Into the Heart

Hot Flashes, Menopause and Cardiovascular Health

Concern regarding hot flashes, menopause and cardiovascular health had been related in an earlier post on this blog. High global readership on this topic indicates more clarity would be beneficial for women with hot flash concerns. As such, the enclosed provides more perspective.

Vasomotor symptoms, hot flashes correlate with lower level of plasma antioxidant activity, an increased cardiovascular reactivity to stressful situations, elevated cholesterol, higher sympathetic nerve activity, impaired flow-mediated dilation, hypertension and a higher risk of aortic calcification.

Hot flushes are an indicator of, a marker for underlying arterial changes among otherwise healthy menopausal women. More specifically, healthy postmenopausal women with hot flashes have different cardiovascular risk factors than postmenopausal women without hot flashes.

Hot flashes are more than just bothersome, they are an indication, a message to women of potential heightened cardiovascular risk factors . . . as noted in the second paragraph.

Source:
Vasomotor symptoms and cardiovascular risk.
Climacteric. 2009;12 Suppl 1:32-5.
Gambacciani M, Pepe A.
Department of Obstetrics and Gynecology, Menopause and Osteoporosis Center,
Pisa University Hospital, Pisa, Italy

Peaceful Arteries

A bump above the eyebrow or a cut on the arm becomes tender and swollen due to cellular activity. In a similar manner arterial inflammation contributes to atherosclerotic cardiovascular disease.  Medical studies have found elevated concentrations of inflammation and vascular cell activation markers in individuals with cardiovascular disease.  Dietary components and dietary patterns are thought to influence cardiovascular risk due to their effect on arterial inflammation.

 Foods rich in omega 3 such as walnuts, and cold water fish have been shown to improve endothelial function, and  nuts, cocoa, and berries are associated with less inflammatory biomarkers. Red wine, dark chocolate and tea consumption have been shown to hush  inflammation, and nurture artery health because of there antioxidant properties. Research strongly suggests that diets high in antioxidant-rich fruit and vegetables and whole grains decrease inflammation and improve endothelial function.

The post below regards a research study noting how four different dietary patterns influence cardiovascular disease risk.  Keep in mind, most often foods are not consumed in isolation, there is synergy among and within foods. The blended effect of the diet's parts is greater than the individual effects of single foods and nutrients.

Beautiful Food Hushes Arterial Inflammation

Dietary patterns influence cardiovascular disease risk through effects on inflammation and endothelial activation within the artery. The endothelium is a thin lining covering the internal surface of blood vessels. Blood moving through the arteries glides along side the protective endothelium lining.

The Multi-Ethnic Study of Atherosclerosis examined the relationship between dietary patterns and markers of inflammation and endothelial activation. In this study, concentrations of C-reactive protein, interleukin 6, homocysteine, soluble intercellular adhesion molecule-1, and soluble E selectin were assessed in 5089 non diabetic participants.

With this study four dietary patterns were analysis. The dietary pattern of fats, oils, processed meats, fried potatoes, salty snacks, and desserts was associated with inflammation, noted by  C-reactive protein , interleukin 6, and homocysteine.

The beans, tomatoes, refined grains, and high-fat dairy products diet pattern was associated with  intercellular adhesion molecule-1activity. In the artery, cell adhesion molecules draw monocyte cells to the endothelium . . . The monocyte cell then nests between the endothelial cells and become swollen with oxidized LDL cholesterol. This swollen cholesterol tends to bubble and brew, eventually causing arterial build up.

However, in the study a diet that emphasized whole grains, fruit, nuts, and green leafy vegetables suppressed/hushed inflammatory messengers: C-reactive protein, interleukin 6, homocysteine, and soluble intercellular adhesion molecule-1activity. The fish and dark-yellow, cruciferous, and vegetables dietary pattern suppressed interleukin 6.

The inflammation associated  (C-reactive protein, interleukin 6, and homocysteine) with the fats and processed meats dietary pattern was independent of demographics and lifestyle factors.

The lack of inflammation (the goal is less inflammation) associated with the whole grains and fruit dietary patterns was also independent of demographics and lifestyle factors.

The results of this study indicate race or ethnicity does not generate inflammation in the arteries. More so, a dietary pattern contributes to arterial inflammation. A whole grains, fruit, nuts, green leafy vegetables, and fish diet comforts the protective endothelium and reduces arterial stress/inflammation.

