individuals with cardiovascular disease who are taking medication to prevent a second heart attack, stroke or death.
“Physicians should advise their high-risk patients to improve their diet and eat more vegetables, fruits, grains and fish,” Dehghan said. “This could substantially reduce cardiovascular recurrence beyond drug therapy alone and save lives globally.”
Source : Newswise
Link to Source
No Heart Risk for Women From Calcium
The calcium supplements widely prescribed for bone health in women did not appear to be associated with increased cardiovascular risk, researchers found.With more than 2 decades of follow-up in a cohort of almost 75,000 women, the relative risk for cardiovascular disease was 0.86 (95% CI 0.65 to 0.88), Julie Paik, MD, of Harvard Medical School in Boston, reported here at the annual meeting of the American Society for Bone and Mineral Research.
Despite the popularity of calcium supplements -- one estimate says 60% of women older than 60 use them -- there has been a growing interest in a potential link with cardiovascular problems, with conflicting data having emerged.
In a secondary analysis of one study, calcium use was associated with an increased risk of myocardial infarction (MI) and for a composite endpoint of MI, stroke, and sudden death.
And in a meta-analysis of randomized trials, there was an increased risk of MI with or without additional vitamin D, while another meta-analysis found neutral effects for the supplements.
Because the prospective studies thus far have been of short duration, Paik and colleagues analyzed data from the Nurses' Health Study, which began enrolling women in 1976 at ages 30 to 55.
This analysis was based on outcomes for 74,272 women who completed a food questionnaire in 1984, in which participants detailed their routine intake of food, beverages, and dietary supplements.
Calcium was reported every 4 years.
All participants were free of cardiovascular disease and cancer at baseline.
The analyses were adjusted for dietary confounders such as fiber intake as well as nondietary factors such as smoking, family history, and aspirin use.
Outcomes were verified through review of clinical and imaging medical records.
During 24 years and 1,681,307 person-years of follow-up, there were 4,662 cardiovascular events.
A total of 2,855 related to coronary heart disease, with 748 being fatal, while 1,807 were strokes, 1,409 of which were ischemic.
"Of note, calcium supplement use increased dramatically over the study period, from 30% in 1984 to 72% in 2004," Paik said.
In an analysis looking at outcomes for women who took more than 1,000 mg of calcium each day -- the dose that has been used in many of the trials included in the meta-analyses -- no significant risks were identified:
- Coronary heart disease, RR 0.75 (95% CI 0.65 to 0.88)
- Nonfatal MI, RR 0.74 (95% CI 0.62 to 0.88)
- Fatal MI RR 0.81 (95% CI 0.60 to 1.09)
- Stroke, RR 1.01 (95% CI 0.85 to 1.21)
Limitations of the study included the possible lack of generalizability, because all participants were female and, because they were nurses, they were likely to be relatively healthy.
In addition, there may have been residual confounding because the study was observational.
However, strengths included detailed information on calcium use and cardiovascular risk factors, and the large population.
"We found no association between calcium supplementation and cardiovascular risk, including MI, and this was a very conservative conclusion," Paik said.
Source : Medpage Today via
Primary source: American Society for Bone and Mineral Research
Source reference: Paik J, et al "A prospective study of calcium supplement intake and risk of cardiovascular disease in women" ASBMR 2012; Abstract 1135.
Link to Source
Daily Apple versus Dried Plum: Impact on Cardiovascular Disease Risk Factors in Postmenopausal Women.
Chai SC, Hooshmand S, Saadat RL, Payton ME, Brummel-Smith K, Arjmandi BH.
BACKGROUND: Evidence suggests that consumption of apple or its bioactive components modulate lipid metabolism and reduce the production of proinflammatory molecules. However, there is a paucity of such research in human beings.
OBJECTIVE: Women experience a lower rate of cardiovascular disease before menopause compared with men. However, after the onset of menopause, the risk of cardiovascular disease increases drastically due to ovarian hormone deficiency. Hence, we conducted a 1-year clinical trial to evaluate the effect of dried apple vs dried plum consumption in reducing cardiovascular disease risk factors in postmenopausal women.
