References
Despite the encouragement to get more active, Americans are more sedentary and overweight now than at any other time in history. The combination of extra fat and lack of exercise is driving up the rate of cardiovascular disease (CVD). While it has been the leading cause of death in the United States since the 1900s, heart-related complications killed almost 1 million Americans in 2002, according to the Centers for Disease Control and Prevention (CDC). The next leading cause of death—cancer—took the lives of just over half that amount.
However, there are many ways people can take charge of their cardiovascular health—by addressing concerns such as high cholesterol, high blood pressure and more. Something as simple as taking a daily multivitamin has been shown to benefit heart health. Researchers at the Cooper Institute in Dallas found in two trials that those participants taking vitamin supplements showed improved LDL (“bad”) cholesterol oxidation.1,2 Follow-up work showed multivitamin use was associated with lower C-reactive protein levels—indicating a decreased risk of CVD.3 A similar trial conducted in Sweden also showed low-dose multivitamin use reduced the risk of heart attack among women by 21 percent and among men by 34 percent.4
Reviews of diet have also shown the impact of different foods and nutrients on heart health. Researchers at Michigan State University, East Lansing, identified a number of dietary patterns linked to CVD risk.5 The “Western pattern,” with a high intake of red meat, high-fat dairy products and processed meat, was associated with higher CVD risk factors, while the “American-healthy pattern,” which features high intakes of vegetables and tea, was inversely associated with those factors. In another study, South Carolina researchers found regional variations in stroke and hypertension rates associated with dietary intake of many vitamins and minerals.6 The highest rate of stroke and hypertension was in the South, which also had the lowest intake of several vitamins (A, C, B6) and minerals (potassium, niacin, magnesium).
Ultimately, recommendations for a heart-healthy diet have promoted intake of omega-3 fatty acids, an abundance of fruits and vegetables, and whole grains as primary carbohydrates.7 Researchers even speculate increasing consumption of vegetables, fruits, nuts and grains (which supply fiber and sterols) could correct the lipid abnormalities associated with contemporary eating patterns.8
Consumers are learning about the benefits of these heart-healthy eating patterns, as well as the specific phytonutrients that may be associated with reducing CVD risk factors. Canadian researchers reported results from a multicenter study that use of complementary and alternative medicine (CAM) was widespread among cardiac patients.9 The most commonly used products were vitamins C, E and B; calcium; garlic; and cayenne pepper. In the United States, consumers are also incorporating heart-healthy nutrients into their daily regime. The market research firm SPINS/ACNielsen reported a 2.5-percent increase (52 weeks ended Oct. 4, 2003) in spending on supplements supporting cardiovascular health. Specific ingredients that posted increased sales were calcium, L-carnitine, coenzyme Q10 (CoQ10) and grapeseed extract.
Grapeseed extract and CoQ10 are only two of the many antioxidants studied for promoting heart health. Other studies have examined the role of antioxidants in reducing CVD risk factors. It is suggested antioxidants prevent the oxidation of LDL cholesterol, which is linked to atherosclerosis, thus preventing events such as myocardial infarction (heart attack) and stroke. While increased consumption of antioxidant-rich fruits and vegetables has been shown to help cardiovascular health,10 large-scale studies of supplementation have not been as definitive. A research review out of the University of Florida, Gainesville, found clinical studies support targeted antioxidant intake for CVD prevention.11 However, two meta-analyses of antioxidant studies did not show a consistent beneficial effect on heart health, leading the authors to suggest future studies are needed to clarify the role of antioxidants in heart health.12, 13
Recent clinical trials have shown positive results for antioxidants such as vitamin C and vitamin E. One such study, from Shiraz University, Iran, investigated the effects of vitamin C and E in combination and individually on cholesterol levels.14 The researchers found the combination and individual supplementation lowered total cholesterol and LDL levels, while raising serum HDL (“good”) cholesterol levels. The ability of vitamin C to further protect against oxidation was shown in a study out of Midwestern University, Chicago, which found vitamin C protected LDL against oxidation in vitro.15
Vitamin E has also been the independent subject of many trials investigating its ability to help the heart. One population-based study in Naples, Italy, found an inverse association between vitamin E intake and atherosclerosis; women with the lowest intake of vitamin E had the highest occurrence of atherosclerotic plaques and high cholesterol.16 In clinical trials, vitamin E (as alpha-tocopherol) has been shown to improve the blood pressure status of mildly hypertensive patients.17 It may also reduce the oxidation of LDL cholesterol, though the reduction was not shown to change atherosclerosis incidence.18
“The totality of evidence supports the preventive role of vitamin E when taken over the long term,” said Cindy Schweitzer, Ph.D., senior scientist with La Grange, Ill.-based Cognis Nutrition & Health, a supplier of natural source vitamin E and mixed tocopherols. “Leading researchers would agree that vitamin E is not a magic bullet capable of reversing pre-existing health conditions and disease, especially in high-risk patients.”
