According to the World Health Organization (WHO), non-communicable diseases (NCDs), which are mostly chronic, kill 40 million people each year, amounting to 70% of all deaths globally.1
Of those NCDs, cardiovascular diseases are the leading cause of death and disability worldwide, accounting for 17.7 million annual mortalities (37% of total deaths), whereas cancer (8.8 million), respiratory diseases (3.9 million) and diabetes (1.6 million) add up to more than 80% of premature deaths (younger than 70).2
These are alarming statistics and the future burden is predicted to grow as a result of the globalisation of risk factors. By 2020, CVDs and ischaemic heart disease in particular could overtake infectious diseases to prevail as the primary contender for the “leading causes of death.”3
CVDs, diseases that involve heart and/or blood vessels, have been considered for a long time to be the inevitable consequence of ageing. It was only during the middle of the twentieth century that the influence of lifestyle, environment and genetics were identified as predisposing factors leading to the concept of “risk factors.”
Indeed, the term “cardiovascular risk factors” was introduced by the Framingham study, a long-term, ongoing epidemiological study that began in 1948 with the objectives of understanding, treating and preventing cardiovascular diseases.4
The study showed the influence of behavioural risk factors such as tobacco use, unhealthy diet and physical inactivity, and metabolic risk factors such as hypertension, hyperglycaemia, hyperlipidemia, and overweight and obesity, on the occurrence of CVDs.5 In 1976, the study led to the implementation of the “Framingham Risk Score” to estimate the 10-year cardiovascular risk of an individual.
Prevention of CVDs with phytochemicals
The first line of prevention against most cardiovascular diseases is to reduce behavioural risk factors and adopt a healthy lifestyle comprising a balanced diet associated with physical activity. The Mediterranean diet, characterised by high intakes of olive oil, fruits, nuts, vegetables and cereals, is well documented for its preventive and beneficial effects on health.
Several epidemiological and observational studies have provided evidence for cardiovascular protection associated with adherence to the Mediterranean diet, such as a 10% reduction in CVD occurrence.6
Numerous observational and scientific studies support the role of botanical dietary supplements to maintain good cardiovascular health
In a long-term study involving 7447 participants, the Mediterranean diet was reported to reduce the prevalence of metabolic syndrome and to have beneficial effects on several markers of cardiovascular risk (blood pressure, lipid profile, lipoprotein particles, inflammation, oxidative stress and carotid atherosclerosis). In general, the consumption of fruits and vegetables was inversely associated with CVD risk.7
Their beneficial effects on health is primarily attributed to the presence of phytochemicals, which are bioactive compounds that are naturally present in small quantities in food and display a wide range of health benefits. Among the wide range of phytochemicals, phenolic compounds, found in almost all plants, phyto-oestrogens, organosulphur compounds, carotenoids, terpenes and phytosterols have been widely studied for their protective effect on CVDs.8
They have been reported to reduce CVD risk factors through several beneficial properties, such as hypotensive, antihypercholesterolaemia, antihyperglycaemia, antioxidant, vasodilator or antiplatelet aggregation effects.
Numerous observational and scientific studies support the role of botanical dietary supplements to maintain good cardiovascular health and prevent CVDs.
Vidya Herbs is a leading and highly innovative producer of natural ingredients dedicated to human and animal nutrition and cosmetics. Vidya Herbs Group leverages its profound expertise and deep knowledge of herbs and natural products to develop and produce high quality plant extracts, standardised for their bioactive compounds, that are useful for their cardioprotective effects.
Polyphenol extracts and CVD prevention
Turmeric and curcumin, the main active principle responsible for the spice’s yellow colour, display a wide range of biological activities and health benefits — derived from their antioxidant and anti-inflammatory properties.
Curcumin demonstrates strong scavenging capacities against hydroxyl and superoxide radicals, which are responsible for LDL oxidation, a crucial event in atherogenesis.9
The antioxidant effects of curcumin have been shown to attenuate adriamycin-induced cardiotoxicity and may prevent diabetic cardiovascular complications. The antithrombotic, antiproliferative and anti-inflammatory effects of curcumin and its effect in decreasing the serum cholesterol level have a positive action on atherosclerosis risks.
The p300-HAT inhibitory effects of curcumin have been demonstrated to ameliorate the development of cardiac hypertrophy and heart failure in animal models.10 Curcumin is also reported to prevent arrhythmias, possibly through its anti-inflammatory action and its ability to control Ca2+ homeostasis.
Resveratrol is a stilbene-type polyphenol that’s naturally present in grapes and grape products, such as wine, and has been involved in the “French paradox.” Resveratrol exerts its cardiovascular protective effect mainly through its antioxidant properties and its capacity to regulate nitric oxide (NO) metabolism.11
Like curcumin, resveratrol possesses strong radical scavenging capacity and prevents LDL oxidation. Besides, resveratrol is able to upregulate NO production, which has vasorelaxant and antiaggregatory properties. Resveratrol is thus able to modulate vascular cell functions and suppress platelet aggregation.
Moreover, resveratrol possesses lipid-lowering properties and anti-inflammatory activities. Although more clinical evidence is needed, preclinical studies provide strong evidence that resveratrol has beneficial effects against hypertension, atherosclerosis, stroke, ischaemic heart disease, arrhythmia, diabetes and heart failure.12
Cocoa (Theobroma cacao) is a well-known source of phenolic compounds, including flavanols such as epicatechins, which possess strong antioxidant properties. Several studies have shown that cocoa decreases LDL oxidation susceptibility, inhibits hydrogen peroxide and superoxide anion production, inhibits cyclo-oxygenase activity and stimulates NO production, resulting in a positive effect on the cardiovascular endothelium.