DESIGN: One-hundred sixty qualified postmenopausal women were recruited from the greater Tallahassee, FL, area during 2007-2009 and were randomly assigned to one of two groups: dried apple (75 g/day) or dried plum (comparative control). Fasting blood samples were collected at baseline, 3, 6, and 12 months to measure various parameters. Physical activity recall and 7-day dietary recall were also obtained.
RESULTS: Neither of the dried fruit regimens significantly affected the participants' reported total energy intake throughout the study period. On the contrary, women who consumed dried apple lost 1.5 kg body weight by the end of the study, albeit not significantly different from the dried plum group. In terms of cholesterol, serum total cholesterol levels were significantly lower in the dried apple group compared with the dried plum group only at 6 months. Although dried plum consumption did not significantly reduce serum total cholesterol and low-density lipoprotein cholesterol levels, it lowered their levels numerically by 3.5% and 8%, respectively, at 12 months compared with baseline. This may explain the lack of significance observed between the groups. However, within the group, women who consumed dried apple had significantly lower serum levels of total cholesterol and low-density lipoprotein cholesterol by 9% and 16%, respectively, at 3 months compared with baseline. These serum values were further decreased to 13% and 24%, respectively, after 6 months but stayed constant thereafter. The within-group analysis also reported that daily apple consumption profoundly improved atherogenic risk ratios, whereas there were no significant changes in lipid profile or atherogenic risk ratios as a result of dried plum consumption. Both dried fruits were able to lower serum levels of lipid hydroperoxide and C-reactive protein. However, serum C-reactive protein levels were significantly lower in the dried plum group compared with the dried apple group at 3 months.
CONCLUSIONS: There were no significant differences between the dried apple and dried plum groups in altering serum levels of atherogenic cholesterols except total cholesterol at 6 months. However, when within treatment group comparisons are made, consumption of 75 g dried apple (about two medium-sized apples) can significantly lower atherogenic cholesterol levels as early as 3 months. Furthermore, consumption of dried apple and dried plum are beneficial to human health in terms of anti-inflammatory and antioxidative properties.
Source : J Acad Nutr Diet. 2012 Aug;112(8):1158-68.
Link to Abstract
High Fatty Acid Intake Lessens Risk for CHD
Higher levels of omega-6 fatty acid in the blood were associated with a lower risk of coronary heart disease (CHD), results of a nested case-control study found.
Patients with the highest plasma concentration of omega-6 polyunsaturated fatty acids had a significantly lower risk of CHD compared with those who had the lowest concentrations (adjusted OR 0.84 95% CI 0.76 to 0.92, P<0.0001), according to Kay-Tee Khaw, MA, MSc, FRCP, of the University of Cambridge in the U.K., and colleagues.
They also saw a weak but significant relationship between higher blood levels of saturated fatty acids and greater risk of CHD, Khaw and co-authors wrote in the July issue of PLoS Medicine.
The study assessed the relationship between plasma concentrations of various saturated and polyunsaturated fatty acids and incident CHD in 2,424 patients -- including 633 fatal incidents -- versus 4,930 patients who were alive and had no cardiovascular disease.
Participants were gathered through the European Prospective Investigation into Cancer (EPIC)-Norfolk, and included patients, ages 40 to 79 at baseline, from 1993 to 1997 who were followed until 2009 s.
They completed a questionnaire on medical history, smoking, alcohol intake, physical activity, social class, and education. Blood samples were taken at baseline and were evaluated for concentrations of 22 different phospholipid fatty acids.
The types of fatty acids were grouped into six "families:"
- Even chain saturated
- Odd chain saturated
- Omega-6 polyunsaturated
- Omega-3 polyunsaturated
- Trans-fatty acids
Omega-6 polyunsaturated fatty acid concentration had a significant inverse association with risk of developing CHD, as did odd chain saturated fatty acids (RR 0.67, 95% CI 0.54 to 0.80) when comparing those with highest versus lowest concentrations of plasma fatty acid.
There was "no overall significant relationship between total plasma phospholipid fatty acid concentration and CHD," the researchers wrote. However, there was an increased strength and significance of the association between CHD and saturated fatty acids with adjustment for other fatty acid concentrations (OR 1.83, 95% CI 1.37 to 2.46, P<0.0001) for those with the lowest versus highest concentrations of saturated fatty acids.