This jibes with several recent research reviews questioning the role of alpha-tocopherol in CVD prevention. One such review, from Brigham & Women’s Hospital in Boston, noted that even while trials have demonstrated little benefit, supplementation may still be useful in some cases, particularly for patients with nutritional deficiencies.19 However, the researchers noted there was not enough evidence to recommend consumers take vitamin E to prevent CVD. Similarly, a review from the University of Pennsylvania, Philadelphia, noted while there are many trials now failing to show a benefit of vitamin E supplementation, there may be an explanation—variability in dosage or patient selection, for example.20 Industry members have suggested it is not only dosage but the type of vitamin E used; since most trials have used isolated alpha-tocopherol rather than the full eight isomers of natural vitamin E (alpha-, beta-, gamma- and delta-tocopherol and the corresponding tocotrienols).
“The real problem with those studies may have been that alphatocopherol does not in itself provide the right vitamin E activity and protection for the heart,” said W.H. Leong, vice president of Edison, N.J.-based Carotech Inc., supplier of a full-spectrum vitamin E complex. “When one considers all the heart-protective properties of the other vitamin E family members—cholesterol lowering, reversal of arterial blockage, inhibition of platelet aggregation, etc.—one might expect that alpha-tocopherol alone is not going to be the heart’s cureall many people expect it to be.”
Findings from studies have supported this idea. Researchers in Sweden compared a mixed tocopherol preparation to alphatocopherol alone in platelet aggregation and found mixed tocopherols significantly reduced aggregation, while alpha-tocopherol had no effect.21 And research conducted at the University of North Carolina, Chapel Hill, found mice predisposed to CVD that were given palm tocotrienol complex (as Tocomin® from Carotech) had significantly smaller atherosclerotic lesions and lower plasma cholesterol levels compared to control mice.22
Vitamins don’t only work as antioxidants. The B vitamins have been extensively researched for their role in CVD. Researchers at the Harvard School of Public Health found a strong inverse association between folic acid and peripheral arterial disease, as well as weak associations for overall heart health with vitamin B6 and vitamin B12.23 The most popular theory as to how B vitamins impact heart health is that they reduce levels of homocysteine, an amino acid that may increase the risk of heart disease. Folic acid in particular has been shown to lower plasma homocysteine levels by approximately 25 percent.24 This effect led researchers at the Taichung Veterans General Hospital in China to suggest using folate as a routine supplement for individuals with risk factors for coronary artery disease (CAD), even if they show adequate folate status.25
Another B vitamin linked to heart health is niacin. In fact, researchers from the University of California at Irvine noted niacin is “the most effective medication in current clinical use for increasing [HDL] cholesterol.”26 Clinical research combining niacin and simvastatin (a cholesterol-lowering drug) showed significant benefits in patients with coronary disease and low HDL levels.27 Niacin has also been shown to protect the heart during myocardial infarction, possibly by preserving glycolysis and improving the recovery of the myocardium.28
Pantethine, also known as vitamin B5, has been studied for its ability to treat hyperlipidemia. A derivative of pantothenic acid, pantethine is converted to coenzyme A in the body. It has been reported to be effective at improving abnormal lipid profiles in both adults and children. Particularly, it lowers elevated triglycerides and LDL cholesterol while raising levels of beneficial HDL cholesterol, and is used for treatment of hyperlipidemia as a pharmaceutical in Japan, primarily by Daiichi Pharmaceutical (which sells its Pantesin™ pantethine through Vernon Hills, Ill.-based Daiichi Fine Chemicals). A recent review noted pantethine’s efficacy as a hypolipidemic agent may be attributed to its ability to inhibit liver acetyl-CoA carboxylase, offering possible opportunities in the treatment of obesity.29
Two vitamin-like compounds have also shown promise in the area of cardiovascular wellness. The first is CoQ10, which works to both regenerate vitamin E and to contribute its own antioxidant qualities.30 A review of CoQ10/CVD studies conducted at Virginia Commonwealth University, Richmond, found oral CoQ10 appeared to have positive effects on chronic heart failure (CHF), angina and hypertension, and that the therapy was well tolerated.31 The researchers suggested it be used as a complementary therapy for patients with CHF. And a clinical trial conducted at the Department of Veterans Affairs Medical Center in Boise, Idaho, found 60 mg/d of CoQ10 significantly reduced systolic blood pressure in patients with systolic hypertension.32
The second vitamin-like compound is L-carnitine, a nutrient that is naturally present in the human body. “L-carnitine’s physiological role is in facilitating fat breakdown, with the ultimate production of energy,” explained Paula Gaynor, Ph.D., associate director of nutrition for Fair Lawn, N.J.-based Lonza Inc., which supplies L-Carnipure®.“ High concentrations of L-carnitine are found in the heart, and scientists believe the heart actually depends on L-carnitine for most of its energy production. Also, L-carnitine supplementation can be beneficial even after certain cardiovascular conditions have developed.”
