Category: Cardiovascular

Folic Acid: It Seems Wise to Take a Supplement

Claus Hancke

February 7, 2005

Folic acid reduces the blood pressure, but only if you take a folic acid supplement, as you will not get enough simply through your diet. At the same time, folic acid protects your heart and brain from blood clots.

Since long, it has been documented that the B-vitamin folic acid (B9) prevents congenital neural tube defects. In Canada, all kinds of flour have been enriched with folic acid during the past 8 years, and 80% of the congenital neural tube defects have thus been prevented. In the USA, enrichment is also obligatory, but in Britain, expectant mothers are left to themselves. They have to figure out for themselves to take a supplement – before they become pregnant!

The main source of folic acid is leafy green vegetables (the latin “folium” means “leaf”). Many people do not like these leafy greens and folic acid deficiency is therefore more common than any other vitamin deficiency. Unfortunately, the deficiency probably does not only harm the unborn baby but does also increase the mortality of coronary thrombosis and cerebral apoplexy in adults. But this is not all: Folic acid deficiency probably also increases the risk of hypertension.

The connection between folic acid deficiency and hypertension that has been unknown till now was discovered when an eight-year study was concluded involving 156,000 American nurses *1). The risk of the nurses having hypertension while being 27 – 44 years of age was only half as great when they took 1 mg (1000 mcg.) of folic acid a day compared to when they took 0.2 mg. In both the US and Britain, 0.2 mg. is just below the average daily folic acid intake which is 0.25 mg. It is almost impossible to get 1 mg. of folic acid a day – which is four times as much – without taking a supplement.

With regard to apoplexy and coronary thrombosis, much interesting knowledge has been produced during recent years:
In the US, where enrichment of flour with folic acid began in 1996, the mortality rate following apoplexy has droppped dramatically – in all groups of society, that is, and for both men and women – so the results are rather regardless of lifestyle, etc.

Before 1996, the annual drop in mortality as a result of apoplexy was about 1%. This drop was the result of improved treatment and prophylaxis. However, in the succeeding three years, mortality rates dropped three times as fast, i.e. with a total of 10 – 15%! Statistically, this has been explained by the fact that the average American now has twice as much folic acid in his/her blood as before *2).

Moreover, apoplexy is far more dangerous if you are deficient in folic acid. This was recently demonstrated on mice. They were given an artificial apoplexy in that their cerebral artery was simply clamped. It turned out that the cerebral damage was only half as great in the mice that had been given enough folic acid *3).

Folic acid seems to be able to protect the heart as well. This appeared most recently when Italian doctors studied 900 patients hospitalized with or without coronary thrombosis. The patients were divided into three groups according to their estimated daily intake of folic acid. Among the patients admitted to the cardiology department, most of them belonged to the group that got the least folic acid!

The third of the patients that got the least folic acid had twice as great a risk compared to the third of the patients that got the most folic acid. When vitamin B6 intake was also taken into account (vitamin B6 collaborates with folic acid), the ones who got the most folic acid only had a relative risk of 29% *4).

It is not the folic acid itself that protects the heart and the brain. However, folic acid reduces the blood content of the harmful amino acid homocysteine which attacks the blood vessels.

About 10% of the population are unaware that they have a hereditarily increased homocysteine level in their blood (and therefore need more folic acid). Recently, it was discovered that these 10% suffer apoplexy significantly more often than others *5, 6). It was already known that these people already have an increased risk of suffering coronary thrombosis *7).

Nobody has yet performed a blinded study in which supplements have been used to efficiently lower the blood contents of homocysteine. However, this kind of research is now being encouraged *8). Yet, with our existing knowledge, it seems wise to take a folic acid supplement. The ideal dosage may be around 0.8 mg. (800 mcg.) a day.