The risk was "attenuated after adjusting for cholesterol levels, indicating that much of the association between saturated fatty acid and CHD is likely to be mediated through blood cholesterol levels," Martijn Katan, PhD, of the Vrije Universiteit in Amsterdam, wrote in an editor's summary.
Khaw and colleagues also noted that the lack of association with saturated fat intake and CHD was "unsurprising given the large measurement errors in dietary assessment of fat intake through recall errors, ubiquity of fats leading to quantification difficulties, and, critically, huge variability in fatty acid composition of foods such that discrimination between different fats is problematic."
The authors noted several limitations with the study, including a priori hypotheses for main fatty acid family analyses, only measuring the two most common trans-fatty acids, and use of plasma fatty acid measures from one point in time. Katan added that the study was limited by the exclusion of non-diet factors' contributions to changes in plasma fatty acid levels.
Both Katan and the researchers said future research could include an evaluation of biological and health effects on individual fatty acids. The authors also said that future research should include overall fatty acid profiles and balances between fatty acids.
The team concluded that dietary recommendations should evolve to discriminate between individual fatty acids and their interactions with each other and a patient's metabolism.
Primary source: PLoS Medicine
Khaw KT, et al. "Plasma phospholipid fatty acid concentration and incident coronary heart disease in men and women: the EPIC-Norfolk Prospective Study" PLoS Med 2012;9:e1001255.
Source : Medpage Today
Link to Source
Metabolomic profiles of myocardial ischemia under treatment with salvianolic acid B
Yonghai Lu1,3, Yue Zheng2,4, Xinru Liu1, Xu Liang1, Saiming Ngai3, Tiejun Li2* and Weidong Zhang1*
1 Department of Medicinal Chemistry of Nature Product, School of Pharmacy, Second Military Medical University, No. 325 Guohe Road, Shanghai 200433, China
2 Department of Pharmacology, School of Pharmacy, Second Military Medical University, No. 325 Guohe Road, Shanghai 200433, China
3 School of Life Sciences, Faculty of Science, The Chinese University of Hong Kong, Hong Kong, China
4 Institute for Drug and Instrument Control of Health Department, General Logistics Department of the Chinese People's Liberation Army, Beijing 100071, China
Background Radix Salvia miltiorrhiza (Danshen) has been used as a principal herb in treating cardiovascular diseases in Chinese medicine. Salvianolic acid B (SA-B), a water-soluble active component of Danshen, was found to have anti-myocardial ischemia (anti-MI) effect. This study aims to investigate mechanisms of SA-B on MI.
Methods Five conventional Western medicines (isosorbide dinitrate, verapamil, propranolol, captopril and trimethazine) with different mechanisms for treating cardiovascular diseases were selected as positive references to compare with SA-B in changing of the metabolomic profiles in MI rats under treatment. Potential mechanisms of SA-B were further investigated in H9C2 cell line.
Results The metabolomic profiles between SA-B- and propranolol-treated MI rats were similar, since there was a big overlap between the two groups in the PLS-DA score plot. Finally, it was demonstrated that SA-B exhibited a protective effect on MI mainly by decreasing the concentration of cyclic adenosine monophosphate (cAMP) and Ca2+ and inhibiting protein kinase A (PKA).
Conclusion SA-B and propanolol exhibited similar metabolomic profiles, indicating that the two drugs might have a similar mechanism.
Source : Chinese Medicine
Link to Full Article
Sugary Drinks Tied to More Heart Attacks
Men who frequently drink sodas and other sugar-sweetened beverages may be putting themselves at risk of a heart attack, an observational study showed.
In a study of male healthcare professionals, those who consumed the most sugary drinks -- a median of 6.5 per week -- were 20% more likely to have a myocardial infarction (MI) during follow-up than those who never drank them (RR 1.20, 95% CI 1.09 to 1.33), according to Frank Hu, MD, PhD, of the Harvard School of Public Health in Boston, and colleagues.
A similar relationship was not seen for consumption of artificially sweetened diet beverages, they reported online in Circulation: Journal of the American Heart Association.
"These results, as well as those from other observational studies and trials, support recommendations to reduce the consumption of sugar-sweetened beverages in order to prevent cardiovascular disease," the authors wrote.