A review out of Temple University Medical Center, Philadelphia, stated L-carnitine therapy may assist in treating congestive heart failure, arrhythmia, peripheral vascular disease and acute ischemia.33 A study of the effects of L-carnitine on ischemic rat hearts showed L-carnitine promoted post ischemic ventricular recovery.34 And L-carnitine’s ability to reduce plasma lipoprotein levels was demonstrated in a clinical trial conducted at the University of Milan, Italy.35 Patients with elevated lipoprotein (a) levels who received 2 g/d of L-carnitine had significant reductions in their lipoprotein (a) levels; it was also well tolerated with no major side effects.
Vitamins are not the only basic nutrients with the ability to impact CVD. A review out of the University of Helsinki, Finland, noted minerals such as magnesium, selenium and calcium can help lower blood pressure and positively effect the blood lipid profile.36 Magnesium deficiency plays a role in ischemic heart disease, congestive heart failure, atherosclerosis and blood vessel constriction, according to a research review from the University of Kalyani, India.37 Additional reviews have suggested magnesium deficiency increases LDL concentration and oxidation,38 and causes an immuno-inflammatory reaction.39
Selenium also aids in heart health. Animal research out of France indicated a seleniumenriched diet could improve the prognosis of CVD in elderly patients by improving heart recovery after a heart attack and increasing the body’s own antioxidant defenses.40 And calcium has been shown to lower blood pressure and benefit serum lipid levels.41 In addition, calcium can improve the health of the blood vessels by reducing plasma total cholesterol and improving the HDL-to-LDL ratio.42
Another mineral that may benefit cardiovascular health is chromium. Chromium supplementation improves high cholesterol and dyslipidemia, and may reduce the risk of early onset CHD by offsetting associated complications, according to Vijaya Juturu and James Komorowski of Purchase, N.Y.-based Nutrition 21, who presented research on this subject at Experimental Biology 2002.43 The company’s patented chromium picolinate (Chromax®) was found in animal research to reduce plasma total cholesterol and increase HDL in obese rats, compared to controls.44
Another form of chromium, niacin-bound chromium (also called chromium nicotinate or chromium polynicotinate), has been shown to lower blood pressure, decrease lipid peroxidation and lower total and LDL cholesterol. An animal study indicated niacin-bound chromium prevented a sugar-induced elevation of blood pressure in an animal model of hypertension.45 And niacin-bound chromium (as ChromeMate® from Benicia, Calif.-based InterHealth Nutraceuticals) was shown to lower serum cholesterol by an average of 14 percent in young males with moderate cholesterol levels.46
Beyond the basic vitamins and minerals, some macronutrients have also shown promising research in helping boost heart health. For example, the quantity and type of fat in the diet is an important consideration. A research review from Tufts University in Boston considered the issue of quantity or quality in the relationship between dietary fat and cardiovascular disease risk.47 “A diet low in saturated and trans-fatty acids, with adequate amounts of monounsaturated and polyunsaturated fatty acids—especially long-chain omega-3 fatty acids— would be recommended to reduce the risk of developing CHD,” it noted.
