Cardiovascular disease is defined as medical conditions affecting the cardiovascular system, including heart, blood vessels(arteries and veins).
II. Ischemic heart disease
Ischemic heart disease is defined as a condition of reduced blood supply of the heart muscle, as a result of coronary artery disease caused by plague building up in the arteries.
D.3. Phytochemicals to prevent Ischaemic heart disease
1. Omega-3 Fatty Acids
a. Systolic blood pressure, triglycerides and LDL cholesterol
In the ccomparison of the cardiovascular risk-reduction potential of three major polyunsaturated fatty acids in a double-blind study. showed that for the diet supplemented with EPA plus DHA compared with the linoleic acid diet systolic blood pressure fell 5.1 mm Hg (p = 0.01); plasma triglyceride and VLDL cholesterol fell by 39% (p = 0.001) and 49% (p = 0.01), respectively; and LDL cholesterol rose by 9% (p = 0.01). There were no significant changes with the diet supplemented with alpha-linolenic acid. The net effect on cardiovascular risk therefore is complex and the systolic blood pressure reduction was substantial, according to "n-3 fatty acids of marine origin lower systolic blood pressure and triglycerides but raise LDL cholesterol compared with n-3 and n-6 fatty acids from plants" by Kestin M, Clifton P, Belling GB, Nestel PJ.(49)
b. Cardiovascular effects
In the comparison of the effects of alpha-linolenic acid (ALA, C18:3n-3) to those of eicosapentaenoic acid (EPA, C20:5n-3) plus docosahexaenoic acid (DHA, C22:6n-3) on cardiovascular risk markers in healthy elderly subjects, found that Both n-3 fatty acid diets did not change concentrations of total-cholesterol, LDL-cholesterol, HDL-cholesterol, triacylglycerol and apoA-1 when compared with the oleic acid-rich diet. However, after the EPA/DHA-rich diet, LDL-cholesterol increased by 0.39 mmol/l (P = 0.0323, 95% CI (0.030, 0.780 mmol/l)) when compared with the ALA-rich diet. Intake of EPA/DHA also increased apoB concentrations by 14 mg/dl (P = 0.0031, 95% CI (4, 23 mg/dl)) and 12 mg/dl (P = 0.005, 95% CI (3, 21 mg/dl)) versus the oleic acid and ALA-rich diet, respectively. Except for an EPA/DHA-induced increase in tissue factor pathway inhibitor (TFPI) of 14.6% (P = 0.0184 versus ALA diet, 95% CI (1.5, 18.3%)), changes in markers of hemostasis and endothelial integrity did not reach statistical significance following consumption of the two n-3 fatty acid diets, according to "Effects of alpha-linolenic acid versus those of EPA/DHA on cardiovascular risk markers in healthy elderly subjects" by Goyens PL, Mensink RP.(50)
c. Health effects
In the investigation of the health effects of Perilla frutescens seeds, a good source of polyunsaturated fatty acids (PUFAs), showed that in comparing to other plant oils, perilla seed oil consistently contains the one of the highest proportion of omega-3 (ALA) fatty acids, at 54-64%. The omega-6 (linoleic acid) component is usually around 14% and omega-9 (Oleic acid) is also present in perilla oil. These polyunsaturated fatty acids are most beneficial to human health and in prevention of different diseases like cardiovascular disorders, cancer, inflammatory, rheumatoid arthritis etc., according to "Health effects of omega-3,6,9 fatty acids: Perilla frutescens is a good example of plant oils" by Asif M.(51)
in the determination of whether obesity modifies the association between plasma phospholipid polyunsaturated fatty acids (PUFAs) and markers of inflammation and endothelial activation in Multi-Ethnic Study of Atherosclerosis (MESA) participants, found that the modifying effect of obesity on the association of plasma PUFAs with IL-6 and sICAM-1 suggests differences in fatty acid metabolism and may also have implications in dietary fatty acid intake for obese individuals, particularly for linoleic and EPAs. Further study is warranted to confirm and explain the strong associations of dihomo-γ-linolenic acid (DGLA) with inflammatory and endothelial activation markers, according to "Obesity modifies the association between plasma phospholipid polyunsaturated fatty acids and markers of inflammation: the Multi-Ethnic Study of Atherosclerosis" by Steffen BT, Steffen LM, Tracy R, Siscovick D, Hanson NQ, Nettleton J, Tsai MY.(52)
2. Catechin is phytochemical of Flavan-3-ols, in the group of Flavonoids (polyphenols), found abundantly in white tea, green tea, black tea, grapes, wine, apple juice, cocoa, lentils, etc.
