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Prescription 2019: Natural Heart Health for Women

March 14, 2019 Written by JP       [Font too small?]

The most common symptoms of a heart attack are experienced by both men and women, namely chest discomfort, pain, pressure and/or tightness. Having said that, certain less common symptoms primarily affect women. Examples include difficulty breathing, dizziness, fatigue, nausea and pain in various sites including the abdomen, arms, back, jaw and neck. Additionally, the Mayo Clinic notes that when women have a heart attack, the symptoms can be more subtle and often take place during rest or stressful events.

Hormonal changes are something men and women invariably encounter as they age. The most studied forms of hormonal shifts are andropause in men and menopause in women. To date, there has been more attention focused on how menopause influences cardiovascular health. A decline in estrogen is believed to be an important contributor to the elevated cardiovascular risk that presents itself in postmenopausal women. Fortunately, hormone replacement therapy isn’t the only option to address this inevitability.

Many traditional foods, medicinal herbs and spices can assist postmenopausal women in relieving age-related symptoms such as hot flashes, mood changes and osteoporosis. Three recent studies illustrate the potential of natural remedies in promoting cardioprotection. The first reports that taking a black cohosh supplement, in addition to standard antihypertensive therapy, is more effective at reducing blood pressure and improving quality of life than medication alone. The second describes how equol, a soy derivative, safely reduces arterial stiffness while improving markers of bone health. Finally, the third study revealed that a standardized fenugreek supplement (FenuSMART) significantly stifled menopausal discomforts and prevented an increase in LDL, total cholesterol and triglycerides that was noted in women who were given a placebo instead of the fenugreek.

An unexpected study in the December 2018 edition of Complementary Therapies in Medicine reports that consuming 20 grams a day of Tualang honey may reduce a few cardiometabolic risk factors. The authors of the trial noted a decline in diastolic blood pressure and fasting blood sugar in a group of postmenopausal women receiving the honey. A separate study in middle-aged, prehypertensive women found that green tea, in the form of a concentrated extract (containing a total of 780 mg/day polyphenols), successfully lowered systolic blood pressure. Both results are encouraging. But, combining honey and tea may yield even greater effects. Although theoretical, I’m proposing this idea because of previous research from 2013 that describes a synergistic effect when tea and honey are combined. Not only does it taste good, but it seems that this combination results in a potentiation of the natural antioxidant activity of tea.

As in my previous blog about men’s heart health, I would be remiss if I didn’t address the role the gut plays in influencing cardiovascular wellness. Several recent publications highlight this ever-strengthening association and provide a basis for actionable steps women can take right away.

  • In July 2018, the European Heart Journal featured a paper that stated the following, “Gut microbiome diversity is inversely associated with arterial stiffness in women”. In the concluding remarks, the authors declared, “This first human observation linking the gut microbiome to arterial stiffness suggests that targeting the microbiome may be a way to treat arterial ageing”.
  • Another promising study can be found in the June 2018 issue of the journal, Nutrients. In it, a group of obese, postmenopausal women were given either a placebo or a multispecies probiotic supplement (Ecologic Barrier). The participants who received the probiotic demonstrated numerous positive changes relating to cardiometabolic risk. In particular, the insulin-resistance index, LDL cholesterol, triglycerides and uric acid declined, as did body fat percentage and visceral fat.
  • Older trials, including one from 2014, likewise suggest that certain probiotic strains may offer a measure of protection in at-risk populations. In this case, women with metabolic syndrome (MetS) were given a non-fermented milk (NFM) or a fermented milk containing Lactobacillus plantarum over a 90 day period. The fermented, probiotic milk, “showed more favorable results than NFM in relation to cardiovascular risk factors in postmenopausal women with MetS”. Of interest, both blood glucose and homocysteine, which are recognized risk markers, were significantly lower in the group receiving L. plantarum.

