The American Heart Association, or the AHA, has had a consistent, long-standing focus towards providing the public with the necessary information regarding the role of nutrition reducing the risk of cardiovascular disease. Periodic AHA Dietary Guidelines support a dietary pattern that promotes the consumption of fruits, vegetables, whole grains, low-fat or nonfat dairy products, fish, legumes, poultry, and lean meats. An improper nutrition consisting of foods rich in saturated and trans fats, can raise the human body’s “bad” cholesterol levels, increasing the risk of cardiovascular disease.
The American Heart Association’s Dietary Guidelines can help with weight control as well as provide a high nutrient density to meet all nutritional needs. As reviewed in the first AHA Science Advisory, epidemiological and population studies reported that some vitamins, such as vitamin C, vitamin E, vitamin D and vitamin B6 (pyridoxine), may beneficially affect cardiovascular disease. Reducing the overall risk of cardiovascular disease can be achieved by the long-term consumption of dietary patterns consistent with the AHA Dietary Guidelines. Vitamin C, vitamin E, vitamin D and vitamin B6 (pyridoxine), each perform a specific function in the prevention and improvement of CVD. The following are described in detail, below.
Vitamin C is a powerful water-soluble electron-donor. At physiologic levels, it is an antioxidant, although at supra-physiologic doses such as those achieved with intravenous vitamin C, it donates electrons to different enzymes in a pro-oxidative effect. At physiologic doses, vitamin C recycles vitamin E, improves ED and produces a diuresis. Intake of vitamin C and plasma ascorbate concentration in humans is related to heart rate, DBP and SBP.
A review of clinical trials suggest that vitamin C dosing in 250 mg twice daily will lower SBP 5-7 mmHg and diastolic BP 2-4 mmHg in more than 8 weeks. Vitamin C may give rise to a sodium water diuresis, enhance nitric oxide, improve endothelial function, increase nitric oxide and PGI2, decrease adrenal hormone production, improve sympathovagal balance, boost RBC Na/K ATPase, boost SOD, improve aortic elasticity and elasticity, enhance circulation conducive vaso-dilation, reduce pulse wave speed and augmentation index, raise cyclic GMP, trigger potassium channels, reduce cytosolic calcium and reduce serum aldehydes. Vitamin C prevents ED, decreasing the binding affinity of the AT 1 receptor for angiotensin II by disrupting the disulfide bridges, it enriches the antihypertensive effects of drugs and medications in the elderly with hypertension. In patients with hypertension already on maximum pharmacologic therapy, 600 mg of vitamin C lowered the BP in 20/16 mmHg. The lower the first ascorbate serum amount, the greater the blood pressure response. A serum level of 100 ?mol/L is recommended. The SBP and 24 ABM reveal the most important reductions with chronic oral administration of Vitamin C. Block et al within an elegant depletion-repletion study of vitamin C revealed an inverse correlation of plasma ascorbate levels, SBP and DBP. At a meta-analysis of thirteen clinical trials jointly with 284 patients, vitamin C in 500 mg/d in more than 6 weeks decreased SBP 3.9 mmHg and DBP 2.1 mmHg. Hypertensive individuals were found to have significantly lower plasma ascorbate levels in comparison with normotensive subjects (40 ?mol/L vs 57 ?mol/L respectively), and plasma ascorbate is inversely correlated with BP even in healthy, normotensive individuals.
Most studies have not shown reductions in BP with most forms of tocopherols or tocotrienols.. Patients with T2DM and controlled hypertension (130/76 mmHg) on prescription drugs and medications with an average blood pressure of 136/76 mmHg were administered mixed tocopherols containing 60 percent gamma, 25 per cent delta and 15 percent alpha tocopherols. The BP really increased by 6.8/3.6 mmHg in the research patients (de < 0.0001) but was significantly less compared to this growth with alpha tocopherol of 7/5.3 mmHg (p< 0.0001). This might be a reflection of drug interactions with tocopherols via cytochrome P 450 (3A4 and 4F2) and reduction in the serum levels of the pharmacologic therapy treatments that were concurrently being granted to the patients. Gamma tocopherol could have natriuretic effects by inhibition of this potassium channel in the thick ascending limb of the loop of Henle and reduced BP. Insulin sensitivity improves and enhances adiponectin expression through gamma dependent procedures, which have the potential to serum glucose and lower BP. When vitamin E has an effect, it is most likely small and might be restricted to those with cardiovascular disease or untreated hypertensive patients or psychiatric problems, such as hyperlipidemia or diabetes.