Several in vitro studies suggest that cocoa also acts on platelet function, angiotensin-converting enzyme activity and glucose transport. Moreover, clinical studies proved that cocoa reduces insulin resistance and supports endothelial function. A reduction of diastolic blood pressure, triglycerides and mean arterial pressure was also observed.13
Native to India, moringa (Moringa oleifera) is a small tree with a wide range of applications. Commonly thought of as a “superfood,” its leaf juice is traditionally used as a diuretic and to regulate blood glucose and arterial pressure.
Moringa leaves are rich in polyphenols, mainly flavonoids, and are reported to have a positive effect on blood lipidemia and glycaemia, two important risk factors of CVDs. Moringa leaves also contain thiocarbamates, namely niazinins and isothiocyanate glycosides, which are known to have hypotensive properties.14
Pomegranate, the fruit of Punica granatum, contain about 0.2–1.0% soluble polyphenols, particularly tannins, such as punicallagins, and ellagic and gallic acids, which possess strong antioxidant properties. Pomegranate protects against oxidative stress and consequently supports the endothelium of the cardiovascular system by preventing the degradation of NO by reactive oxygen species.
Pomegranate has also been shown to prevent the oxidation of LDL and HDL cholesterol, to lower blood lipidemia and to inhibit atherogenesis and atherosclerosis development in animals and humans.15
Besides, pomegranate juice has been proven clinically to reduce blood pressure in hypertensive patients and to decrease the activity of the serum angiotensin converting enzyme (ACE), which was associated with a reduced mortality in cardiovascular patients.16
Bilberry, the fruits of Vaccinium myrtillus plant, contain high levels of anthocyanins, natural water-soluble pigments that give them their dark-purple colour. Anthocyanins possess potent antioxidant activity, which is associated with a protective effect on cardiovascular diseases, inflammation and diabetes.
Bilberry fruits are reported to prevent coronary heart disease and atherosclerosis and to improve microcirculation.17 Animal studies support its capacity to lower vascular permeability and improve vascular tone and blood flow.18 The cardiovascular protection of bilberry extracts has been assessed in a number of human studies and proven to decrease both platelet aggregation and HDL-cholesterol levels.
References
- http://origin.who.int/mediacentre/factsheets/fs355/en.
- www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds).
- C.J. Murray and A.D. Lopez, “Alternative Projections of Mortality and Disability by Cause 1990–2020: Global Burden of Disease Study,” Lancet 349, 1498–1504 (1997).
- S.S. Mahmood, et al., “The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective,” Lancet 383(9921), 999–1008 (2014).
- W.P. Castelli, “Epidemiology of Coronary Heart Disease: The Framingham Study,” The American Journal of Medicine 24, 4–12 (1984).
- E. Ros, et al., “Mediterranean Diet and Cardiovascular Health: Teachings of the PREDIMED Study,” Adv. Nutr. 5(3), 330S–336S (2014).
- A.R. Ness and J.W. Powles “Fruit and Vegetables, and Cardiovascular Disease: A Review,” International Journal of Epidemiology 26, 1–13 (1997).
- P.M. Kris-Etherton, et al., “Bioactive Compounds in Foods: Their Role in the Prevention of Cardiovascular Disease and Cancer,” Am. J. Med. 113(9B), 71S–88S (2002).
- M. Pulido-Moran, et al., “Curcumin and Health,” Molecules 21, 264–286 (2016).
- W. Wongcharoen and A. Phrommintikul, “The Protective Role of Curcumin in Cardiovascular Diseases,” International Journal of Cardiology 133(2), 145–151 (2009).
- D. Bonnefont-Rousselot, “Resveratrol and Cardiovascular Diseases,” Nutrients 8, 250: doi:10.3390/nu8050250 (2016).
- B.N.M. Zordoky, et al., “Preclinical and Clinical Evidence for the Role of Resveratrol in the Treatment of Cardiovascular Diseases,” Biochimica et Biophysica Acta 1852, 1155–1177 (2015).
- L. Hooper, et al., “Effects of Chocolate, Cocoa and Flavan-3-Ols on Cardiovascular Health: A Systematic Review and Meta-Analysis of Randomized Trials,” Am. J. Clin. Nutr. 95, 740–751 (2012).
- F. Anwar, et al., “Moringa oleifera: A Food Plant with Multiple Medicinal Uses,” Phytotherapy Research 21, 17–25 (2007).
- M. Aviram and M. Rosenblat, “Pomegranate Protection Against Cardiovascular Diseases,” Evidence-Based Complementary and Alternative Medicine: doi:10.1155/2012/382763 (2012).
- M. Aviram and L. Dornfeld, “Pomegranate Juice Consumption Inhibits Serum Angiotensin Converting Enzyme Activity and Reduces Systolic Blood Pressure,” Atherosclerosis 158, 195–198 (2011).
- Y. Madihi, et al., “Bioactive Components and the Effect of Hydroalcoholic Extract of Vaccinium myrtillus on Postprandial Atherosclerosis Risk Factors in Rabbits,” Pakistan Journal of Medical Sciences 29(1 Suppl.), 384–389 (2013).
- E. Pojer, et al., “The Case for Anthocyanin Consumption to Promote Human Health: A Review,” Comprehensive Reviews in Food Science and Food Safety 12(5), 483–508 (2013).