For three peaceful recipes to hush arterial inflammation visit:
http://www.ForHerHeart.org/a.aspx

Source:
Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis
American Journal of Clinical Nutrition, Vol. 83, No. 6, 1369-1379, June 2006
Jennifer A Nettleton, Lyn M Steffen

Fresh Ginger Root: Healthy Arteries

5-lipoxygenase is a member of a large family of enzymes called lipoxygenases.  5-lipoxygenase is expressed in the cardiovascular system: the aorta, coronary, and carotid arteries. Under certain circumstances such as cell oxidation (pollution) this enzymatic pathway generates inflammatory mediators called leukotrienes.

Essentially, select leukotrienes signal and collect fatty type deposits that build-up in the arteries. Inhibiting 5-lipoxygenase enzyme helps protective the aorta, coronary, and carotid arteries from damage and irritation.

Medical research suggests that ginger, the underground stem of the plant Zingiber Officinale suppresses leukotriene biosynthesis by inhibiting 5-lipooxygenase. This is significant because ginger is now thought to possess duel anti-inflammatory inhibitor properties via leukotriene and prostaglandin pathways.

Ginger has been found to suppresses prostaglandin synthesis and inflammation through inhibition of the cyclooxygenase enzyme, much like non-steroid anti-inflammatory medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve). For generations ginger root has been used as an herbal medicinal product to suppress nausea, soothe sore throats and reduce inflammation and joint pain.

Fresh ginger root is available at the produce section in most food stores. It is a light weight, low cost item. Fresh grated ginger provides a warm and spicy substitute for salt when preparing certain meals and a healthy substitute for sugar in fresh baked cookies & muffins.

Keep in mind, omega 3 fatty acids from cold water fish (salmon, albacore tuna) also help inhibit inflammation that initiates and inflames fatty build-up in the arteries (atherosclerosis). Omega 3 fatty acids help suppress three types of inflammatory mediators: prostaglandins, leukotrienes and thromboxanes. Blending ginger and omega 3 fatty acids into meal planning will help block inflammation that brews and becomes troublesome in the arteries.


Sources:
The 5-Lipoxygenase as a Common Pathway for Pathological Brain and Vascular Aging
Cardiovascular Psychiatry and Neurology Volume 2009
Jin Chu MD, Domenico Praticò MD

Ginger: An Herbal Medicinal Product with Broad Anti-inflammatory Actions
Journal Med Food 2005
Grzanna R, Lindmark L

Folate Helps Nurture Cardiovascular Health for Postmenopausal Women

Folate is a water soluble B vitamin. Low intake or low levels of folate, elevated homocysteine and high blood pressure contribute to cardiovascular disease. High homocysteine levels* are associated with an increased risk for stroke, myocardial infarction, and venous thrombosis (blood clot). The amount of homocysteine in the blood is regulated by folate, vitamin B12, and vitamin B6.

A placebo-controlled study completed in Italy investigated whether in healthy postmenopausal women a three week administration of folate at a dose of 15 mg/day was capable of modifying 24-hour ambulatory blood pressure. The study also investigated the relationship of folate to homocysteine and insulin metabolism.

The study found the folate supplement significantly decreased nocturnal systolic blood pressure -4.48 mm Hg, diastolic blood pressure -5.33 mm Hg and mean blood pressure -5.10 mm Hg. The placebo did not  produce any changes in blood pressure.

Folate also reduced homocysteine and insulin resistance.
The recommended dietary allowance for folate is 400 mcg a day.
Doses equal to or greater than 1 mg require a prescription. Keep in mind, this study used high-dose short-term folate administration.

*The endothelium is a thin layer of protective cells inside the artery. Plasma total homocysteine concentration of 10-30 µM produces endothelial dysfunction, including impaired endothelium-dependent vasodilatation and decreased thrombomodulin anticoagulant activity.

Sources:
High-dose short-term folate administration modifies ambulatory blood pressure in postmenopausal women.
A Cagnacci MD
European Journal of Clinical Nutrition (2009) 63, 1266–1268

Folate dependence of hyperhomocysteinemia and vascular dysfunction
in cystathionine -synthase-deficient mice
Steven R. Lentz, Rochelle A. Erger
Am J Physiol Heart Circ Physiol
Vol. 279, Issue 3, H970-H975, September 2000

Vegan Diet. . . Less LDL Cholesterol

Dyslipidemia refers to abnormal amounts of fat (lipids) and lipoproteins in the blood. Dyslipidemia more commonly referred to as high cholesterol is a primary risk factor for cardiovascular disease, peripheral vascular disease, and stroke. This is because more fats are being transported to and stored in the arteries. Dietary modification is often first-line therapy for individuals with elevated cholesterol. More specifically, plant-based dietary interventions are effective in lowering plasma cholesterol concentrations.

