| | | | Other Names | | | Atherosclerosis, Hardening of the Arteries, Hardened Arteries.
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| | | Arteriosclerosis / Atherosclerosis, or hardening of the arteries,
is a very common disease of the major blood vessels. It is characterized
by fatty streaks along the vessel walls and by deposits of cholesterol and
calcium. Atherosclerosis of arteries supplying the heart is called
coronary artery disease. It can restrict the flow of blood to the heart,
which often triggers heart attacks-the leading cause of death in Americans
and Europeans. Atherosclerosis of the arteries supplying the legs causes a
condition called intermittent claudication.
People with elevated
cholesterol levels are much more likely to have atherosclerosis than
people with low cholesterol levels. Many important nutritional approaches
to protecting against atherosclerosis are aimed at lowering serum
cholesterol levels.
People with diabetes are also at very high risk
for atherosclerosis, as are people with elevated triglycerides and high
homocysteine.
What are the symptoms of atherosclerosis?
Atherosclerosis is typically a silent disease until one of the many
late-stage vascular manifestations intervenes. Some people with
atherosclerosis may experience angina (chest pain) or intermittent
claudication (leg cramps and pain) on exertion. Symptoms such as these
develop gradually as the disease progresses.
Conventional
Treatment Options: Prevention is the highest form of treatment for
atherosclerosis. Once the disease is established, treatment is directed at
the various complications (i.e., angina, heart attacks, heart failure,
stroke, kidney failure, and peripheral vascular disease).
Dietary
changes that may be helpful: The most important dietary changes in
protecting arteries from atherosclerosis include avoiding meat and dairy
fat and avoiding foods that contain trans fatty acids (margarine, some
vegetable oils, and many processed foods containing vegetable oils).
Increasingly, the importance of avoiding trans fatty acids is being
accepted by the scientific community. Leading researchers have recently
begun to view the evidence linking trans fatty acids to markers for heart
disease as "unequivocal."
People who eat diets high in
alpha-linolenic acid (ALA), which is found in canola and flaxseed oils,
have higher blood levels of omega-3 fatty acids than those consuming lower
amounts, which may confer some protection against atherosclerosis. In
1994, researchers conducted a study in people with a history of heart
disease, using what they called the "Mediterranean" diet. The
diet differed significantly from what people from Mediterranean countries
actually eat, in that it contained little olive oil. Instead, the diet
included a special margarine high in ALA. Those people assigned to the
Mediterranean diet had a remarkable 70% reduced risk of dying from heart
disease compared with the control group during the first 27 months.
Similar results were also confirmed after almost four years. The diet was
high in beans and peas, fish, fruit, vegetables, bread, and cereals, and
low in meat, dairy fat, and eggs. Although the authors believe that the
high ALA content of the diet was partly responsible for the surprising
outcome, other aspects of the diet may have been partly or even totally
responsible for decreased death rates. Therefore, the success of the
Mediterranean diet does not prove that ALA protects against heart
disease.
A systematic review of 20 years of research evaluated the
association between dietary fiber and coronary heart disease. The
meta-analysis portion of this review showed that regular whole grain foods
are associated with a coronary heart disease risk reduction of about 26%.
In general, the fibers most linked to the reduction of cholesterol levels
are found in oats, psyllium seeds, fruit (pectin) and beans (guar gum). An
analysis of many soluble fiber trials proves that a cholesterol lowering
effect exists, but the amount the cholesterol falls is quite modest. For
unknown reasons, however, diets higher in insoluble fiber (found in whole
grains and vegetables and mostly unrelated to cholesterol levels) have
been reported to correlate better with protection against heart disease in
both men and women. Some trials have used 20 grams of additional fiber per
day for several months to successfully lower
cholesterol.
Independent of their action on serum cholesterol,
foods that contain high amounts of cholesterol-mostly egg yolks-can induce
atherosclerosis. It makes sense to reduce the intake of egg yolks.
However, eating eggs does not increase serum cholesterol as much as eating
saturated fat, and eggs may not increase serum cholesterol at all if the
overall diet is low in fat. A decrease in atherosclerosis resulting from a
pure vegetarian diet (no meat, poultry, dairy or eggs), combined with
exercise and stress reduction, has been proven by controlled medical
research.
Preliminary evidence has suggested that excessive salt
consumption is a risk factor for heart disease and death from heart
disease in overweight people. Controlled trials are needed to confirm
these observations.
Eating a diet high in refined carbohydrates
(e.g., white flour, white rice, simple sugars) appears to increase the
risk of coronary heart disease, and thus of heart attacks, especially in
overweight women. However, controlled trials of reducing refined
carbohydrate intake to prevent heart disease have not been attempted to
confirm these preliminary findings.
