Heart Health Protocol

The human heart beats on average 103,680 times per day, encouraging the blood to flow through 60,000 miles of blood vessels. It takes a great deal of energy expenditure to accomplish this task, which is why heart muscle cells contain the highest concentration of mitochondria of any organ in the body. Yet, when supporting cardiac health, we must not become myopic in our thinking of the heart in isolation and stay focused on the fact that all the cells in the body need foundational vitamin and mineral support for the cardiovascular system to remain healthy.

Furthermore, heart health is more than merely pursuing cardiac indices, lipid levels, homocysteine, fibrinogen, C-reactive protein (CRP), and heart energetics. It is a composite of sustainable cellular health of the heart and body as a whole.

This paper will scientifically justify supporting heart health using three critical dietary supplements. I have utilized the following three supplements in clinical practice and have found them to support the health of my cardiovascular patients:

• Highly bioavailable CoQ10 using an innovative delivery system,
• Heart Support Ingredients to Look for, and
• The Importance of A Cardiac and Antioxidant Focused Multivitamin

Coenzyme Q10 as a Mitochondrial Rejuvenator

The best illustration of CoQ10’s importance in cardiovascular health involves the research that has been conducted on this nutrient in heart failure patients. Oxidative stress and mitochondrial dysfunction leading to endothelial dysfunction typically characterize heart failure.¹ Coenzyme Q10 (CoQ10) is involved in electron transport in mitochondria oxidative phosphorylation. It is an antioxidant, membrane stabilizer, and cofactor in the synthesis of adenosine triphosphate (ATP) during the oxidative phosphorylation pathway, suppressing oxidation of proteins and DNA.¹ Many patients with chronic heart failure have a CoQ10 deficiency, especially those patients presenting with a high New York Heart Association (NYHA) class and reduced left ventricular ejection fraction.¹

Because CoQ10 is involved in cellular energetics and has anti-inflammatory effects that lead to improved endothelial function, researchers have conducted clinical trials on the effects of CoQ10 in patients with chronic heart failure. These trials have documented a number of beneficial effects of CoQ10. For example, one study investigated the use of conventional therapy plus CoQ10 in chronic congestive heart failure patients (New York Heart Association functional class III and IV).² The study found that less people needed to be hospitalized for worsening heart failure in the CoQ10-treated group compared to the control group.

In a randomized, double-blind, placebo-controlled trial of 39 heart failure patients, researchers found a significant reduction in NYHA class in the patients taking the CoQ10 compared with the placebo group.³ A correlation existed between an increase in exercise time and an increase in serum CoQ10 levels.

The Vital Importance of CoQ10 Absorption

CoQ10 is critical for mitochondrial health, energy production, and healthy heart function. Yet, the CoQ10 found in commercial supplements is often poorly absorbed in the intestines. Clinical trials have shown that CoQ10 bioavailability can be enhanced by its delivery system.⁴ A particularly effective delivery system is known as VESIsorb®, a self-assembling colloidal droplet delivery system that mimics the physiological absorption pathway of nutritional lipids.

In a published human pharmacokinetic study, researchers compared VESIsorb® CoQ10 with three other CoQ10 formulas.⁴ VESIsorb® CoQ10 was superior to the other three formulas, producing the highest plasma concentration level after one hour compared to the other types of CoQ10, and the levels continued to increase for up to four hours.

Other Ingredients for Superior Cardiovascular Health

Red Yeast Rice, PMF-source Citrus Flavones, and Tocosource Palm Tocotrienols are a synergistic solution for maintaining heart health. The ingredients not only support healthy cholesterol metabolism, they also maintain optimal triglyceride levels and support a healthy inflammatory response with a 57% drop in inflammation.⁵ Research indicates these key ingredients, along with Highly Bioavailable CoQ10,  significantly promote healthy lipid levels, including a 4% improvement in HDL. Here is a quick highlight of each ingredient:

• Ultimate Red Yeast Rice – The organic, non-GMO, US-produced red yeast rice in Cholesstrinol™ HPe undergoes rigorous testing to detect the contaminant citrinin and therapeutic levels of monacolin k, the component of red yeast rice known to suppress the production of cholesterols. Other competing red yeast rice products don’t test their formulas for citrinin, a contaminant that may lead to kidney damage.
• PMF-source® Citrus Flavones – A subclass of citrus bioflavonoids that contain an extra methyl group, polymethoxylated flavones (PMF) are known for their cardiovascular benefits. Citrus-derived PMFs, including tangeretin and nobiletin, are especially powerful at supporting healthy lipid levels, as demonstrated in animal models.^6,7
• Tocosource® Red Palm Tocotrienols – Fresh virgin red palm oil is a rich source of tocotrienols, isomers of natural vitamin E, as well as other nutrients like CoQ10.⁸ Red palm oil is known to have cardioprotective properties.⁸ In a human study, red palm oil decreased levels of tissue plasminogen activator antigen.⁹ Lower levels of this marker may be associated with better cardiovascular health.¹⁰

Can a Good Multivitamin Support Heart Health?