a. Body-weight regulation
Green tea has been proposed as a tool for obesity management as strategies for weight loss and weight maintenance, as researchers found that a green tea-caffeine mixture improves weight maintenance, through thermogenesis, fat oxidation, and sparing fat free mass. The sympathetic nervous system is involved in the regulation of lipolysis, and the sympathetic innervation of white adipose tissue may play an important role in the regulation of total body fat in general, according to "Green tea catechins, caffeine and body-weight regulation" by Westerterp-Plantenga MS.(53)
In a systematic review and meta-analysis of randomized controlled trials evaluating the relationship between GTCs and serum lipid levels, including total, low-density lipoprotein (LDL), high-density lipoprotein (HDL) cholesterol, and triglycerides, found that the consumption of GTCs is associated with a statistically significant reduction in total and LDL cholesterol levels; however, there was no significant effect on HDL cholesterol or triglyceride levels, according to " Green tea catechins decrease total and low-density lipoprotein cholesterol: a systematic review and meta-analysis" by Kim A, Chiu A, Barone MK, Avino D, Wang F, Coleman CI, Phung OJ.(54)
c. Antioxidant activity
In the research on polyphenolic compounds (included catechins) in the berries of edible honeysuckle and their biological effects, including recommended utilization, are reviewed found that These berries seem to be prospective sources of health-supporting phytochemicals that exhibit beneficial anti-adherence and chemo-protective activities, thus they may provide protection against a number of chronic conditions, e.g., cancer, diabetes mellitus, tumour growth or cardiovascular and neurodegenerative diseases, according to "Phenolic profile of edible honeysuckle berries (genus lonicera) and their biological effects" by Jurikova T, Rop O, Mlcek J, Sochor J, Balla S, Szekeres L, Hegedusova A, Hubalek J, Adam V, Kizek R.(55)
d. Cholesterol and glucose levels
In the examination of the effect of the main green tea catechin, epigallocatechin gallate (EGCG), taken in a green tea extract, Polyphenon E (PPE) and their effect on circulating hormone levels, an established breast cancer risk factor, found that Glucose and insulin levels decreased nonsignificantly in the PPE groups but increased in the placebo group; statistically significant differences in changes in glucose (P=0.008) and insulin (P=0.01) were found. In summary, green tea (400 and 800 mg EGCG as PPE; ~5-10 cups) supplementation for 2 months had suggestive beneficial effects on LDL cholesterol concentrations and glucose-related markers, according to "Effect of 2-month controlled green tea intervention on lipoprotein cholesterol, glucose, and hormonal levels in healthy postmenopausal women" by Wu AH, Spicer D, Stanczyk FZ, Tseng C, Yang CS, Pike MC.(56)
3. Theaflavin with reddish in color, is a phytochemical of Flavan-3-ols, in the group of Flavonoids (polyphenols), formed in tea leaves during fermentation.