By: Vitality Council

References:
1. Forman JP, Rimm EB, Stampfer MJ, Curhan GC. Folate intake and the risk of incident hypertension among US women. JAMA. 2005 Jan 19;293(3):320-9.
2. American Heart Association’s 44th annual Conference on Cardiovascular Disease Epidemiology and Prevention.carole.bullock@heart.org
3. Endres M, Ahmadi M, Kruman I, Biniszkiewicz D, Meisel A, Gertz K. Folate deficiency increases postischemic brain injury. Stroke. 2005 Feb;36(2):321-5.
4. Taivani A et al. Folate and vitamin B6 intake and risk of acute myocardial infarct in Italy. Eur J Clin Nutr 2004;58:1266-72
5. Al-Delaimy WK, Rexrode KM, Hu FB, Albert CM, Stampfer MJ, Willett WC, Manson JE. Folate intake and risk of stroke among women. Stroke. 2004 Jun;35(6):1259-63.
6. Casas JP et al. Homocysteine and stroke: Evidence on a causal link from mendelian randomisation. The Lancet 2005;365: 224-32
7. Klerk M, Verhoef P, Clarke R, Blom HJ, Kok FJ, Schouten EG; MTHFR Studies Collaboration Group. MTHFR 677C–>T polymorphism and risk of coronary heart disease: a meta-analysis. JAMA. 2002 Oct 23-30; 288(16):2023-31.
8. S Schwammenthal et al. Homocysteine, B-vitamin supplementation, and stroke prevention. From observational to interventional trials. Lancet Neurol. 2004;3(8):493-5.

jama.ama-assn.org
www.lancet.com
stroke.ahajournals.org
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Decisive Agreement About Fish Oil Has Now Been Reached

Claus Hancke

January 10, 2005

For the first time, there is agreement about chronic lack of fish oil increasing the risk of coronary heart disease. An official American report sets a recommended intake for all adults.

It looks like there is now decisive agreement among experts that there is a connection between coronary heart disease and a chronic lack of the fatty acids in fish oil. This is the conclusion of a report published in Current Atherosclerosis Reports which was prepared at the request of the federal health authorities of the USA.

According to the report, the indications for a connection between a lack of fatty acids and death caused by coronary heart disease have become stronger year by year. It is the two N-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) that are significant. According to the report, DHA and EPA have “clear heart-protective effects.”

It also states that both national American and international experts now recommend larger intakes of N-3 fatty acids. The recommended daily intake is 450 mg. a day (EPA + DHA), but for persons with recognized coronary heart disease, the recommendation is 1000 mg. a day. This equals 1.5 g. of ordinary fish oil for healthy persons and 3 g. in case of heart disease, respectively; this is half the contents of a concentrated fish oil capsule.

The report underlines that according to both cellular- and animal tests, the N-3 fatty acids are capable of preventing irregular heartbeat and that this has now also been confirmed in tests on humans; this fact is also mentioned elsewhere on this site. In particular, the fatty acids can counteract the extremely common and often uncomfortable atrial fibrillation. All in all, the risk of death as a result of coronary heart disease is reduced by 25% when taking sufficient amounts of fish oil, as mentioned.

The strength of this evidence is now so comprehensive that the report encourages measuring people’s blood content of fatty acids just as measuring the blood pressure, checking the cholesterol, etc. is being done at present to estimate the risk of coronary heart disease. Likewise, it is now appreciated that it must become a national priority to see to it that everyone gets a sufficient intake of fish oil.

By: Vitality Council

Reference:
Harris WS. Are omega-3 fatty acids the most important nutritional modulators of coronary heart disease risk? Curr atheroscler Rep. 2004;6:447-52.

lansbury.bwh.harvard.edu/docosahexaenoic_acid_reviews_L.htm

Vitamin C Can Protect the Heart

Claus Hancke

December 20, 2004

A new meta-analysis was published some weeks ago with the positive conclusion that high doses of Vitamin C can reduce the risk of coronary thrombosis (blood clots) in the heart by 25%.

Nine scientific studies with a total of 290,000 people who did not suffer from cardiac disease were thoroughly analysed by a group of researchers from several large centres in Denmark, Sweden, Finland, Israel, and the USA.

In this group, during the course of ten years, approx. 4600 large coronary thromboses were discovered. Then, various factors that could influence this result were analysed.