Lifestyle changes that may
be helpful: Virtually all doctors acknowledge the abundant evidence
that smoking is directly linked to atherosclerosis and heart disease.
Quitting smoking protects many people from atherosclerosis and heart
disease, and is a critical step in the process of disease
prevention.
Obesity, type A behavior (time conscious, impatient,
and aggressive), stress, and sedentary lifestyle are all associated with
an increased risk of atherosclerosis; interventions designed to change
these risk factors are linked to protection from this
condition.
Aggressive verbal or physical responses when angry have
been consistently related to coronary atherosclerosis in numerous
preliminary studies. A low level of social support, especially when
combined with a high level of outwardly expressed anger has also been
associated with accelerated progression of corona
atherosclerosis.
Nutritional supplements that may be
helpful: Tocotrienols may offer protection against atherosclerosis by
preventing oxidative damage to LDL cholesterol. In a double-blind trial in
people with severe atherosclerosis of the carotid artery-the main artery
supplying blood to the head-tocotrienol administration (200 mg per day)
reduced the level of lipid peroxides in the blood. Moreover, people
receiving tocotrienols for 12 months had significantly more protection
against atherosclerosis progression, and in some cases reductions in the
size of their atherosclerotic plaques, compared with those taking a
placebo.
Supplementation with fish oil, rich in omega-3 fatty
acids, has been associated with favorable changes in various risk factors
for atherosclerosis and heart disease in some, but not all, studies. A
double-blind trial showed that people with atherosclerosis who took fish
oil (6 grams per day for 3 months and then 3 grams a day for 21 months)
had significant regression of atherosclerotic plaques and a decrease in
cardiovascular events (e.g., heart attack and stroke) compared with those
who did not take fish oil. These results contradict the findings of an
earlier controlled trial in which fish oil supplementation for two years
(6 grams per day) did not promote major favorable changes in the diameter
of atherosclerotic coronary arteries.
In some studies, people who
consumed more selenium in their diet had a lower risk of heart disease. In
one double-blind report, people who had already had one heart attack were
given 100 mcg of selenium per day or placebo for six months. At the end of
the trial, there were four deaths from heart disease in the placebo group
but none in the selenium group; however, the number of people was too
small for this difference to be statistically significant. Some doctors
recommend that people with atherosclerosis supplement with 100-200 mcg of
selenium per day.
Experimentally increasing homocysteine levels in
humans has led to temporary dysfunction of the cells lining blood vessels.
Researchers are concerned this dysfunction may be linked to
atherosclerosis and heart disease. Vitamin C has been reported in one
controlled study to reverse the dysfunction caused by increases in
homocysteine. Vitamin C also protects LDL.
Despite the protective
mechanisms attributed to vitamin C, some research has been unable to link
vitamin C intake to protection against heart disease. These negative
trials have mostly been conducted using people who consume 90 mg of
vitamin C per day or more-a level beyond which further protection of LDL
may not occur. Studies of people who eat foods containing lower amounts of
vitamin C have been able to show a link between dietary vitamin C and
protection from heart disease. Therefore, leading vitamin C researchers
have begun to suggest that vitamin C may be important in preventing heart
disease, but only up to 100-200 mg of intake per day. In a double-blind
trial, supplementation with 250 mg of timed-release vitamin C twice daily
for three years resulted in a 15% reduction in the progression of
atherosclerosis, compared with placebo. Many doctors suggest that people
take vitamin C-often 1 gram per day-despite the fact that research does
not yet support levels higher than 500 mg per day.
Vitamin E is an
antioxidant that serves to protect LDL from oxidative damage and has been
linked to prevention of heart disease in double-blind research. Many
doctors recommend 400-800 IU of vitamin E per day to lower the risk of
atherosclerosis and heart attacks. However, some leading researchers
suggest taking only 100-200 IU per day, as studies that have explored the
long-term effects of different supplemental levels suggest no further
benefit beyond that amount, and research reporting positive effects with
400-800 IU per day have not investigated the effects of lower intakes. In
a double-blind trial, people with high cholesterol who took 136 IU of
natural vitamin E per day for three years had 10% less progression of
atherosclerosis compared with those taking placebo.
Blood levels of
an amino acid called homocysteine have been linked to atherosclerosis and
heart disease in most research, though uncertainty remains about whether
elevated homocysteine actually causes heart disease. Although some reports
have found associations between homocysteine levels and dietary factors,
such as coffee and protein intakes, evidence linking specific foods to
homocysteine remains preliminary. Higher blood levels of vitamin B6,
vitamin B12, and folic acid are associated with low levels of homocysteine
and supplementing with these vitamins lowers homocysteine
levels.