Sugar-sweetened beverages have been associated with weight gain and type 2 diabetes, but few studies have examined the relationship between the sugary drinks and coronary heart disease.
Hu and colleagues looked at data from the Health Professionals Follow-Up study, a prospective cohort study of mostly white men who were ages 40 to 75 at baseline in 1986.
The current analysis included 42,883 participants after excluding those with type 2 diabetes, cardiovascular disease, or cancer at baseline.
The men reported their consumption of sugar-sweetened and artificially sweetened beverages at baseline and every four years using a food frequency questionnaire. At baseline, the average intake was 2.5 sugar-sweetened beverages and 3.4 artificially sweetened beverages each week.
Over 22 years of follow-up, there were 3,683 incident coronary heart disease cases, defined as fatal or nonfatal MIs.
The greater risk of having a heart attack in the quartile with the greatest consumption of sugar-sweetened beverages was significant after controlling for numerous potential confounders, including age, smoking, physical activity, alcohol, multivitamins, family history, diet quality, energy intake, body mass index, pre-enrollment weight change, and dieting.
Further adjustment for self-reported high cholesterol, triglycerides, and blood pressure, as well as diagnosed type 2 diabetes, only slightly weakened the association.
"This suggests that sugar-sweetened beverages may impact on coronary heart disease risk above and beyond traditional risk factors," the authors wrote.
When treated as a continuous variable, each additional serving per day of sugar-sweetened beverages was associated with a 19% greater relative risk of coronary heart disease (P<0.01). That is consistent with a previous analysis of women participating in the Nurses' Health Study, which showed that each serving increase was associated with a 15% greater risk.
Hu and colleagues also examined the relationship between consuming sugary drinks and various biomarkers, finding an association between greater consumption and adverse effects on triglycerides, C-reactive protein, interleukin-6, tumor necrosis factors 1 and 2, HDL cholesterol, lipoprotein(a), and leptin (P≤0.02 for all).
Referring to the inflammatory markers, they noted that "inflammation is a key factor in the pathogenesis of cardiovascular disease and cardiometabolic disease, and could represent an additional pathway by which sugar-sweetened beverages influence risk."
The study, according to the authors, was limited by some error in measuring dietary intakes, the uncertain generalizability of the findings beyond the study population, the possibility of unmeasured and residual confounding, and the large number of comparisons that were made.
Source : Medpage Today
via : De Koning L, et al “Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men” Circulation 2012; DOI: 10.1161/CIRCULATIONAHA.111.067017.
Link to Source
Effects of different forms of hazelnuts on blood lipids and α-tocopherol concentrations in mildly hypercholesterolemic individuals
Background/Objectives: Diets high in nuts reduce cholesterol, probably due to their favorable lipid profile and other bioactive substances. However, the physical form of the nut may be important as the cell wall of intact nuts may limit the hypocholesterolemic effect of nuts by reducing lipid bioavailability. Therefore, we investigated the effects on blood lipids of incorporating three different forms of hazelnuts (ground, sliced and whole) into the usual diet.
Subjects/Methods: In a randomized crossover study with three phases, 48 mildly hypercholesterolemic participants were asked to consume 30 g of ground, sliced or whole hazelnuts for 4 weeks. Body weight, plasma total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triacylglycerol (TAG), apolipoprotein (apo) A1, apo B100 and α-tocopherol were measured at baseline and at the end of each dietary phase.
Results: There were no significant differences in any outcome variable between the different forms of nuts (all P0.159). However, compared with baseline, mean values at the end of each hazelnut intervention were significantly higher for HDL-C (P=0.023) and α-tocopherol (P=0.005), and significantly lower for TC (P<0.001), LDL-C (P<0.001), TC:HDL-C ratio (P<0.001), apo B100 (P=0.002) and apo B100:apo A1 ratio (P<0.001), with no significant difference in body weight (P=0.813).
Conclusion s: The ingestion of three different forms of hazelnuts equally improved the lipoprotein profile and α-tocopherol concentrations in mildly hypercholesterolemic individuals. Hazelnuts can therefore be incorporated into the usual diet as a means of reducing cardiovascular disease risk.