Vitamin D3 may have an independent and immediate role in the regulation of insulin metabolism and BP. Blood pressure, with its consequences, affects the RAA system, control of adrenal glands, immune system, calcium-phosphate metabolism and ED. The circulating PRA amounts are higher which increases angiotensin II if the vitamin D degree is below 30 ng/mL, increases BP and blunts plasma renal blood flow. The lower the degree of vitamin D, the greater the chance of hypertension, with the lowest quartile of serum Vitamin D with an incidence of hypertension in addition to the maximum quartile. Vitamin D3 markedly suppresses renin transcription. Its function in quantity, electrolytes and BP homeostasis indicates that Vitamin D3 is important in amelioration of hypertension. Vitamin D lowers ADMA, suppresses pro-inflammatory cytokines for example TNF-?, raises nitric oxide, improves endothelial function and arterial elasticity, decreases vascular smooth muscle hypertrophy, modulates electrolytes and blood glucose, increases insulin sensitivity, reduces free fatty acid concentration, regulates the expression of the natriuretic peptide receptor additionally reduces HS-CRP.
The hypotensive effect of vitamin D has been inversely related to the pretreatment serum levels of 1,25(OH)2D3and additive to antihypertensive drugs and medications. Pfeifer et al revealed that supplementation with vitamin D3 and calcium is more effective in reducing SBP. In a study, 148 women with low 25(OH)2D3 levels, the management of 1200 mg calcium and 800 IU of vitamin D3 decreased SBP 9.3 percent more (p< 0.02) in comparison to 1200 mg of calcium alone. The HR fell 5.4 percent (p = 0.02), but DBP wasn’t changed. The scope in BP reduction was 3.6/3.1 to 13.1/7.2 mmHg. The reduction in BP is about serum level of vitamin D3, the dose of vitamin D3 and the level of vitamin D3, but BP is reduced only in patients. Although vitamin D deficiency is associated with hypertension in observational studies, their meta-analysis and randomized clinical trials have yielded inconclusive results. Vitamin D receptor gene polymorphisms may effect the risk of hypertension. A 25 hydroxyvitamin D level of 60 ng/mL is suggested.
Low serum vitamin B6 (pyridoxine) levels are linked to hypertension in several individuals. One research study conducted by Aybak et al demonstrated that blood pressure was significantly reduced by high dose vitamin B6 at 5 mg/kg daily for 4 wk by 14/10 mmHg. Pyridoxine (vitamin B6) is a cofactor in neurotransmitter and hormone synthesis in the central nervous system(norepinephrine, epinephrine, serotonin, GABA and kynurenine), raises cysteine synthesis to neutralize aldehydes, improves the production of glutathione, blocks calcium channels, enhances insulin resistance, reduces central sympathetic tone and reduces end organ responsiveness to glucocorticoids and mineralo-corticoids. Vitamin B6 is decreased using pyrollactams and chronic therapy. Vitamin B6 has actions to diuretics alpha agonists and CCB’s. The proposed dose is 200 mg/d orally.
In conclusion, individuals with cardiovascular disease can benefit from the proper diet and nutrition. Essential vitamins found in the dietary patterns provided by the American Heart Association’s Dietary Guidelines can ultimately help reduce and prevent the risk of cardiovascular disease as well as help improve overall heart health. An improper nutrition consisting of foods rich in saturated and trans fats can increase the prevalence of cardiovascular disease. While diagnosis and drugs/medications can be prescribed to treat cardiovascular disease, a balanced nutrition can have similar effects. The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Overall health and wellness are essential towards maintaining the proper mental and physical balance in the body. From eating a balanced nutrition as well as exercising and participating in physical activities, to sleeping a healthy amount of time on a regular basis, following the best health and wellness tips can ultimately help maintain overall well-being. Eating plenty of fruits and vegetables can go a long way towards helping people become healthy.
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