By: Gretel Galan, Panama QC Manager
Heart failure is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the heart’s ability to pump enough blood to meet the body’s needs. Several nutraceuticals have shown interesting clinical results in supporting heart health alone or in association with pharmacological therapy.
Heart failure affects 23 million people worldwide, and it is a main cause of mortality in Western countries. Supporting heart health is essential not only to improve quality of life but also because of the great economic load imposed in the healthcare system and society, through hospitalization, pharmacological therapy, lost productivity, morbidity and premature mortality.
Recently, University of Bologna researchers, used a systematic search strategy to identify clinical trials in PubMed, a searchable database of biomedical citations and abstracts (January 1980 to April 2016), using terms such as ‘nutraceuticals’, ‘dietary supplements’, ‘herbal drug’ and ‘heart failure’. They reviewed all citations retrieved to identify relevant articles, mainly focused on human trials. They selected randomized controlled trials (RCTs) on natural substances with potential positive effects on Heart Failure.
Researchers found clinically relevant data on the following nutraceuticals and plant extracts: Hawthorn extract, Coenzyme Q10, L-carnosine, Vitamin D, D-ribose, and Omega-3 fatty acids.
Hawthorn acts as an antioxidant, an antinflammatory, has inotropic effects and is a coronary vasodilator. Through statistical analyses of various RTCs, with 320-1800 mg/day doses, an increase in maximal workload was detected along with a decrease in heart failure symptoms discomfort.
Coenzyme Q10 acts as an antioxidant, increases ATP synthesis, and stabilizes Calcium dependent channels. Through a RCT with dosages of 60-300mg/day effects such as increase in ejection fraction (fraction of blood ejected from a ventricle of a heart with each heartbeat), increased cardiac output and index, increase in stroke volume (blood volume ejected with each pump), end diastolic volume (volume left in the ventricle at end load of before systole) and increased exercise capacity, while decreasing major adverse cardiovascular events and total mortality.
Anti-inflammatory effects found in Vitamin D, increased ejection fraction with tested dosages of 4000 IU/day.
Heart failure is characterized by a deficiency of various micronutrients in heart tissues; several studies highlight an amino-acid supplementation plays a nutritional and metabolic effect in patients. D-ribose administered by 5g/day increased levels of ATP, improving diastolic dysfunction caused by ischemia and increased tissue doppler velocity (velocity of myocardial motion). L-carnosine acts as antioxidant, chelator of iron and copper and has a sensitizing action on calcium channels in cardiac contraction. In a study with administered doses of 500mg/day showed a cardio-protector effect against ischemia-reperfusion damage, pro-contractile action and increased quality of life and exercise performance in patients.
Omega-3 polyunsaturated fatty acids act as stabilizers of mitochondrial membranes, altering the structure and function; dietary supplementation on doses of 1g/day, showed decreasing end-diastolic and end-systolic left ventricle dimensions, an increase in atrial ejection fraction and decreasing B-type natriuretic peptide (protein markers in heart failure patients).
What It Means:
These nutraceuticals have found a significant importance for Heart Failure patients. These seem to ameliorate symptoms, as well as quality of life and exercise performance in some cardiac parameters, such as ejection fraction, stroke volume and cardiac output, to mention a few. Parallel to drug therapy, a potential support is given by nutraceuticals or dietary supplements associated with a healthy lifestyle. Clinical evidence supports the use of some nutraceuticals in heart failure prevention or in the treatment of early phases of the condition, with the advantage of excellent clinical tolerance.
Note: Always consult with your healthcare provider before taking any dietary supplement.
Cicero, A., Colletti, A. (2017) Nutraceuticals and Dietary Supplements to Improve Quality of Life and Outcomes in Heart Failure Patients. Current Pharmaceutical Design. Volume 23: 1265-1272.