In the investigation of 240 men and women 18 years or older on a low-fat diet with mild to moderate hypercholesterolemia were randomly assigned to receive a daily capsule containing theaflavin-enriched green tea extract (375 mg) or placebo for 12 weeks, found that after 12 weeks, the mean ± SEM changes from baseline in total cholesterol, LDL-C, HDL-C, and triglyceride levels were -11.3% ± 0.9% (P = .01), -16.4% ± 1.1% (P = .01), 2.3% ± 2.1% (P = .27), and 2.6% ± 3.5% (P = .47), respectively, in the tea extract group. The mean levels of total cholesterol, LDL-C, HDL-C, and triglycerides did not change significantly in the placebo group. No significant adverse events were observed, according to "Cholesterol-Lowering Effect of a Theaflavin-Enriched Green Tea Extract" by David J. Maron, MD; Guo Ping Lu, MD; Nai Sheng Cai, MD; Zong Gui Wu, MD; Yue Hua Li, MD; Hui Chen, MD; Jian Qiu Zhu, MD; Xue Juan Jin, MS; Bert C. Wouters, MA; Jian Zhao, PhD.(57)
b. Antioxidant effects
In the investigation of four main TF derivatives (theaflavin (TF(1)), theaflavin-3-gallate (TF(2)A), theaflavin-3'-gallate (TF(2)B), and theaflavin-3,3'-digallate (TF(3))) in scavenging reactive oxygen species (ROS) in vitro, their properties of inhibiting superoxide, singlet oxygen, hydrogen peroxide, and the hydroxyl radical, and their effects on hydroxyl radical-induced DNA oxidative damage, found that compared with (-)-epigallocatechin gallate (EGCG), TF derivatives were good antioxidants for scavenging ROS and preventing the hydroxyl radical-induced DNA damage in vitro. TF(3) was the most positive in scavenging hydrogen peroxide and hydroxyl radical, and TF(1) suppressed superoxide. Positive antioxidant capacities of TF(2)B on singlet oxygen, hydrogen peroxide, hydroxyl radical, and the hydroxyl radical-induced DNA damage in vitro were found, according to "Evaluation of the antioxidant effects of four main theaflavin derivatives through chemiluminescence and DNA damage analyses" by Wu YY, Li W, Xu Y, Jin EH, Tu YY.(58)
c. Cardio-protective activities
In the analyzing the protective effect of theaflavin (TF1) and its underlying mechanism,
found that (1) compared with the control group, TF1 (10, 20, 40 μmol/l) displayed a better recovery of cardiac function after ischemia/reperfusion in a concentration-dependent manner. At 60 min of reperfusion, LVDP, ± LVdP/dt (max) and CF in the TF1 group were much higher than those in the control group, whereas left ventricular end-diastolic pressure (LVEDP) in the TF1 group was lower than that in the control group (P < 0.01). (2) Pretreatment with glibenclamide (10 μmol/l), a K(ATP) antagonist, completely abolished the cardioprotective effects of TF1 (20 μmol/l). Also, most of the effects of TF1 (20 μmol/l) on cardiac function after 60 min of reperfusion were reversed by 5-HD (100 μmol/l), a selective mitochondria K(ATP) antagonist. (3) Atractyloside (20 μmol/l), a mitochondrial permeability transition pore (mPTP) opener, administered at the beginning of 15 min of reperfusion completely abolished the cardioprotection of TF1 (20 μmol/l), according to "ATP-dependent potassium channels and mitochondrial permeability transition pores play roles in the cardioprotection of theaflavin in young rat" by Ma H, Huang X, Li Q, Guan Y, Yuan F, Zhang Y.(59)
4. Resveratrol is a type of natural phenol in the group of Stilbenoids, produced naturally by many plants when under attack by bacteria or fungi. It has been studied by many researchers for it health benefits in treating chronic diaereses, including cancer, diabetes, heart disease, etc.
a. In a study of "Resveratrol: a promising agent in promoting cardioprotection against coronary heart disease." by Penumathsa SV, Maulik N. (Source from Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-1110, USA.), posted in PubMed, researchers indicated in abstract that many studies have provided evidence that resveratrol possesses antioxidant and antiapoptotic effects apart from activation of longevity proteins (such as SIRT-1). We have recently reported the angiogenic, antihypercholesterolemic, and antihypercholesterolemic, antihypercholesterolemic, antidiabetic effects of resveratrol and the mechanisms involved in reduced ventricular remodeling and increased cardiac functions. We have also shown different strategic target molecules involved in resveratrol-mediated.
b. Lipid metabolism
in a study of " [Effects of resveratrol on lipid metabolism in C57BL/6J mice]."[Article in Chinese]
According to the study of " Resveratrol, obesity and diabetes." by Szkudelska K, Szkudelski T. (Source from Department of Animal Physiology and Biochemistry, Poznan University of Life Sciences, Poznan, Poland. firstname.lastname@example.org) posted in PubMed, researchers found that The accumulating evidence also indicates the benefits of resveratrol in diabetes and diabetic complications. It is known that resveratrol affects insulin secretion and blood insulin concentration. In animals with hyperinsulinemia, resveratrol was found to reduce blood insulin. Moreover, numerous data indicate that in diabetic rats, resveratrol is able to reduce hyperglycemia. The mechanism of resveratrol's action is complex and is demonstrated to involve both insulin-dependent and insulin-independent effects. These data point to the potential possibility of use of resveratrol in preventing and/or treating both obesity and diabetes.