Documentation that large amounts of fruit and vegetables reduce this cardiovascular risk is vast, and therefore, it was important to the researchers to distinguish between the ones who had only received their vitamins through their diet and the ones who had supplemented their diet with dietary supplements.

The research group found out that a daily dietary supplement with a high dose of Vitamin C with large statistic certainty (p<0.001) could reduce the risk of coronary thrombosis with 25% compared to the ones who did not take any supplements.

The dose of vitamin C to take for this reduced risk to set in was more than 700 mg. a day. This more or less equals the amount of Vitamin C that can be found in: 15 fresh oranges, 35 fresh apples, 75 fresh bananas, or ½ kg. of fresh blackcurrant. These amounts of fruit should be eaten every day – so there must be an easier way!

Moreover, the analysis confirms the results of a study that was made earlier this year that showed that Vitamin C reduces hs-CRP (high-sensitive C-reactive protein), which is a blood test that can predict the cardiac risk in a much more secure way than any cholesterol values in the world.

The analysis could only give weak support to the hypothesis that Vitamin E reduces the risk of coronary thrombosis. This result was not statistically certain.

By: Vitality Council

Reference:
Knekt P, Heitmann Berit L, Augustsson Katarina et al: Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts.American Journal of Clinical Nutrition (vol. 80, issue 6, pp1508-1520, 2004).

www.ajcn.com
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Dangerous to Stop Taking Fish Oil!

Claus Hancke

September 8, 2004

Recent media reports have been saying that, according to a Danish study, fish oil does not prevent cardial arrythmia. Many have gotten the impression that fish oil does not at all benefit the heart. This is very wrong! Considering the many who take fish oil for the health of their heart, it is of utmost importance that this mistake be corrected, as it may be dangerous to stop supplementing with fish oil!

By: Vitality Council

References:
1) Albert C. Fish oil – an appetising alternative to anti-arrhytmic drugs? Lancet 2004;363:1412-3.
2) Schrepf, R et al. Immediate effects of n-3 fatty acid infusion on the induction of sustained ventricular tachycardia. Lancet 2004;363:1441-2.

www.lancet.com
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Nobel Prize Award Winner: Vitamin E and C Prevent Hardening of the Arteries!

Claus Hancke

July 13, 2004

The theory that antioxidants protects against arteriosclerosis and thereby cardiac thrombosis, brain haemorrhage, and more, is now supported by one of the World’s leading experts in the field.

The American Nobel laureate Louis J Ignarro from UCLA University in California recommends in clear terms that you take supplements of the antioxidants vitamin E and C.

– It works on mice, he says. It will work on humans too!

Ignarro is a chemist and pharmacologist by training, but he is first and foremost a world-renowned expert when it comes to blood vessels. In 1998, aged only 57, he received the Nobel Prize in Medicine for his discoveries of NO’s (nitrogen oxide) effect on the blood vessels.

It was a groundbreaking discovery. Previously, it was believed that this simple molecule was just a nuisance part of the air pollution over big cities.

Ignarro demonstrated that NO is a biologically active molecule that forms in the blood vessels and ensures that they stay open. He also showed that NO dramatically prevents platelets from clumping together and forming blood clots.

In the years around 1980, he discovered that the well-known heart medicine nitroglycerin – whose mode of action until then was a mystery – dilates the heart’s coronary arteries precisely by being converted to NO.

Ignarro’s research has been overwhelmingly inspiring for other researchers. Without his efforts, e.g. Viagra, which increases the NO content in the penis’ blood vessels, has been unthinkable.

In the new and very meticulous experiments, mice were used which, due to high cholesterol, were strongly predisposed to atherosclerosis. When the mice were allowed to complete a swimming program, the content of NO in the blood vessels increased and the extent of atherosclerosis was 35% less than in inactive mice.

When the mice were supplemented with both vitamin E and C instead of exercise, the protection was slightly greater than with exercise! But when they both swam and got vitamins, the effect was significantly enhanced.

