Nutraceuticals in Cardiovascular Prevention: Lessons from Studies on Endothelial Function

Abstract

An “unhealthy” diet is considered as a main cause of increased atherosclerotic cardiovascular disease in the industrialized countries. There is a substantial interest in the potential cardiovascular protective effects of “nutraceuticals,” that is food‐derived substances that exert beneficial health effects. The correct understanding of cardiovascular effects of these compounds will have important implications for cardiovascular prevention strategies. Endothelial dysfunction is thought to play an important role in development and progression of atherosclerosis, and the characterization of the endothelial effects of several nutraceuticals may provide important insights into their potential role in cardiovascular prevention. At the same time, the analysis of the endothelial effects of nutraceuticals may also provide valuable insights into mechanisms of why certain nutraceuticals may not be effective in cardiovascular prevention, and it may aid in the identification of food‐derived substances that may have detrimental cardiovascular effects. These findings further support the notion that nutraceuticals do need support from large clinical outcome trials with respect to their efficacy and safety profile for cardiovascular prevention, before their widespread use can be recommended. In fact, the term nutraceutical was coined to encourage an extensive and profound research activity in this field, and numerous large‐scale clinical outcome trials to examine the effects of nutraceuticals on cardiovascular events have now been performed or are still ongoing. Whereas it is possible that single nutraceuticals may be effective in cardiovascular prevention, this field of research provides also valuable insights into which food components may be particularly important for cardiovascular prevention, to further advice the composition of a particularly healthy diet. The present review summarizes recent studies on the endothelial effects of several nutraceuticals, that have been intensely studied.

Evidence for a protective effect of polyphenols-containing foods on cardiovascular health: an update for clinicians

“…Several intervention studies have suggested that the consumption of flavonoid-rich foods such as tea, red wine, cocoa and soya can improve endothelial function in patients with manifest cardiovascular and cerebrovascular disease as well as in healthy volunteers with or without cardiovascular risk factors [Vita, 2005;Zuchi et al 2010]. Teragawa and colleagues offered an overview of the studies investigating the effect of isoflavone supplementation, using soy protein isolates and isoflavone extract, on endothelial function, as determined by assessing brachial FMD [Teragawa et al 2008].…”

Nutraceuticals and dyslipidaemia: Beyond the common therapeutics

“…In particular, the Mediterranean diet, which may be considered on top of the list, can improve the overall outcome and prognosis of the general population by reducing major cardiovascular risk events (myocardial infarction, stroke, or death from cardiovascular causes) rates (Estruch et al, 2013). This positive action may be related to several mechanisms such as endothelial function amelioration (Zuchi et al, 2010), atherosclerosis burden reduction (Badimon, Vilahur, & Padro, 2010), antithrombotic activities (Chakrabarti & Freedman, 2010), decreases in diabetes and metabolic syndrome incidence and evolution (Davì, Santilli, & Patrono, 2010) and improving dyslipidaemia (Houston, 2012) via lipid metabolism mechanisms (such as improving paraoxonase activities) (Rahimi-Ardabili et al, 2012).…”

Separate and co-administration of Amaranthus spinosus and vitamin C modulates cardiovascular disease risk in high fat diet-fed experimental rats

“…Increasing evidence indicates that certain natural products can influence the aetiology, progression and treatment of CVD (Osadolor et al, 2005;Amadou et al, 2009;Zuchi et al, 2010;Sahebkar, 2013) and this may occur by modifying risk factors such as obesity, dyslipidaemia as well as factors involved in systemic inflammation, oxidative stress and thrombosis (Parikh et al, 2005;Napoli et al, 2007). The role of dietary fat in health has been under intensive research during the past decades (Ursula et al, 2014).…”