According to the study of " Antioxidant Health Effects of Aged Garlic Extract" by Carmia Borek, posted in (Journal of Nutrition. 2001;131:1010S-1015S.)© 2001 The American Society for Nutritional Sciences, researcher found that AGE contains a wide range of antioxidants that can act in synergistic or additive fashion and protect cells against oxidative damage, thus helping to lower the risk of heart disease, stroke, cancer and Alzheimer’s disease and protect against toxic, tissue-damaging effects of ROS-producing radiation, including UV light, drugs used in therapy and chemicals in the environment and industry. b. Cholesterol, heart disease and stroke
In an article of "GARLICTHE BOUNTIFUL BULB" by Carmia Borek, Ph.D. posted in Life extension magazine, the author indicated that in the past 15 years, garlic supplementation studies have concentrated on the bulb's effects in reducing blood cholesterol and triglycerides (the form in which fat is transported in the blood). All studies did not agree with one another, given differences in the kind of garlic preparation, quality of standardization, doses and periods of treatment. But most findings showed that garlic slightly lowered blood cholesterol, LDL cholesterol and triglycerides with a consistent lowering of blood lipids seen in studies that used aged garlic extract as the supplement. For example, while a University of Oxford study showed that garlic powder, given to patients at 900 mg a day for six months, had no protective effects and did not lower cholesterol levels, a study at East Carolina University found that aged garlic extract given at 2.4-4.8 gm a day, for six months, lowered cholesterol by 5-7%, and reduced LDL, triglycerides and blood pressure in men with high cholesterol.
c. Blood circulation
In an article of "Onions, Garlic, and Scallions… Oh My!" By Dr. Leo Galland, M.D., and Jonathan Galland", posted in the Chritian Broacasting Network, the authors wrote that scientists believe the components in onions, garlic, and scallions called allyl sulfides and bioflavonoids are key to their powerful health benefits. For cardiovascular health, clinical experiments have shown regular consumption of garlic may help improve circulation and help decrease calcium deposits and the size of arterial plaque in coronary arteries. As for detoxification, one study found that eating fresh garlic and onions each day can help remove toxins from the body.
According to the study of "Effect of garlic on blood pressure: a systematic review and meta-analysis." by Ried K, Frank OR, Stocks NP, Fakler P, Sullivan T. posted in US National Library of Medicine National Institutes of Health, researchers found that Eleven of 25 studies included in the systematic review were suitable for meta-analysis. Meta-analysis of all studies showed a mean decrease of 4.6 +/- 2.8 mm Hg for SBP in the garlic group compared to placebo (n = 10; p = 0.001), while the mean decrease in the hypertensive subgroup was 8.4 +/- 2.8 mm Hg for SBP (n = 4; p < 0.001), and 7.3 +/- 1.5 mm Hg for DBP (n = 3; p < 0.001). Regression analysis revealed a significant association between blood pressure at the start of the intervention and the level of blood pressure reduction (SBP: R = 0.057; p = 0.03; DBP: R = -0.315; p = 0.02), and concluded that Our meta-analysis suggests that garlic preparations are superior to placebo in reducing blood pressure in individuals with hypertension. f. Arteriosclerosis
In a study of "Effect of garlic feeding on regression of experimental atherosclerosis in rabbits." by Bordia A, Verma SK. posted in US National Library of Medicine National Institutes of Health., researchers found that there was an increase in HDL levels in the garlic fed groups. Cholesterol feeding resulted in 80.9% atheromatous involvement of aortic surface in Group I. This remained almost the same (71.1%) after 9 months of stock feeding (Group II) while in the garlic fed group only 30.4% of the aortic surface had lesions. Correspondingly, the aortic lipid content of garlic fed animals was reduced by 72%, while in the control group there was no significant reduction. The data suggests that cholesterol is depleted from experimentally induces atherosclerosis by garlic administration.
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