The enhanced protection is explained by Ignarro with the fact that vitamins E and C are antioxidants that protect NO from being destroyed by oxygen. Thus, the two vitamins ensure, when taken together, a higher NO concentration in the blood vessels. Ignarro declares that what is good for mice – in this regard – is also good for humans!

He recommends exercising moderately and taking dietary supplements if you want to avoid atherosclerosis. Consequences of atherosclerosis is the most common cause of death in the Western world!

By: Vitality Council

 

Reference:
Ignarro L J et al. Long Term Beneficial Effects of Physical Training and Metabolic Treatment on Atherosclerosis in Hypercholesterolemic Mice. PNAS 2004.

www.pnas.org
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Fish Oil is Effective Against Cardiac Arrest (Heart Failure)

Claus Hancke

July 7. 2004

With an interesting study doctors from the University Hospital of München have shown that fish oil may very likely prevent incidents of heart failure considerably.

According to the medical journal The Lancet, a German study can lead the way to using fish oil as a harmless and more savoury alternative to traditional heart medicine.

If cardiac atherosclerosis is the cause of death, then, in every other case, death occurs as unpremeditated cardiac arrest and the person affected will simply fall to the ground. In approximately every other one of these cases, the cardiac arrest is both the first and last symptom of the disease, and a blood clot is often the triggering factor.

In an interesting study, doctors of the Munich University Hospital have demonstrated that fish oil is supposedly to a very lage extent capable of preventing these cases of cardiac arrest. This took place in an experiment with ten patients suffering from heart problems who all had a high risk of dying of their disease and for that reason had had a defibrillator surgically implanted; this device is capable of re-vitalizing the heart if it stops.

The experiment was supposed to examine whether fish oil can protect against the rhythm disturbances that can lead to cardiac arrest and death. All ten patients were predisposed to attacks in which the heart beats with up to 200 beats per minute. This is very often a premonitory symptom of so-called ventricular fibrillation which is the cause of almost all cases of cardiac arrest. In ventricular fibrillation, the cardiac action is transformed into a very fast but weak tremble.

In the German study, the hazardous rhythm disturbances to which the patients were predisposed were stimulated with electrical impulses. As expected, provoking the attacks were an easy task. In three out of the seven, however, they did not succeed, and it turned out that – contrary to the other seven – they were used to eating fish 2 – 3 times a week. The other seven people had triggered attacks which were interrupted by the defibrillator.

The sensational thing about this was that after having been given fish oil as intravenous transfusions, it was impossible to provoke attacks in now five out of the seven patients! Left were only two patients who apparently were not protected by fish oil. Despite the infusion (equalling 12 g. of ordinary fish oil), one of them had a very low blood level of fish oil.

In total, eight out of the ten patients were so effectively protected by fatty fish or fish oil that provoking the deadly attacks in them was impossible. However, this German study is only a pilot study. Larger and more thorough studies must succeed in order for the effect to be considered reliable.

The result matches other findings from very large studies. The most famous one is the Italian GISSI study from 1999; a randomized trial with 10,000 men who had recently survived a cardiac thrombosis. It stated with great certainty that taking fish oil supplements resulted in a total reduction in mortality of 20% and a reduction in the risk of sudden cardiac death of more than 50%.

According to the editorial commentary of the magazine, the German study that was published in The Lancet can lead the way to using fish oil as a safe and more appetizing alternative to traditional heart medicine. First and foremost, fish oil can substantially reduce the danger of having a cardiac thrombosis!

By: Vitality Council

 

References:
1. Albert C. Fish oil – an appetising alternative to anti-arrhytmic drugs? Lancet 2004;363:1412-3.
2. Schrepf R et al. Immediate effects of n-3 fatty acid infusion on the induction of sustained ventricular tachycardia. Lancet 2004;363:1441-2.

www.thelancet.com
www.iom.dk

Feel Safe to Use Ginkgo biloba

Admin

June 24, 2004

A large number of people use this natural remedy on account of its ability to improve memory. This ability has been documented in numerous studies, including British ones. According to the press, the WHO is quoted for having warned against a danger of hemorrhage when Ginkgo biloba is consumed together with anticoagulants.

