Antioxidants have role in treating heart patients
Antioxidants have role in treating heart patients
Studies show dramatic results
Congestive heart failure (CHF) and other forms of cardiovascular disease are marked by an alarming increase in circulating free radicals, so using antioxidants to combat free radicals’ ability to wreak havoc in the human body "makes perfect sense," says Steve Sinatra, MD, a cardiologist and director of Optimum Health in New York City and author of Heart Sense for Women.
Proponents of complementary therapies say antioxidants are effective and fundamental to the treatment of patients with cardiovascular disease and other chronic conditions. Specific antioxidants linked to cardiovascular disease include:
• vitamin C;
• vitamin E;
• vitamin B;
• magnesium;
• carotenoids;
• flavonoids;
• mega-boosts of coenzyme Q10 (CoQ10);
• lipoic acid.
Citing his 50 years of research in human nutrition, Lester Packer, PhD, recommends almost universal supplementation with what he calls the "network" antioxidants — C, E, lipoic acid, CoQ10, and glutathione. Packer is a professor of microbiology and director of the Packer Lab at the University of California in Berkeley and senior scientist at the Lawrence Berkeley Laboratories. Lawrence Berkeley is a multidisciplinary research lab jointly operated by the University of California and the U.S. Department of Energy.
Packer also recommends a support structure containing flavonoids and selenium. "What makes the network antioxidants so special is that they greatly enhance the power of one another. As a result, they are particularly effective in slowing down the aging process and boosting the body’s ability to fight disease."
Packer describes some of the antioxidants:
• CoQ10.
Found in fish and organ meats, Packer calls CoQ10 the "cellular spark plug." It is essential for the production of energy and helps produce adenosine triphosphate (ATP), the energy carrier molecule that converts fuel into energy while regenerating vitamin E in the antioxidant network. ATP makes a deficiency in this enzyme a factor in heart disease. He calls it a powerful link in the line of defense against angina, congestive heart failure, and cardiomyopathy. There have been two studies that report some success in using CoQ10 as a treatment for advanced breast cancer.
He recommends 50 mg a day for everyone over 40 because the body’s ability to produce this fat-soluble enzyme decreases with age, and for patients with heart disease, he suggests an additional 50 mg daily.
"Heart patients often have dangerously low levels of CoQ10, an indication they lack the spark plug’ required to keep the heart running normally," says Packer. "In fact, heart muscle biopsies in patients with various heart diseases showed a CoQ10 deficiency in 50% to 75% of all cases."
He cites two Texas studies, which showed dramatic improvements for heart patients given 75 mg to 600 mg of CoQ10, and an Italian study, which showed 54% of patients with CHF gained improvement in at least three symptoms of their disease.
Sinatra is another enthusiastic advocate of CoQ10. He says hearty biopsy specimens taken from patients with chronic CHF have shown decreased ATP concentrations, signaling a defect in the CoQ10 function.
"Given its usefulness in patients with CHF, angina, myocardial preservation in heart surgery, and after acute myocardial infarction (MI), CoQ10 should at least be considered for any patient with these conditions who has an unsatisfactory quality of life despite conventional medical treatment," he says.
Both Sinatra and Packer strongly advocate the use of CoQ10 for patients who are taking statin drugs because the powerful cholesterol blockers also block the metabolism of CoQ10.
In addition, Sinatra says CoQ10 has a role in preventing heart disease because of its ability to recycle the oxidized form of vitamin E to its original form and to increase resistance to low-density lipoprotein (LDL) oxidation.
• Lipoic acid.
This is what Packer calls the "universal antioxidant," which offers powerful protection against three common ailments of aging: stroke, heart disease, and cataracts. Lipoic acid acts as a booster for the entire antioxidant network by helping recycle all the network antioxidants and restore "used up" vitamins C and E and CoQ10 to their original form.
While its benefits are new to the United States, lipoic acid, found in small amounts in potatoes, spinach, and red meat, also has been used "safely and effectively" in Europe for more than 20 years to prevent and relieve the complications of diabetes.
Packer’s animal studies show that 60% of rats given lipoic acid after an artificially induced MI recovered, while only 25% of those without the antioxidant regained heart function. Rats given lipoic acid then exposed to free radical attack had much more protection against damage during a simulated MI.