We know that nutrients contained in multivitamins provide significant cardiovascular support. For example, vitamins B6, B12, and folate all lower levels of homocysteine, an amino acid linked to poor heart health. Multivitamins also contain antioxidant vitamins and minerals that quench reactive oxygen species that are harmful to heart health and prevent homocysteine levels from rising.¹¹ Vitamin D is another example of a heart-healthy nutrient found in multivitamins and supplementation can be beneficial in patients with a vitamin D deficiency.¹²

As far as multivitamins as a whole, a recent study investigated the use of a multivitamin, multimineral, and phytonutrient supplement on blood nutrient status and biomarkers of heart health risk in 120 healthy adults.¹¹ The subjects received either the dietary supplement or a placebo for eight weeks. At the end of the study, the patients taking the multivitamin/multimineral supplement had improved nutrient status and reduced biomarkers of heart health risk, including reduced serum homocysteine.

Look for a multivitamin goes above and beyond the nutrients normally found in an average multi; An ingredient like pomegranate fruit extract (Punica granatum) for its ability to support a healthy inflammatory response and maintain glycemic indicators, along with healthy lipid metabolism.¹³ Wild blueberry extract (Vaccinium corymbosum) is included to support key markers of cardiovascular health¹⁴, and resveratrol has beneficial effects on cardiac dynamics.¹⁵ Also, Look for a Multivitamin that contains the MTHF form of folate due to the high prevalence of the MTHFr polymorphism in the general population, which prevents the utilization of the folic acid used in many multivitamins.

References:

1. Di Lorenzo A, Iannuzzo G, Parlato A, et al. Clinical Evidence for Q10 Coenzyme Supplementation in Heart Failure: From Energetics to Functional Improvement. J Clin Med. 2020;9(5).
2. Morisco C, Trimarco B, Condorelli M. Effect of coenzyme Q10 therapy in patients with congestive heart failure: a long-term multicenter randomized study. Clin Investig. 1993;71(8 Suppl):S134-136.
3. Keogh A, Fenton S, Leslie C, et al. Randomised double-blind, placebo-controlled trial of coenzyme Q, therapy in class II and III systolic heart failure. Heart Lung Circ. 2003;12(3):135-141.
4. Liu ZX, Artmann C. Relative bioavailability comparison of different coenzyme Q10 formulations with a novel delivery system. Altern Ther Health Med. 2009;15(2):42-46.
5. Roza JM, Xian-Liu Z, Guthrie N. Effect of citrus flavonoids and tocotrienols on serum cholesterol levels in hypercholesterolemic subjects. Altern Ther Health Med. 2007;13(6):44-48.
6. Kurowska EM, Manthey JA. Hypolipidemic effects and absorption of citrus polymethoxylated flavones in hamsters with diet-induced hypercholesterolemia. J Agric Food Chem. 2004;52(10):2879-2886.
7. Li RW, Theriault AG, Au K, et al. Citrus polymethoxylated flavones improve lipid and glucose homeostasis and modulate adipocytokines in fructose-induced insulin resistant hamsters. Life Sci. 2006;79(4):365-373.
8. Loganathan R, Subramaniam KM, Radhakrishnan AK, Choo YM, Teng KT. Health-promoting effects of red palm oil: evidence from animal and human studies. Nutr Rev. 2017;75(2):98-113.
9. Scholtz SC, Pieters M, Oosthuizen W, Jerling JC, Bosman MJ, Vorster HH. The effect of red palm olein and refined palm olein on lipids and haemostatic factors in hyperfibrinogenaemic subjects. Thromb Res. 2004;113(1):13-25.
10. Lowe GD, Danesh J, Lewington S, et al. Tissue plasminogen activator antigen and coronary heart disease. Prospective study and meta-analysis. Eur Heart J. 2004;25(3):252-259.
11. Isakov VA, Bogdanova AA, Bessonov VV, et al. Effects of Multivitamin, Multimineral and Phytonutrient Supplementation on Nutrient Status and Biomarkers of Heart Health Risk in a Russian Population: A Randomized, Double Blind, Placebo Controlled Study. Nutrients. 2018;10(2).
12. Latic N, Erben RG. Vitamin D and Cardiovascular Disease, with Emphasis on Hypertension, Atherosclerosis, and Heart Failure. Int J Mol Sci. 2020;21(18).
13. Goodarzi R, Jafarirad S, Mohammadtaghvaei N, Dastoorpoor M, Alavinejad P. The effect of pomegranate extract on anthropometric indices, serum lipids, glycemic indicators, and blood pressure in patients with nonalcoholic fatty liver disease: A randomized double-blind clinical trial. Phytother Res. 2021;35(10):5871-5882.
14. Spohr L, de Aguiar MSS, Bona NP, et al. Blueberry Extract Modulates Brain Enzymes Activities and Reduces Neuroinflammation: Promising Effect on Lipopolysaccharide-Induced Depressive-Like Behavior. Neurochem Res. 2023;48(3):846-861.
15. Zheng X, Hai J, Yang Y, et al. Effects of resveratrol supplementation on cardiac remodeling in hypertensive patients: a randomized controlled clinical trial. Hypertens Res. 2023;46(6):1493-1503.