Investigators reviewed published scientific research to determine the effectiveness of plant-based diets in modifying cholesterol concentrations (plasma lipids) . Twenty-seven randomized controlled and observational trials were included.

Of the four types of plant-based diets, interventions testing a combination diet: a vegetarian or vegan diet combined with nuts, soy, and/or fiber, demonstrated the greatest effects (up to 35% LDL cholesterol reduction) followed by vegan (excludes all animal products) and ovolactovegetarian (includes eggs and milk or milk products) diets.

Interventions allowing small amounts of lean meat demonstrated less dramatic reductions in total and LDL cholesterol levels. There is an abundance of ideas regarding vegetarian meal planning on the web. In addition to being visually beautiful, vegetarian cooking is also economical.

Large prospective trials have also demonstrated that populations following plant-based diets, particularly vegetarian and vegan diets, are at lower risk for ischemic (decrease in the blood supply, decreased flow) heart disease mortality.

Source:
Effects of Plant-Based Diets on Plasma Lipids
Hope R. Ferdowsian, MD, MPH, Neal D. Barnard, MD
Washington Center for Clinical Research, The George Washington University, Washington, DC
American Journal Cardiology Volume 104, Issue 7, Pages 947-956 (1 October 2009)

Tea Comforts Women's Arteries

Coronary arteries are the major blood vessels that supply the heart with blood, oxygen and nutrients. The carotid arteries are the two primary arteries on the sides of the neck that supply blood to the brain. Plaque build-up in the coronary or carotid arteries contributes to arterial narrowing which reduces the flow of blood, oxygen and nutrients to the brain or heart cells.

Plaque is also troublesome when bits breaks off the artery wall. This bit or plaque fragment can cause a blockage that results in a heart attack or stroke. Less plaque is better for arteries.

The study noted below found daily tea consumption was associated with a lower prevalence of carotid plaques in women. The best results were found with 3 cups of tea per day.

The study involved 6597 French men and women aged 65 years or older. Carotid plaque frequency was 44% in women who did not drink tea, 42.5% in women drinking 1 to 2 cups of tea per day, and 33.7% in women who enjoyed 3 cups of tea per day. This association was independent of age, study center, major vascular risk factors, educational level, and dietary habits.

Results were tested in another, younger, French population (EVA-Study, 1123 subjects).  In the EVA-Study, carotid plaque frequency was 18.8% in women who did not drink tea , 18.5% in women drinking 1 to 2 cups of tea per day, and 8.9% in women who enjoyed 3 cups of tea per day. Increasing daily tea consumption was associated with a lower prevalence of carotid plaques in women, independent of vascular risk factors and dietary habits.

There was no association of tea consumption with carotid plaques in men, or extracranial carotid artery/ intima media thickness in both genders. A cup of tea with a peaceful friend or after a meditation session . . . so very comforting, especially for women's arteries.

Source:
Tea Consumption Is Inversely Associated With Carotid Plaques in Women: Three City Study and The EVA Study
Mahmoud Zureik, MD
Arteriosclerosis, Thrombosis, and Vascular Biology. 2008;28:353.

Vegetables Calm Blood Pressure

High blood pressure is the leading cause of cardiovascular disease. High blood pressure (hypertension) affects approximately 1 billion individuals worldwide.  It has been estimated that ninety percent of adults will develop hypertension by age sixty-five. With the application of evolving knowledge, as noted below, we should anticipate delaying the onset of hypertension by a least a decade.

The potassium/sodium ratio is a key factor in regulating blood pressure. Prior emphasis was focused on lowering sodium to moderate blood pressure. Lowering sodium intake is effective means to lower blood pressure. This is because sodium tends to tighten blood vessels.  However, newer research suggests increasing potassium has a favorable effect on blood pressure.  More specifically, a higher intake of potassium and lower sodium consumption seems to be more beneficial than focusing exclusively on sodium or potassium in reducing the risk of cardiovascular disease.

The advocacy and application of a correct potassium/sodium ratio will result in less hypertension and  cardiovascular disease worldwide. A favorable potassium/sodium ratio can be achieved through dietary means. A good start is to avoid pre-made and processed foods. They are very high in sodium.

Fruits and vegetables are high in potassium. Kidney and pinto beans, bananas, tomato sauce, tomato juice and orange juice are especially rich in potassium. Keep in mind, canned  beans will likely have added salt; a bag of dried beans is more economical and more healthful. Also look for no salt added tomato sauce. Orange juice with added calcium is more heart healthy.