The specific mention of omega-3 fatty acids comes as no surprise. Even the Bush Administration has requested Health and Human Services (HHS) promote omega-3 consumption in its 2005 Dietary Guidelines for Americans. The evidence backs up the recommendation. An Italian review article noted early Eskimo and Japanese population studies indicated omega-3 intake was associated with low mortality from CHD, and tracked the population studies into intervention protocols such as the GISSI-Prevenzione study.48 The review noted GISSI found 1 g/d of omega- 3 fatty acids significantly decreased the risk of cardiovascular disease and death. Follow-up clinical research on the GISSI patients further supported the effect of 1 g/d of omega-3 fatty acids on sudden death, and suggested it was due to an anti-arrhythmic effect.49
Another study, this one at the University of Guelph, Canada, investigated the effects of fish oil concentrate on risk factors for cardiovascular disease in postmenopausal women.50 Researchers gave 36 postmenopausal women placebo or fish oil supplements delivering 2.4 g eicosapentaenoic acid (EPA) and 1.6 g docosahexaenoic acid (DHA) daily (supplied by Pronova Biocare). The researchers found postmenopausal women could reduce their risk of CHD by 27 percent by supplementing with a fish-oil-derived concentrate.
Fish oil is not the only fat being investigated for its cardiovascular effects; plant sterols (phytosterols) are a class of fat-like compounds with chemical structures similar to cholesterol. A November 2003 VERIS summary, produced by Cognis Nutrition & Health, discussed the history of phytosterols and heart health. The compounds achieved GRAS (generally recognized as safe) status in the late 1990s, and were the subject of a health claim from the Food and Drug Administration (FDA) in 2000, recognizing their ability to reduce the risk of heart disease by lowering cholesterol levels. It is suggested they do this by reducing absorption of dietary cholesterol and endogenous cholesterol produced by the body.
“Sterol esters offer a safe and convenient dietary means for maintaining normal cholesterol levels for people with modestly elevated cholesterol levels,” Schweitzer said. “And because sterol esters reduce cholesterol through a different mechanism than statin drugs, they can work in a complementary manner with these drugs.” Cognis produces VEGAPURE® vegetable sterol esters, which can be used in softgels, drink mixes and nutrition bars.
A review from the University of Maastricht, The Netherlands, noted that foods containing plant sterol or stanol esters could be useful for lowering cholesterol by decreasing cholesterol absorption.51 The researchers added that studies have shown plant sterols may decrease development of atherosclerotic lesions. Nonesterified plant sterols may also have these effects, according to a clinical trial from Helsinki University Central Hospital in Finland.52 Patients receiving low-fat foods containing natural nonesterified plant sterols plus minerals to lower blood pressure had both lowered cholesterol concentrations and lower blood pressure.
Another macronutrient of interest in the cardiovascular field is fiber. The American Dietetic Association issued a position paper in 2002 urging consumers to increase consumption of dietary fiber, including fruits, vegetables, whole grains and legumes.53 Fiber may act through a variety of mechanisms— including lowering blood cholesterol and triglycerides, decreasing blood pressure and normalizing postprandial blood glucose levels—as noted by researchers at Texas A&M University in College Station.54
Population studies support the association. A study of 9,776 adults examined CHD and CVD cases, and found higher intakes of dietary fiber—particularly water-soluble fiber—significantly reduced the risk of CHD.55 Another study, this one conducted at the University of Southern California, Los Angeles, found the intake of water-soluble fiber protected participants against atherosclerotic progression.56 And a study of 3,588 elderly men and women at the University of Washington, Seattle, found a significant association between increased cereal fiber consumption and decreased CVD.57
These population findings are supported by clinical studies backing FDA’s decision to approve health claims for intake of dietary fiber (4 servings/d) and reduced risk of CVD. For example, in one study at St. Michael’s Hospital, Toronto, hyperlipidemic adults on a high-fiber diet had reduced total cholesterol and lipoprotein, and an improved HDL-to-LDL ratio.58 While the researchers noted the decrease was relatively small in terms of treatment, “the reduction in cardiovascular disease risk is likely to be significant on a population basis.”
Fruits and vegetables are not only major dietary sources of fiber, but also contribute nutrients such as carotenoids and flavonoids that have their own impact on heart health. Studies have investigated the effects of whole vegetables; for example, French researchers found carrot consumption modifies cholesterol absorption and increases antioxidant status in the blood.59 Tomatoes have been a particular focus of cardiovascular research. One review from North Carolina State University, Raleigh, noted the array of nutrients—lycopene, folate, potassium, flavonoids, etc.—may function in concert to protect lipoproteins from oxidation, reduce LDL cholesterol and lower blood pressure.60
The combination of tomato phytochemicals may be behind its beneficial effects. Researchers at Ben Gurion University in Israel conducted a trial using a tomato complex (as Lyc-O-Mato® from Beer Sheva, Israel-based LycoRed Natural Products) and found the 30 hypertensive patients taking the supplement experienced reductions in systolic and diastolic blood pressure. Additional research with Lyc-O-Mato showed the complex rendered LDL particles 90-percent more resistant to oxidation than LDL alone.