While several trials have consistently shown that B6, B12,
and folic acid lower homocysteine, the amounts used vary from study to
study. Many doctors recommend 50 mg of vitamin B6, 100-300 mcg of vitamin
B12, and 500-800 mcg of folic acid. Even researchers finding only
inconsistent links between homocysteine and heart disease have
acknowledged that a B vitamin might offer protection against heart disease
independent of the homocysteine-lowering effect. In one trial, people with
normal homocysteine levels had demonstrable reversal of atherosclerosis
when supplementing B vitamins (2.5 mg folic acid, 25 mg vitamin B6, and
250 mcg of vitamin B12 per day).
For the few cases in which vitamin
B6, vitamin B12, and folic acid fail to normalize homocysteine, adding 6
grams per day of betaine (trimethylglycine) may be effective. Of these
four supplements, folic acid appears to be the most important. Attempts to
lower homocysteine by simply changing the diet rather than by using
vitamin supplements have not been successful.
Quercetin, a
flavonoid, protects LDL cholesterol from damage. While several preliminary
studies have found that eating foods high in quercetin lowers the risk of
heart disease, the research on this subject is not always consistent, and
some research finds no protective link. Quercetin is found in apples,
onions, black tea, and as a supplement. In some studies, dietary amounts
linked to protection from heart disease are as low as 35 mg per
day.
Though low levels (2 grams per day) of evening primrose oil
appear to be without action, 3-4 grams per day have lowered cholesterol in
double-blind research. Lowering cholesterol levels should in turn reduce
the risk of atherosclerosis.
Preliminary research shows that
chondroitin sulfate may prevent atherosclerosis in animals and humans and
may also prevent heart attacks in people who already have atherosclerosis.
However, further research is needed to determine the value of chondroitin
sulfate supplements for preventing or treating
atherosclerosis.
Preliminary studies have found that people who
drink red wine, which contains resveratrol, are at lower risk of death
from heart disease. Because of its antioxidant activity and its effect on
platelets, some researchers believe that resveratrol is the protective
agent in red wine. Resveratrol research remains very preliminary, however,
and as yet there is no evidence that the amounts found in supplements help
prevent atherosclerosis in humans.
In 1992, a Finnish study found a
strong link between unnecessary exposure to iron and increased risk for
heart disease. Since then many studies have not found that link, though
perhaps an equal number have been able to confirm the outcome of the
original report. One 1999 analysis of 12 studies looking at iron status
and heart disease found no overall relationship, though another 1999
analysis of published studies came to a different conclusion. While the
effect of unnecessary exposure to iron, including iron supplements, on the
risk of heart disease remains unclear, there is no benefit in
supplementing iron in the absence of a diagnosed deficiency.
The
carotenoid, lycopene, has been found to be low in the blood of people with
atherosclerosis, particularly if they are smokers. Although no association
between atherosclerosis and blood level of any other carotenoid (e.g.,
beta-carotene) was found, the results of this study suggested a protective
role for lycopene. Lycopene is present in high amounts in
tomatoes.
Are there any side effects or interactions? Refer
to the individual supplement for information about any side effects or
interactions.
Herbs that may be helpful: Many actions
associated with herbal supplements may help prevent or potentially
alleviate atherosclerosis. Herbs such as garlic and ginkgo appear to
directly affect the hardened arteries by multiple mechanisms. Herbs such
as psyllium, guggul, and fenugreek reduce cholesterol and other lipid
levels in the blood-known risk factors for hardened arteries. A related
group are herbs, including green tea, prevents the oxidation of
cholesterol, an important step in protecting against atherosclerosis.
Finally, there are herbs such as ginger and turmeric that reduce excessive
stickiness of platelets, thereby reducing
atherosclerosis.
Garlic - Directly
anti-atherosclerotic
Fenugreek, garlic, guggul, psyllium -
Cholesterol-lowering
Green tea - Block oxidation of
cholesterol
Garlic, ginger, ginkgo, peony, turmeric -
Decrease excessive platelet stickiness
Butcher's broom,
rosemary - Traditionally considered circulatory
stimulant
Garlic has been shown to prevent atherosclerosis in a
four-year double-blind trial.88 The preparation used, standardized for
0.6% allicin content, provided 900 mg of standardized garlic powder per
day. The people in this trial were 50 to 80 years old, and the benefits
were most notable in women. This trial points to the long-term benefits of
garlic to both prevent and possibly slow the progression of
atherosclerosis in people at risk.
Garlic has also lowered
cholesterol levels in double-blind research, though more recently, some
double-blind trials have not found garlic to be effective. Some of the
negative trials have flaws in their design. Nonetheless, the relationship
between garlic and cholesterol-lowering is somewhat unclear.