There are reports of two deaths and a number of non-fatal bleedings from a total of 22 countries. The suspicion is that Ginkgo biloba enhances the effect of the anticoagulants.

Anticoagulants themselves involve a serious risk of internal bleedings, and every year, hundreds of people die as a result of taking anticoagulants. Therefore, without a scientific investigation, it is impossible to know whether it is Ginkgo biloba, the anticoagulants, or solely a combination of both that is responsible.

Every year, several hundred people – in Scandinavia alone – die from this inevitable side effect of anticoagulants, but a great many more are saved by it. The fact that some of the people who have suffered a cerebral haemorrhage have used Ginkgo biloba at the same time, in no way proves that the combination is risky.

More than 30 medicaments in general use can either fortify or weaken the effect of anticoagulants. Both situations can be highly dangerous. Examples of medicine that fortify the effect of anticoagulants are sulpha drugs used against cystitis, a number of antibiotics, and common painkillers like aspirin.

Kale, chicory, spinach, and many other vegetables also affect the treatment. That Ginkgo biloba should affect the treatment, however, has been repudiated in the only serious study performed to date. It is of Danish origin and was published in the Danish Weekly Magazine for Medical practitioners last year.

In a double-blind, randomized trial it was established that neither Ginkgo biloba nor co-enzyme Q10 had any influence on the haemorrhagic tendency in the 24 participants who were all being long-term treated with warfarin which is the most commonly used anticoagulant.

Unfortunately, anticoagulants do involve a risk of internal bleedings. This is unevitable. However, there is nothing to indicate that the this risk should be increased by taking Ginkgo biloba. On the contrary; present knowledge indicates the opposite!

Professor Ralph Edwards of the WHO Monitoring Centre in Uppsala, Sweden, feels abused by the press in this matter, as he says:
“We have NOT warned against Ginkgo biloba. There is no news in the statement of the WHO which is only a press release about new guidelines on information regarding dietary supplements and natural medicine. It is not even very likely that Ginkgo biloba should interact with anticoagulants, but it is common sense not to use a vasodilating supplement together with anticoagulants or in relation to an operation.”

By: Vitality Council

Reference:
Ugeskr Laeger. 2003;4;28;165(18):1868-71. [Effect of Coenzyme Q10 and Ginkgo biloba on warfarin dosage in patients on long-term warfarin treatment. A randomized, double-blind, placebo-controlled cross-over trial].

Also see the original press release of the WHO.

www.dadlnet.dk
www.who.int/mediacentre/news/releases/2004/pr44/en
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Dietary Supplements Reduce the Need for Medicine

Claus Hancke

March 1, 2004

Like nutrition, many supplements have a positive effect on the physiological processes of the body. A new scientific study has shown that Pycnogenol, a substance extracted from pine bark, can lower the blood pressure to such an extent that the need for hypotensive medicine is reduced by 50%.

As is the case with food, a lot of dietary supplements have a positive effect on the body’s physiological processes.

For instance, new scientific research has shown that Pycnogenol can lower the blood pressure to such an extent that the need for hypotensive medicine can be reduced by 50%.

Pycnogenol is an extract of a particular type of pine bark that is found along the French southwest coast. Pycnogenol has the effect of an antioxidant, i.e. it inhibits the damaging processes that contribute to making us ill and grow old before our time.

In recent years, studies have shown that hypertension is responsible for more than 50% of all strokes and heart attacks.

Previous studies have also shown that Pycnogenol has a long line of positive effects on the body’s functions, but the news is that it is capable of lowering the blood pressure as well.

According to a scientific article in Life Sciences (no 74;7:855-862), Professor Rohdewald from Hamburg has made a so-called double-blind, placebo-controlled trial along with colleagues from Beijing in which the trial subjects were given either 100 mg. Pycnogenol or placebo during a period of 12 weeks.

It turned out that Pycnogenol was capable of lowering the blood pressure to such an extent that the amount of hypotensive medicine (Nifedipine) could be reduced by 50% after the 12 weeks.