Serum and tissue lycopene levels have been found to be inversely related with CVD risk.61 A study of plasma lycopene and risk of CVD in middle-aged women found higher plasma lycopene concentrations were associated with a lower risk of CVD.62 Other carotenoids may also contribute to a lower risk of CVD, according to researchers at the University of Southern California.63 Their study found in a cohort of 573 participants, higher levels of lutein, zeaxanthin, beta-cryptoxanthin and alpha-carotene were protective against development of atherosclerosis.
Like carotenoids, phenols are antioxidant plant pigments that may offer humans cardiovascular benefits. A review from The Alfred Hospital and Baker Heart Research Institute in Australia noted epidemiological studies have demonstrated a strong link between phenolic intake and reduced cardiovascular risk, particularly for flavonoids and endothelial function.64 Flavonoids are found in a range of fruits and vegetables, and they may work in several ways: inhibiting LDL oxidation, reducing thrombosis, improving endothelial function and decreasing inflammation.65
Recent news about flavonoids includes last year’s reports about chocolate and heart health. A research review from the University of California, Davis, noted the flavonoids in dark chocolate do offer antioxidant protection and modulate vascular function.66 Another study indicated both cocoa and tea are rich sources of flavonoids, exhibiting strong antioxidant properties and reducing platelet reactivity.67
Tea has been more extensively studied, as it is one of the primary sources of flavonoids for most people around the world. Data from the Rotterdam Study—a population-based study of more than 4,800 men and women—indicate an increased intake of tea and flavonoids may prevent ischemic heart disease.68 Another study found that patients hospitalized for myocardial infarction had lower mortality after the event if they were tea drinkers before it occurred.69
Both black and green teas appear to benefit cardiovascular health. A study from the WHO Collaborating Center for Research on Primary Prevention of Cardiovascular Diseases in Kyoto, Japan, examined the effects of black and green tea on blood pressure in hypertensive rats.70 The polyphenols from both types of tea prevented blood pressure increases through antioxidant properties. Independently, black tea has been shown to work by improving vasodilator function of conduit arteries,71 while green tea polyphenols may both improve vasodilator function,72 and reduce cholesterol and triglyceride levels.73
A flavonoid extract of French maritime pine bark is also known to exhibit antioxidant effects. Researchers at the University of California, Davis, assigned 25 healthy subjects to take 150 mg/d of the extract (as Pycnogenol®, from Natural Health Science) for six weeks, at which point the volunteers exhibited significant increases in antioxidant capacity and HDL cholesterol, and decreases in LDL cholesterol.74 A research review of Pycnogenol indicated in addition to its antioxidant properties, Pycnogenol demonstrated antiinflammatory and immunomodulatory activities.75
The flavonoids found in grapes and grape products—such as red wine—also seem to offer antioxidant protection against CVD. Research out of the University of Wisconsin Medical School in Madison indicated the flavonoids in grape juice and red wine may inhibit atherosclerosis through one of several mechanisms, such as antiplatelet action, antioxidant properties or improved endothelial function.76 And researchers at the University of Padova in Italy found wine could prevent atherosclerotic lesions even in patients with high cholesterol.77
Whether as red wine, grape juice or grapeseed extract, the polyphenols from grape seeds and skins benefit cardiovascular health, according to researchers from the University of South Florida, Tampa, who found each one offers a range of compounds that are beneficial to heart health.78 Studies on grapeseed extract have shown positive results. One study at the University of Scranton used MegaNatural® Gold (from Polyphenolics) in human subjects, and found patients with high cholesterol taking grapeseed extract showed significant decreases in cholesterol concentrations after treatment.79 Another study, this one from the University of Connecticut, Farmington, used ActiVin® (from San Joaquin Valley Concentrates) in human volunteers and found 100 mg/d of grapeseed extract reduced inflammatory response and oxidative stress in patients with systemic sclerosis.80
In addition to its polyphenol content, grape skin also contains the phytoestrogenic compound resveratrol. A research review from Creighton University School of Pharmacy in Omaha, Neb., noted resveratrol has cardioprotective properties.81 The review addressed Protykin®, a standardized extract of trans-resveratrol from Polygonum cuspidatum (available from InterHealth), and its ability to reduce reactive oxygen species in the ischemic myocardium. A study of Protykin found the extract reduced infarct size and improved postischemic blood flow in rats.82