Garlic
has also been shown to prevent excessive platelet adhesion in humans.
Allicin, often considered the main active component of garlic, is not
alone in this action. The constituent known as ajoene has also shown
beneficial effects on platelets. Aged garlic extract, but not raw garlic,
has been shown, to prevent oxidation of LDL cholesterol in humans, event
believed to be a significant factor in the development of
atherosclerosis.
Ginkgo may reduce the risk of atherosclerosis by
interfering with a chemical the body sometimes makes in excess, called
platelet activating factor (PAF). PAF stimulates platelets to stick
together too much; ginkgo stops this from happening. Ginkgo also increases
blood circulation to the brain, arms, and legs.
Garlic and ginkgo
also decrease excessive blood coagulation. Both have been shown in
double-blind and other controlled trials to decrease the overactive
coagulation of blood that may contribute to atherosclerosis.
Guggul
has been less extensively studied, but double-blind evidence suggests it
can significantly improve cholesterol and triglyceride levels in people.
Numerous medicinal plants and plant compounds have demonstrated an ability
to protect LDL cholesterol from being damaged by free radicals. Garlic,
ginkgo, and guggul are of particular note in this regard. Garlic and
ginkgo have been most convincingly shown to protect LDL cholesterol in
humans.
Several other herbs have been shown in research to lower
lipid levels. Of these, psyllium has the most consistent backing from
multiple double-blind trials showing lower cholesterol and triglyceride
levels. The evidence supporting the ability of fenugreek to lower lipid
levels is not as convincing, coming from preliminary studies
only.
Since oxidation of LDL cholesterol is thought to be important
in causing or accelerating atherosclerosis, and green tea protects against
oxidation, this herb may have a role in preventing atherosclerosis.
However, while some studies show that green tea is an antioxidant in
humans, others have not been able to confirm that it protects LDL
cholesterol from damage. Much of the research documenting the health
benefits of green tea is based on the amount of green tea typically drunk
in Asian countries-about three cups per day (providing 240-320 mg of
polyphenols).
The research on ginger's ability to reduce platelet
stickiness indicates that 10 grams (approximately 1 heaping teaspoon) per
day is the minimum necessary amount to be effective. Lower amounts of dry
ginger, as well as various levels of fresh ginger, have not been shown to
affect platelets.
Turmeric's active compound curcumin has shown
potent anti-platelet activity in animal studies. It has also demonstrated
this effect in preliminary human studies. In a similar vein, bilberry has
been shown to prevent platelet aggregation as has peony. However, none of
these three herbs has been documented to help atherosclerosis in human
trials.
Butcher's broom and rosemary are not well studied as being
circulatory stimulants but are traditionally reputed to have such an
action that might impact atherosclerosis. While butcher's broom is useful
for various diseases of veins, it also exerts effects that are protective
for arteries.
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Please Note: This Traditional Use information is provided as a courtesy only. The products indicated above may be listed in error. This information is based on Traditional and Folklore Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA and is not based on scientific evidence from any source. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
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Arteriosclerosis / Atherosclerosis - Health - Selenium - Hydrolyzed Vegetable Protein (HVP) Chelated - Plus Vitamins C & E - 200mcg
90 tablets
17.68 US
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Arteriosclerosis / Atherosclerosis - Health - Coenzyme Q10 - 60 mg
90 capsules
53.85 US
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Arteriosclerosis / Atherosclerosis - Health - Selenium - 100 mcg - Yeast-Free
100 tablets
7.01 US
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Arteriosclerosis / Atherosclerosis - Health - Selenium - 100 mcg - Yeast-Free
250 tablets
15.47 US
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Arteriosclerosis / Atherosclerosis - Health - Selenium - 200 mcg - Yeast-Free
90 capsules
12.93 US
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Arteriosclerosis / Atherosclerosis - Health - Pycnogenol with Bioflavonoids - 30 mg
30 capsules
20.65 US
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Arteriosclerosis / Atherosclerosis - Health - Pycnogenol with Bioflavonoids - 30 mg
60 capsules
40.40 US
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Arteriosclerosis / Atherosclerosis - Health - Olive Tree Leaf - 400 mg
100 capsules
13.05 US
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Arteriosclerosis / Atherosclerosis - Health - Garlic (Allum Sativum) - 450 mg
100 capsules
11.24 US
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Arteriosclerosis / Atherosclerosis - Health - Garlic Odorless - 450 mg
100 capsules
8.70 US
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Arteriosclerosis / Atherosclerosis - Health - Glucomannan - 500 mg
60 capsules
12.55 US
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Arteriosclerosis / Atherosclerosis - Health - Grape Seed Extract - 50 mg
60 capsules
11.05 US
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