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July 9, 2010

Long-term antioxidant supplementation improves arterial health

Long-term antioxidant supplementation improves arterial health

An article published online on July 6, 2010 in Nutrition and Metabolism reports the outcome of a clinical trial which found that supplementing with four important antioxidants improved arterial elasticity and high density lipoprotein (HDL) cholesterol levels while reducing hemoglobin A1C (glycated hemoglobin, or HbA1C, a marker of prolonged elevated blood glucose) in men and women at risk of cardiovascular disease.

Reuven Zimlichman and colleagues at Israel's Wolfson Medical Center enrolled 70 patients from the Center's hypertension clinic who had at least two of the following risk factors: high blood pressure, diabetes, low HDL cholesterol or cigarette smoking. Participants were randomized to daily supplementation with 1000 milligrams vitamin C, 400 international units vitamin E, 200 micrograms selenium and 120 milligrams coenzyme Q10, or a placebo for 6 months. Arterial elasticity and blood levels of lipids, HbA1C and other factors were evaluated before treatment and at three and six months.

By the end of the treatment period, HDL-cholesterol increased and blood pressure and HbA1C were reduced compared to baseline levels among those who received antioxidants while remaining relatively unchanged in those who received a placebo. Small and large arterial elasticity also significantly improved in the antioxidant-supplemented group.

In their discussion of possible mechanisms for the antioxidants, the authors remark that "Combined supplementation of vitamin E and C have been shown to inhibit DNA oxidation by hydrogen peroxide in human lymphocytes, to enhance endogenous plasma and tissue antioxidant defenses and restore endothelium dependent vasoactivity. Coenzyme Q10, which plays an essential role as an electron carrier in mitochondrial oxidative phosphorylation, improves endothelial dysfunction in diabetic patients. Finally, selenium as a determinant of antioxidative glutathione peroxidase 1 expression and activity provides significant protection of the coronary artery endothelium against damage by oxidative stress."

"Antioxidant supplementation significantly increased large and small artery elasticity in patients with multiple cardiovascular risk factors," Dr Zimlichman concluded. "The findings of the present study justify investigating the overall clinical impact of antioxidant treatment in patients with multiple cardiovascular risk factors."

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Health Concern Life Extension Highlight

Coronary artery disease and atherosclerosis

In the world of conventional medicine, atherosclerosis is a widely misunderstood disease, perhaps because of a fundamental misconception about the nature of the arteries themselves. In this antiquated view, the arteries have been thought of as stiff pipes that gradually become clogged with excess cholesterol floating around the bloodstream. The solution recommended most often has been to reduce the dietary consumption of fats in order to lower levels of cholesterol, triglycerides, and low-density lipoprotein (LDL) in the blood.

Today, our understanding of atherosclerosis has literally redefined the disease. We now understand atherosclerosis as a chronic inflammatory disease that affects the way arteries function at the most basic level. Instead of viewing the arteries as pipes through which blood flows, we now understand that arteries are muscular organs that change and adapt to their environment and contract and expand in response to multiple factors, helping to raise and lower blood pressure and distribute blood throughout the body. Finally, we have begun to unravel the biochemical processes that underlie atherosclerosis.

Vitamin C inhibits damage caused by oxidative stress. In cigarette smokers, daily supplementation with 500 mg vitamin C significantly decreased the appearance of oxidative stress markers (Dietrich M et al 2002). Another study showed that supplementation with 500 mg vitamin C and 400 IU vitamin E daily significantly reduced the development of accelerated coronary arteriosclerosis following cardiac transplantation (Fang JC et al 2002). Vitamin C’s benefits seem especially profound in people who suffer from both diabetes and coronary artery disease. One study demonstrated that, in this group, vitamin C significantly improved vasodilation (Antoniades C et al 2004).

Vitamin E is often studied in conjunction with vitamin C for its potent antioxidant powers. It has been shown to decrease lipid peroxidation and inhibit smooth muscle cell proliferation, platelet aggregation, monocyte adhesion, oxidized LDL uptake, and cytokine production—all of which occur during atherosclerosis (Munteanu A et al 2004; Harris A et al 2002). In cultured arterial endothelial cells, vitamin E increased the production of prostacyclin, a potent vasodilator and inhibitor of platelet aggregation (Wu D et al 2004). Most vitamin E supplements come in the form of alpha-tocopherol. Life Extension recommends about 400 IU alpha-tocopherol a day, along with at least 200 mg gamma-tocopherol and 100 mg of coenzyme Q10. There is a concern that taking only the “alpha” form of vitamin E could deplete the body of gamma-tocopherol, a critically important antioxidant. Coenzyme Q10 helps regenerate oxidized vitamin E in the body.

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