Phytoestrogens are found in many natural products, and the isoflavones found in soy have been particularly investigated in the cardiovascular area. While researchers at McGill University in Quebec stated there is not enough data to recommend isoflavone supplements for reducing plasma cholesterol,83 animal research conducted at Oklahoma State University, Stillwater, showed soy isoflavones prevented hypercholesterolemia and the formation of atherosclerotic lesions induced by estrogen deficiency.84
Soy protein, also, has very positive research linking it to heart health. A review from Wake Forest University in Winston-Salem, N.C., noted dietary soy protein has several beneficial effects on cardiovascular health, including reducing LDL cholesterol, increasing HDL cholesterol and improving vasodilation.85 A combination of isoflavones and soy protein appears beneficial, as a clinical study from the University of California found women taking 25 g/d of soy protein with isoflavones showed positive vascular effects independent of the lipid and antioxidant effects usually linked to just soy.86 However, soyfood intake in general appears beneficial, as the Shanghai Women’s Health Study (a cohort of 75,000 Chinese women) revealed women in the highest quartile of soyfood intake exhibited a clear reduction in CHD risk compared to women in the lowest quartile.87
Garlic also has shown the ability to positively impact the body. A review out of the All India Institute of Medical Sciences in New Delhi noted garlic may serve as a preventive and treatment agent for atherosclerosis, hyperlipidemia, thrombosis and hypertension.88 Similarly, a review from Liverpool John Moores University in England suggested it is garlic’s antioxidant properties that may help prevent CVD, inhibit platelet aggregation and prevent thrombus formation.89 The idea is supported by such studies as an in vitro study in Taiwan that found the organosulfur compounds derived from garlic were found to protect LDL against oxidation and glycation.90
Garlic is not the only botanical compound known to be efficacious against CVD. In fact, Ayurvedic botanicals are increasingly being studied for their application in this field. “The process of narrowing arteries with deposited plaque material was observed 2,000 years ago by Ayurveda scholar Caraka Samhita,” said Vladimir Badmaev, M.D., Ph.D., vice president of medical and scientific affairs at Sabinsa Corp. The company has pioneered investigation into traditionally used Ayurvedic remedies. For example, Sabinsa worked with the University of Pennsylvania in 2000 on protocol for an IND clinical study of standardized natural sterol compounds isolated from the amber-like resin from the Commiphora mukul tree. The 2.5-percent E- and Z-guggulsterone preparation known as Gugulipid® has been the subject of shortterm safety and efficacy studies that convinced FDA to extend IND approval for a follow-up clinical study to further investigate Gugulipid’s hypolipidemic and systemic effects.
Badmaev has also investigated Tibetan medical treatments for cardiovascular conditions, and—with five generations of physicians in the Badmaev family—developed a botanical formula Badmaev No. 28 (sold as Adaptrin®). The formula has been investigated for its effects in peripheral vascular disease (PVD). One study reviewed the research on Adaptrin and noted it may increase the threshold for platelet aggregation, lower total blood cholesterol and LDL levels, increase HDL levels and prevent lipid peroxidation.91
Himalaya USA has also conducted extensive research on its proprietary Ayurvedic formula, HeartCare®. The product includes arjuna (Terminalia arjuna), which nurtures the cells of the heart muscle and arteries; billilotan (Nepeta hindostana), a traditional cardiovascular metabolism tonic; gotu kola (Centella asiatica), which increases collagen production; Ashwagandha (Withania somnifera), a rejuvenative tonic; and Bishop’s weed (Carum copticum), to help regulate blood pressure and nurture the heart muscle. “HeartCare contains additional herbs that work synergistically to optimize cardiovascular health,” added Grace Ormstein, M.D., scientific advisor to Houston-based Himalaya USA. “Herbs in perfect combination are often more powerful than single ingredients. Formulations also help increase assimilation and effectiveness.”
Clinical studies have shown HeartCare is effective in regulating heart wall thickness and blood pressure. One recent double blind study showed a reduction in cholesterol and triglycerides with an increase in HDL levels.92 Ormstein said retailers looking to assist customers in promoting heart health are turning to more clinically supported products. “As customers become more educated and confident in natural health approaches, we expect to see further growth in the purchasing of scientifically backed, cardiotonic herbal formulas,” she said.
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