Source : European Journal of Clinical Nutrition
Link to Full Study
Prevention: Evidence of Heart Benefits From Chocolate
An analysis of studies including more than 100,000 subjects has found that high levels of chocolate consumption are associated with a significant reduction in the risk of certain cardiovascular disorders.
The seven studies looked at the consumption of a variety of chocolate — candies and candy bars, chocolate drinks, cookies, desserts and nutritional supplements. By many measures, consumption of chocolate was linked to lower rates of stroke, coronary heart disease, blood pressure and other cardiovascular conditions.
But there was no beneficial effect on the risk for heart failure or diabetes.
Over all, the report, published Monday in the British medical journal BMJ, showed that those in the group that consumed the most chocolate had decreases of 37 percent in the risk of any cardiovascular disorder and 29 percent in the risk for stroke.
Still, the lead author, Dr. Oscar H. Franco, a lecturer in public health at the University of Cambridge, warned that this finding was not a license to indulge and noted that none of the studies reviewed involved randomized controlled trials.
“Chocolate may be beneficial, but it should be eaten in a moderate way, not in large quantities and not in binges,” he said. “If it is consumed in large quantities, any beneficial effect is going to disappear."
Source + Link : New York Times (Aug 2011)
Link to Study - BMJ - Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis
Cranberry shows heart health benefits: Study
Polyphenol-rich cranberry juice may boost heart health by alleviating arterial stiffness, says a new study from the Boston and Tufts Universities.
Double-strength cranberry containing 835 milligrams of total polyphenols and 94 mg of anthocyanins was associated with improvements in a measure of arterial stiffness called carotid femoral pulse wave velocity, according to findings published in the American Journal of Clinical Nutrition.
On the other hand, the Boston-based scientists report no benefits from cranberry juice consumption were observed for other measures of vascular or cardiovascular function, including blood pressure or brachial artery flow-mediated dilation, a measure of endothelial dysfunction since a low value is indicative of a blood vessel's inability to relax.
“We did observe a highly significant effect of cranberry juice on stiffness of the central aorta, which is increasingly recognized as an important measure of vascular function with relevance to cardiovascular disease,” wrote the researchers, led by Boston University’s Joe Vita, MD.
“Overall, our results may provide further support for the American Heart Association recommendation that cardiovascular disease risk may be reduced by a diet rich in fruit and vegetables, including cranberries,” they added.
Established and emerging health benefits
Cranberry is most famous for its ability to fight urinary tract infections, something that has led to almost one third of parents in the US giving it to their children, according to a recent study.
In 2004 France became the first country to approve a health claim for the North American cranberry species Vaccinium macrocarpon, which states that it can 'help reduce the adhesion of certain E.coli bacteria to the urinary tract walls'.
Other health conditions that may benefit from cranberry include stomach health, with several reports indicating that the berry’s constituents may inhibit the adhesion of Helicobacter pylori in the stomach. H. pylori is the only bacteria that can survive in the acidic environment of the stomach and known to cause peptic ulcers and gastritis.
In addition studies have suggested that proanthocyanidin-rich cranberry extracts may inhibit the growth and spread of human oesophageal adenocarcinoma (a cancer in glandular tissue), or may prevent colon cancer via an anti-inflammatory mechanism.
The researchers performed two studies: The first was an acute pilot study with no placebo involving 15 participants; the second was a chronic placebo-controlled crossover study with 44 participants with coronary artery disease.
In the acute, non-placebo controlled, pilot study, the researchers reported that cranberry juice (480 mL) was associated with improvements in both brachial artery flow-mediated dilation, from 7.7 percent before ingestion to 8.7 percent four hours after ingestion, as well as digital pulse amplitude tonometry ratio from to 0.10 to 0.23.
However, in the placebo-controlled, cross-over study, no such changes were observed. Dr Vita and his researchers did record a reduction in carotid-femoral pulse wave velocity from 8.3 to 7.8 m/s.
“We emphasize that the research beverage contained twice the amount of cranberry juice in commercially available cranberry juice and that the amount of anthocyanins consumed during the study greatly exceeded the average daily intake in the United States,” noted the researchers.