More than 70 million Americans, or nearly one in three adults are estimated to have hypertension. 
Fewer than fifty percent achieve blood pressure control.
Hypertension is the most common reason for visits to physician's offices and the primary reason for prescription drug use.

Sources:
Joint Effects of Sodium and Potassium Intake on Subsequent Cardiovascular Disease
The Trials of Hypertension Prevention Follow-up Study
Nancy R. Cook, ScD; Eva Obarzanek, PhD
Arch Intern Med. 2009;169(1):32-40.

Leading Worldwide cause of Cardiovascular Disease may be Modified by Diet
Mark C. Houston, M.D
Journal Clinical Hypertension 2008/July

Low Dose Aspirin at Bedtime

Low-dose aspirin has also been shown to reduce blood pressure when administered at bedtime as opposed to awakening in untreated pre-hypertensive individuals. A recent study investigated the effects on ambulatory blood pressure of aspirin administered at different times of the day in pre-hypertension: individuals with an elevated risk of developing hypertension.

244 individuals with pre-hypertension, average age 43.0 (plus or minus 13.0 years of age), were randomly divided in three groups: nonpharmacological hygienic dietary recommendations; the same recommendations and aspirin (100 mg/day) on awakening; or the same recommendations and aspirin at bedtime. Blood pressure was measured for 48 consecutive hours before and after 3 months of intervention.

Ambulatory blood pressure was unchanged in subjects randomized to either non-pharmacological intervention or aspirin on awakening.

However, a significant ambulatory blood pressure reduction was observed in the subjects who received aspirin at bedtime: a decrease of 6/3 mm Hg in the twenty four hour mean of systolic/diastolic blood pressure. Blood pressure was homogenously controlled along the twenty four hour after bedtime aspirin administration. A 6/4 mm Hg reduction in activity mean of systolic/diastolic blood pressure; 6/3 mm Hg reduction in sleep-time mean, respectively.

This study demonstrates a significant effect on blood pressure with low dose aspirin when taken at bedtime by pre-hypertensive individuals. The timed administration of low-dose aspirin provides a cost-effective approach for blood pressure control in individuals at elevated risk of developing hypertension.

Source:
Ambulatory Blood Pressure Control With Bedtime Aspirin Administration
in Subjects With Prehypertension
Ramón C. Hermida, Diana E. Ayala, University of Vigo, Vigo, Spain
American Journal of Hypertension 2009

Mulberry Leaf Slows Sugar. . . benefits arteries

One of the most unique qualities of the mulberry leaf is that it contains compounds that inhibit intestinal enzymes from passing sugars into the bloodstream.

This inhibitor compound is called 1-deoxynojirimycin.  Mulberry leaf extract (available as a tea or dietary supplement) also contains compounds such as fagomine, which helps stimulate insulin secretion, and antioxidants such as quercetin/rutin that reduce lipid peroxidation. Antioxidants help prevent the cholesterol in the arteries from becoming polluted and toxic.  

Irregular blood sugar, and insulin spikes are associated with oxidation of LDL cholesterol. This oxidation generates a cascade of cellular activity in the arteries that contributes to coronary artery disease and eventually heart attack or stroke.

High blood sugar (hyperglycemia) is a risk factor for cardiovascular disease. High blood sugar or impaired glucose tolerance is a common feature of both acute myocardial infarction (heart attack) and chronic heart failure.  Enhanced glycemic control slows the progression of cardiovascular diseases.

By preventing large amounts of sugar from entering into circulation, mulberry leaf is also thought to help prevent diabetes and slow the progression of diabetes complications.

The antidiabetic effects of mulberry leaf act as a natural alpha-glucosidase inhibitor: a diabetes medication that blocks the action of enzymes that normally begin to break down certain carbohydrates in the upper part of the small intestine.

A cup of organic mulberry tea to enhance arterial health . . . a comforting thought.

Sources:
Influence of Mulberry Leaf Extract on the Blood Glucose and Breath Hydrogen Response to
Ingestion of 75 g Sucrose by Type 2 Diabetic and Control Subjects
Mudra, M., Ercan-Fang, N., Zhong, L., Furne, J., & Levitt, M.
Am J Clin Nutr, 84:551–55, 2006  

Effect of Mulberry leaves on Diabetes (this is a very informative study)
B Andallu, N Ch Vardacharyulu
International Journal of Diabetes in Developing Countries
2001 Volume : 21, Issue : 3  Page : 147-151