My goal today is to point out several lesser known alternatives that may improve your long-term cardiovascular prospects. Focusing on a nutrient-rich diet, sensible exercise, restorative sleep and social connectivity, as well as spending time in nature and stress management are still the optimal starting points to discourage virtually all disease and promote longevity. However, sometimes more is needed. When that’s the case, it’s reassuring to know that such “bonus therapies” can be as simple as brewing tea with added honey, optimizing gut microbiome and utilizing select foods and plant remedies that have been used safely and successfully as traditional medicine by countless generations of women.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – Heart Disease in Women: Understand Symptoms and Risk (link)

Study 2 - Effects of Cimicifuga Racemosa on the Hemodynamics Parameters (link)

Study 3 - Effects of Equol Supplement on Bone and Cardiovascular Parameters (link)

Study 4 - A Novel Extract of Fenugreek Husk Alleviates Postmenopausal (link)

Study 5 - Long-Term Effects of Honey on Cardiovascular Parameters and (link)

Study 6 - Short-Term Effects of Green Tea on Blood Pressure, Endothelial (link)

Study 7 - Potentiating Effects of Honey on Antioxidant Properties of Lemon- (link)

Study 8 - Gut Microbial Diversity is Associated with Lower Arterial Stiffness in (link)

Study 9 - Dose-Dependent Effects of Multispecies Probiotic Supplementation on (link)

Study 10 - Beneficial Effects of Lactobacillus Plantarum on Glycemia and(link)

A Gut Feeling: Microbiota Diversity May Keep Arteries Flexible

Source: Eur Heart J. 2018 Jul 1; 39(25): 2390–2397. (link)

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4 Comments & Updates to “Prescription 2019: Natural Heart Health for Women”

  1. JP Says:

    Updated 03/14/19:

    http://www.ijoy.org.in/article.asp?issn=0973-6131;year=2018;volume=11;issue=1;spage=37;epage=43;aulast=Praveena

    Int J Yoga. 2018 Jan-Apr;11(1):37-43.

    Yoga Offers Cardiovascular Protection in Early Postmenopausal Women.

    Context: Postmenopause, an estrogen deficient state comes with increased incidence of cardiovascular diseases (CVDs). Yoga has been described as having a beneficial effect on heart rate variability (HRV), a marker for cardiac autonomic activity which can assess cardiovascular risk, in various populations.

    Aim: the aim of the study was to study the effect of 3-month long Yoga practice on HRV in early postmenopausal women.

    Settings and Design: A prospective longitudinal study of 67 women within 5 years of menopause between 45 and 60 years of age attending menopause clinic of Department of Gynaecology, Sucheta Kriplani Hospital fulfilling inclusion and exclusion criteria and consenting were enrolled for the study.

    Subjects and Methods: HRV of 37 cases (Yoga group) and 30 controls (non-Yoga group) was recorded pre and 3-month postintervention.

    Statistical Analysis Used: GraphPad Prism Version 5 software was used. Values are a mean and standard error of mean. Statistical significance was set up at P < 0.05.

    Results: In HRV, frequency domain analysis showed a significant fall in low frequency (LF) in normalized units (nu) and LF: high frequency (HF) ratio and significant rise in HF in nu in the Yoga group (depicting parasympathetic dominance) against a significant rise in LF (nu) and LF: HF ratio and significant fall in HF (nu) in non-Yoga group (indicating sympathetic dominance). Time domain analysis showed a significant decrease in Standard Deviation of NN intervals in Non-Yoga group against nonsignificant changes in Yoga group indicating deterioration in parasympathetic activity in non-Yoga group.

    Conclusions: Three-month long Yoga practice improved HRV in early postmenopausal women significantly and has the potential to attenuate the CVD risk in postmenopausal women.

    Be well!

    JP

  2. JP Says:

    Updated 03/14/19:

    https://journals.viamedica.pl/cardiology_journal/article/view/CJ.a2018.0142/46867

    Cardiol J. 2018 Nov 28.

    The effect of acetylsalicylic acid dosed at bedtime on the anti-aggregation effect in patients with coronary heart disease and arterial hypertension: A randomized, controlled trial.

    BACKGROUND: Acetylsalicylic acid (ASA) is one of the basic drugs used in the secondary prevention of coronary heart disease (CAD), and in most cases it is taken in the morning in one daily dose.. It is suggested that the morning peak of platelet aggregation is responsible for the occurrence of myocardial infarctions and strokes. Hence, the aim of the study was to observe the effect of ASA (morning vs. evening) dosing on the anti-aggregative effect of platelets in patients with CAD and arterial hypertension (AH).

    METHODS: The study involved 175 patients with CAD and AH. Patients were randomly assigned to one of two study groups, taking ASA in the morning or in the evening. The patients had two visits, one baseline and another after 3 months from changing the time of ASA dosage. The platelet aggregation was determined using the VerifyNow analyzer.

    RESULTS: In the ASA evening group, a significant reduction in platelet aggregation was obtained. In the ASA morning group, a significant difference in response to ASA was observed, depending on sex. In men, the reactivity of platelets decreased, but in women it increased.