“Additional studies will be needed to determine how cranberry juice reduces central aortic stiffness, but our finding of improved pulse wave velocity without a change in endothelial function may be consistent with an effect at the level of the arterial wall or a change in sympathetic tone,” they added.
The study was funded by cranberry giant Ocean Spray and the National Institutes of Health (NIH).
Source NutraIngredients via American Journal of Clinical Nutrition
Published online ahead of print, doi: 10.3945/ajcn.110.004242
“Effects of cranberry juice consumption on vascular function in patients with coronary artery disease”
Link to Source
Eskimo study supports omega-3 for heart health
High intakes of omega-3 fatty acids may reduce the risk of obesity-related chronic diseases such as diabetes and heart disease, according to new findings from a study with Alaskan Eskimos.
Yup’ik Eskimos, the most famous indigenous people of the US’ 49th State, have similar obesity rates to the lower 48 states, but the incidence of type-2 diabetes is only 3.3 percent, compared with 7.7 percent nationally.
According to researchers from the Fred Hutchinson Cancer Research Center and the University of Alaska-Fairbanks, this apparent reduction in diabetes risk is linked to the observation that the Eskimos’ average consumption of omega-3s from fish is 20 times more than people in the lower 48 states.
“While genetic, lifestyle and dietary factors may account for this difference,” said lead author Zeina Makhoul, PhD., “it is reasonable to ask, based on our findings, whether the lower prevalence of diabetes in this population might be attributed, at least in part, to their high consumption of omega-3-rich fish.”
Furthermore, in Eskimos with low blood levels of omega-3 fatty acids, most notably EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), obesity was found to strongly increase blood triglycerides and C-reactive protein (CRP), a measure of inflammation. Elevated levels of triglycerides and CRP increase the risk of heart disease and, possibly, diabetes.
“Interestingly, we found that obese persons with high blood levels of omega-3 fats had triglyceride and CRP concentrations that did not differ from those of normal-weight persons,” added Makhoul. “It appeared that high intakes of omega-3-rich seafood protected Yup’ik Eskios from some of the harmful effects of obesity.”
Returning to the native people of the north
The new study, published in the European Journal of Clinical Nutrition, echoes findings from the first studies in this area from 40 years ago, carried out by Dr Jørn Dyerberg and his Danish colleagues amongst the Inuit of Greenland. The Danish scientists sought to understand how the Greenland Eskimos, or Inuit, could eat a high fat diet and still have one of the lowest death rates from cardiovascular disease on the planet.
These studies led to landmark publications in The Lancet and The American Journal of Clinical Nutrition. Since then, the potential benefits of EPA and DHA have extended to include improvements in blood lipid levels, a reduced tendency of thrombosis, blood pressure and heart rate improvements, and improved vascular function.
From Greenland to Alaska
For the new study the researchers recruited 330 Yup’ik with an average age of 45. Seventy percent of the participants were overweight or obese at the start of the study. Yup’ik literally translates as “real people” from the native language.
Analysis of blood samples showed that, while CRP and triglyceride levels were observed in obese Eskimos with low omega-3 blood levels, such increased levels were not observed in people with high blood levels of EPA and DHA.
“Our findings may have important clinical relevance for the prevention of some obesity-related diseases. Obesity prevalence in the US and worldwide has been increasing over the past decades, with subsequent increases in rates of diabetes and other obesity-associated diseases,” wrote the researchers.
“It is likely that these associations are partly mediated by the positive associations of obesity with triglycerides and CRP, two biomarkers that strongly and independently predict risks of CVD and possibly diabetes.
“Chronic, high EPA and DHA intakes, similar to those of Yup’ik Eskimos, could at least partly ameliorate the obesity-associated disease risks,” they added.
The researchers called for a randomized clinical trial to test whether increasing omega-3 fat intake significantly reduces the effects of obesity on inflammation and blood triglycerides.
“If the results of such a trial were positive, it would strongly suggest that omega-3 fats could help prevent obesity-related diseases such as heart disease and diabetes,” she said.
The study was funded by the National Center for Research Resources, and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.
Know your limitations
Harry Rice, PhD, VP regulatory and scientific affairs at the omega-3 trade association Global Organization for EPA and DHA (GOED), told NutraIngredients-USA that the study's results are "exciting given the potential implications for attenuating obesity-related disease risk.