Socioeconomically, it might open up to interesting perspectives as almost 17 million people in the UK suffer from hypertension which increases the risk of coronary thrombosis, cardiac failure, and stroke.

The hospital expenses for cardiovascular diseases are several billion pounds a year and so are the expenses to heart medicine.

If a dietary supplement like Pycnogenol can reduce this consumption of medicine by 50%, it can turn out to be just as interesting as when Glucosamine was able to reduce the consumption of antirheumatic medicine and the number of operations for arthrosis.

By: Vitality Council

Reference:
Life Sciences 74;7:855-862.

www.els.net/els/public/whatsnew/whatsnew_aboutels.asp
www.iom.dk

Vitamin C and E Protects Children Against Arteriosclerosis

Per Larsen

September 1, 2003

Children and young people with increased cholesterol levels may reduce the risk of developing arteriosclerosis if they take a daily supplement of Vitamin C and E. This is the conclusion of a study published in Circulation, published by the American Heart Association.

15 children and young people of the age of 9 to 20 years were part of this study. Half of the children took a daily 500mg Vitamin C and 400i.e. (international units) Vitamin E supplement. The rest of the children took placebo. After 6 weeks the groups were switched.

After 6 weeks of active treatment the results showed a significant betterment of the inner wall of the artery. Vitamins alone do not reduce increased cholesterol, but the vitamins seem to be able to protect the blood vessels against sclerosis and thereby secure that the arteries remain their elasticity.

“This is the first time anyone has studied how antioxidants like Vitamin C and E can better circulatory function,” says the chairman of the Vitality Council, specialist doctor in general medicine, Claus Hancke.

“Even if it is a small study, the results are important for children with increased cholesterol. If they alternatively must have cholesterol lowering medicine for several years, the risk of serious side effects will be pretty high. It is therefore wise to give priority to diet changes and extra Vitamin C and E supplements as a first choice in therapy,” Claus Hancke says.

The American study also involved diet recommendations, but they did not follow those recommendations. Among other things the children got too much animal fat and too little fruit and vegetables. Therefore the doctors chose to combine the diet changes with Vitamin C and E supplementation.

The study is carried out at the University of California, under the supervision of Marguerite Engler, M.D.

By: Per Tork Larsen, DSOM

Reference:
Circulation 2003;108:802

www.circulationaha.org
www.amhrt.org/presenter.jhtml

New Study Shows that Multivitamins May Reduce the Risk of Heart Attack

Per Larsen

August 1, 2003

People taking low dose multivitamins may reduce the risk of getting heart attacks, say Swedish researchers.

There has been much debate about, whether antioxidants like Vitamins C and E may protect against coronary diseases, as several scientific studies have not yet supported this theory.

But scientific results from the Stockholm Heart Epidemiological Programme (SHEEP) has shown, that both Swedish men and women who took multivitamins had a significant lower risk of getting blood clots in the heart than those who did not take supplements, no matter which diets they were on.

The team of the Swedish Karolinska Institute in Stockholm studied a group of Swedish people between 45 and 70 years old from an area, where the intake of fruit and vegetables is relatively low, and where food products are not enriched with folic acid.

Nearly 1,300 people (910 men and 386 women) earlier having experienced a heart attack were compared (for sex, age and local hospital area) with a control group consisting of 1,685 people (1143 men and 542 women).

According to the scientists in this months’ Journal of Nutrition, 57% of the women and 35% of the men in the control group took supplements; the corresponding cases of heart attacks were 42% and 27%. 80% of these supplements were multivitamin tablets.

After an adjustment for risk factors of heart and coronary disease, the risk of heart attacks were 21% lower for those men taking supplements, compared to the ones who did not. For the women the risk was reduced with 33%.

This observation seems to exclude the theory that vitamins found in fruit and vegetables are more effective than through intake of supplements.

By: Per Tork Larsen, DSOM

Reference:
Journal of Nutrition 133:2650-2654, August 2003.

www.cabi-publishing.org/Journals.asp
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