Researchers in Berkeley also found that when the amino acid L-carnitine was administered along with lipoic acid, it rejuvenated the mitochondria in older animals.
Sinatra says he achieved significant improvement in the quality of life for heart patients with a combination of 400 mg of CoQ10 daily with 2 g to 3 g of L-carnitine.
• Flavonoids.
Sinatra cites the "French paradox" by which, despite a diet rich in highly saturated fats, patients have a lower incidence of coronary heart disease to support the value of flavonoids, most notably found in red grapes and that French mealtime favorite — red wine. Studies done in the Netherlands show the use of dietary flavo-noids, phenolic acids, and quercetin reduced the incidence of heart attack and sudden death.
Packer says scientific evidence shows flavo-noids, found in tea leaves, citrus fruit, apples, onions, berries, and pine bark, as well as in grapes, regulate nitric acid, a potent free radical that is a regulator of blood flow. Flavonoids have been shown to prevent blood clots, protect against oxidation of LDL cholesterol, and lower high blood pressure, he adds.
One Packer-recommended flavonoid, pycnogenol, was shown to improve microcirculation by reinforcing capillary walls, making them more resilient, and by protecting against platelet aggregation, the first step in the formation of blood clots.
"It is not my recommendation that red wine be routinely recommended for all patients," cautions Sinatra. "Remember, although the French may have the lowest incidence of coronary heart disease in Europe, they also boast the highest incidence of cirrhosis of the liver."
• Carotenoids.
Found in tomatoes, orange and yellow fruits, and dark green leafy vegetables, carotenoids are perhaps the most controversial, admits Packer. "For one thing, we’re not sure they are true antioxidants. In the test tube, several carotenoids have exhibited strong antioxidant activity, but we have not yet been able to prove that they act the same way in the human body."
Yet there’s no question that several studies show people who eat carotenoid-rich diets are significantly less likely to develop heart disease and cancer than those who do not. Sinatra notes one study that shows increased betacarotene stores in subcutaneous fat was correlated with a decreased risk of MI.
One disappointing study showed supplementation had no heart-protective effect for participants in the 22,000-member Physicians Health Study. Participants were double-blinded to take 50 mg of beta-carotene daily or a placebo.
Sinatra and Packer both suggest that the synthetic form of betacarotene may have been responsible for the disappointing results and that natural forms of some of the 600 other carotenoids may show more promising results in heart disease.
"The diseases of aging — diabetes, heart disease, arthritis, Alzheimer’s, cancer, among others — have extracted a steep toll on our quality of life," concludes Packer. "Our growing knowledge of the antioxidant network now enables us, for the first time, to practice real preventive medicine. Simply by fortifying the body’s anti-oxidant network, it is now possible to give the body the tools it needs to wage an effective fight against disease."
| Daily Antioxidant Cocktail | |
| Morning | |
| - Vitamin E — a natural compound containing 100 mg tocotrienols and 200 mg mixed tocopherols; | |
| - CoQ10 — 30 mg; | |
| - Lipoic Acid — 50 mg; | |
| - Vitamin C — 250 mg ester C; | |
| - Folic Acid — 400 mcg; | |
| - Biotin — 300 mcg; | |
| - Vitamin B6 — 2 mg; | |
| - Plus a natural multivitamin carefully calibrated not to exceed RDAs for other nutrients and without iron, because high iron levels have been associated with increased risk of heart disease. | |
| Evening | |
| - Vitamin E — 200 mg natural alpha tocotrienol; | |
| - Lipoic acid — 50 mg; | |
| - Vitamin C — 250 mg ester C; | |
| - Flavonoids: ginkgo biloba — 30 mg; | |
| - Selenium — 200 mcg. | |
| Source: Packer L. The Antioxidant Miracle. New York City: John Wiley & Sons; 1999. | |
| Cause and Defense | |
| Sources of free radicals | Antioxidant defense |
| Inflammation | Vitamin E |
| Cigarette smoke | Vitamin C |
| Exercise | Beta-carotene |
| Air pollutants | Other carotenoids |
| Radiation | Coenzyme Q10 |
| Ischemia | Catalase |
| Carcinogens | GSH peroxidases |
| Adriamycin | Selenium |
| Acetaminophen | Uric acid |
| Source: Sinatra S. Heart Sense for Women. New York City: Nutri-Books; 2000. | |
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