    CONCLUSIONS: In the group of patients with CAD and AH, bedtime ASA dosing is associated with a significant reduction in platelet aggregation. The response to ASA may differ between sexes. The benefit gained by changing the drug administration from the morning to the evening is greater in women.

    Be well!

    JP

  3. JP Says:

    Updated 03/14/19:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731727/

    Pulm Circ. 2018 Jan-Mar;8(1):2045893217743966.

    A prescribed walking regimen plus arginine supplementation improves function and quality of life for patients with pulmonary arterial hypertension: a pilot study.

    Current evidence suggests that exercise training is beneficial in pulmonary arterial hypertension (PAH). Unfortunately, the standard supervised, hospital-based programs limit patient accessibility to this important intervention. Our proof-of-concept study aimed to provide insight into the usefulness of a prescribed walking regimen along with arginine supplementation to improve outcomes for patients with PAH. Twelve PAH patients (all women) in New York Heart Association (NYHA) functional class (FC) II (n = 7) or III (n = 5) and in stable condition for ≥ 3 months were enrolled. Patients performed home- and fitness-center- based walking at 65-75% heart rate (HR) reserve for 45 min, six sessions/week for 12 weeks. Concomitant L-arginine supplementation (6000 mg/day) was provided to maximize beneficial endothelial training adaptations. Cardiopulmonary exercise testing, 6-min walk testing (6MWT), echocardiography, laboratory studies, and quality of life (QoL) survey (SF-36) were performed at baseline and 12 weeks. Eleven patients completed the study (72 session adherence rate = 96 ± 3%). Objective improvement was demonstrated by the 6MWT distance (increased by 40 ± 13 m, P = 0.01), VO2max (increased by 2 ± 0.7 mL/kg/min, P = 0.02), time-to-VO2max (increased by 2.5 ± 0.6 min, P = 0.001), VO2 at anaerobic threshold (increased by 1.3 ± 0.5 mL/kg/min, P = 0.04), HR recovery (reduced by 68 ± 23% in slope, P = 0.01), and SF-36 subscales of Physical Functioning and Energy/Fatigue (increased by 70 ± 34% and 74 ± 34%, respectively, P < 0.05). No adverse events occurred, and right ventricular function and brain natriuretic peptide levels remained stable, suggesting safety of the intervention. This proof-of-concept study indicates that a simple walking regimen with arginine supplementation is a safe and efficacious intervention for clinically stable PAH patients, with gains in objective function and QoL measures. Further investigation in a randomized controlled trial is warranted.

    Be well!

    JP

  4. JP Says:

    Updated 03/14/19:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218972/
    BMC Complement Altern Med. 2018 Nov 6;18(1):294.

    Effects of green tea extract on overweight and obese women with high levels of low density-lipoprotein-cholesterol (LDL-C): a randomised, double-blind, and cross-over placebo-controlled clinical trial.

    BACKGROUND: This study aims to examine the effects of green tea extract (GTE) supplement on overweight and obese women with high levels of low density lipoprotein-cholesterol (LDL-C).

    METHODS: The randomized, double-blind, crossover and placebo-controlled clinical trial was conducted from August 2012 to December 2013. Seventy-three out of 90 subjects aged between 18 and 65 years, with body mass index (BMI) ≥ 27 kg/m2 and LDL-C ≥ 130 mg/dl were included in the analysis. The subjects were randomly divided into Groups A and B. Group A received GTE supplement treatment for the first 6 weeks, while Group B received placebo daily. After 6 weeks of treatment and 14 days of washout period, Group A switched to placebo and Group B switched to GTE treatment for 6 weeks. The reduction of LDL-C level between treatments was assessed as the outcome. Additionally, anthropometric measurements, plasma lipoproteins and hormone peptides of both groups were measure at the beginning of weeks 6, 8, and 14 after treatment.

    RESULTS: Subjects treated with GTE (n = 73) for 6 weeks showed significant differences, with 4.8% (p = 0.048) reduction in LDL-C and 25.7% (p = 0.046) increase in leptin. However, there was no statistical difference in the levels of total cholesterol, triglyceride and high density lipoprotein between the GTE and placebo groups after treatments.

    CONCLUSIONS: This study shows that green tea extract effectively increases leptin and reduces LDL in overweight and obese women after 6 weeks of treatment even though there were no significant changes in other biochemical markers related to overweight.

    Be well!

    JP

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