"While the optimal way to reduce obesity-related disease risk would be to decrease BMI via weight loss, the reality is that there are individuals genetically predisposed to obesity. For those people, this research may have far-reaching implications for long-term survival," said Dr Rice.
"Perhaps as equally impressive as the results is the authors' recognition of the study's limitations, including the fact that the associations observed may not be causal and the need to replicate the results in other populations before generalizing. My experience has been that the best scientists are those that best understand their limitations!"
Source Nutraingredients via European Journal of Clinical Nutrition doi: 10.1038/ejcn.2011.39
“Associations of obesity with triglycerides and C-reactive protein are attenuated in adults with high red blood cell eicosapentaenoic and docosahexaenoic acids”
Link to Source
Study unlocks lycopene’s heart health benefits
Lycopene, the compound that gives tomatoes their red color, may benefit heart health by boosting the body’s natural antioxidant defenses and protecting against DNA damage, says a new study from South Korea.
A daily supplement of 15 milligrams for eight weeks was associated with increased activity of SOD (super oxide dismutase), a powerful antioxidant enzyme, as well as reductions in measures of DNA damage in white blood cells, according to results published in the journal Atherosclerosis.
Furthermore, the apparent benefits extended to a reduction in systolic blood pressure and a decrease in levels of high-sensitivity C-reactive protein (hsCRP). CRP is a marker of inflammation and is reported to be an independent predictor of cardiovascular-related events.
“These results add to the growing literature on potential protective effects of the antioxidant lycopene in atherosclerosis through an anti-inflammatory effect and preserving endothelial function,” wrote the researchers, led by Jong Ho Lee from Yonsei University in South Korea.
Growing science and market for lycopene
Lycopene is an antioxidant that is present in red- and pink-colored fruits and vegetables. It has been shown to have heart, blood pressure, prostate, osteoporosis, skin and other benefits in both natural and synthetic forms.
As well as being used as a food coloring, it has also used for its functional properties in food supplements and some food and beverage products, particularly those targeting the ‘beauty-from-within’ market.
According to Mintel’s Global New Products Database (GNPD), globally there were over 500 global lycopene product launches between 2003 and 2009 in foods, supplements and cosmetics.
The South Korean researchers recruited 126 health men with an average age of 34 and an average BMI of 24 kg/m2, and randomly assigned them to receive a daily 6 or 15 milligram supplement of lycopene (Lyc-O-Mato, Lycored), or placebo for eight weeks.
At the end of the study the researchers reported that SOD activity increased by 2.37 units per milliliter in the high-dose group, compared with an increase of 1.73 units per milliliter in 6 mg group and a decrease in activity in the placebo group.
In addition, DNA damage was reduced in the high dose group, compared with the other groups. Endothelial function – the function of the cells lining blood vessels – was also improved significantly following the high dose group.
“Interestingly, the beneficial effects of lycopene supplementation on endothelial function were remarkable in subjects with relatively impaired endothelial cell function at initial level,” report the researchers.
CRP levels decreased by 57 percent in the high dose group, while no significant reductions were recorded in the other two groups, said the researchers.
“Subjects supplemented with 15-mg lycopene daily for 8-week also showed reduction in other cardiovascular risk factors, for example, an increase in LDL particle size,” report the researchers. “Since the lycopene capsule used in this study also contains beta-carotene (greater than 0.5 mg), the subjects in the 15-mg lycopene/day group had a 65 percent increase in lycopene concentration and a 20 percent increase in beta-carotene, which is a known effective antioxidant that inactivates free radicals, inversely correlates with CRP, and slows the progression of atherosclerosis.
“Therefore, a synergistic effect of lycopene and beta-carotene in the 15-mg lycopene/day group likely increased the beneficial effects on these atherosclerosis risk factors,” they added.
Source: Nutringredients from Atherosclerosis Published online ahead of print, doi:10.1016/j.atherosclerosis.2010.11.036
“Effects of lycopene supplementation on oxidative stress and markers of endothelial function in healthy men”
Authors: J.Y. Kim, J.K. Paik, O.Y. Kim, H.W. Park, J.H. Lee, Y. Jang, J.H. Lee
Link to Source