Cardiovascular disease refers to more than one disease of the circulatory system including the heart and blood vessels, whether the blood vessels are affecting the lungs, liver, brain, or kidneys. There are four main categories of cardiovascular disease:

Coronary artery disease—also known as atherosclerosis or hardening of the arteries—wherein the arteries feeding blood into the heart muscle are narrowed from the accumulation of cholesterol plaques on the artery walls.

Heart rhythm disorders/arrhythmia: Where the heart beats too slowly, too quickly, or in an irregular fashion.

Structural heart disease: Abnormalities in the structure of the heart including the valves, neighbouring blood vessels, or heart walls, which can either be congenital or acquired.

Heart failure: When the heart loses part of its muscle strength and its ability to contract normally.

Cardiovascular disease represents a major health burden for Canadians—about one-third of Canadians die from heart attacks and stroke, and approximately 16% of hospitalizations are due to cardiovascular disease. As of 2009, cardiovascular disease represents the second leading cause of death among Canadians. The burden of cardiovascular disease, in turn, results in a major economic cost, with more than $22 billion in direct and indirect costs attributed to cardiovascular disease as of 2000.[1], [2], [3]

Cardiovascular disease represents a significant health challenge to Canadians. Exercise and pharmaceutical intervention can help to mitigate risk. But we also know that cardiovascular risk is amenable to diet and lifestyle interventions. So what are some other considerations to help reduce the risk of cardiovascular disease?

Data from the 2017–2018 Canadian Chronic Disease Surveillance System (CCDSS) revealed:

• Roughly 1 in 12 (or 2.6 million) Canadian adults age 20 and over live with diagnosed heart disease.
• Every hour, about 14 Canadians age 20 and over with diagnosed heart disease die.
• Men are twice as likely to suffer a heart attack than women.
• Ninety percent of Canadians still have suboptimal cardiovascular health from multiple cardiovascular risk factors, higher rates of obesity and diabetes, and suboptimal control of hypertension, dyslipidemia (high/suboptimal triglycerides and/or cholesterol) and blood glucose.[4], [5], [6]

Five Key Micronutrients to Support Cardiovascular Health

Vitamin D

Vitamin D is a prohormone synthesized in the skin through ultraviolet radiation of 7‑dehydrocholesterol. Its primary action is on the skeletal system, where it regulates calcium and phosphorus balance. Aside from its effect on bone mineralization, vitamin D also modulates the immune system, can reduce inflammation, and relaxes the muscles in blood-vessel walls. Vitamin D deficiency is observed in high cholesterol, clot formation, calcification of arterial walls, hypertension, as well as diabetes.[7] A meta‑analysis showed that vitamin D supplementation resulted in a reduction in “bad” LDL cholesterol and triglycerides, an increase in the “good” HDL cholesterol, reduced blood pressure, and a reduction in hs‑CRP, a marker of inflammation.[8], [9]

Omega‑3s

Omega‑3 fatty acids are a group of polyunsaturated fatty acids with multiple double bonds. The major types of long-chain omega‑3 fatty acids include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are mainly acquired from the consumption of seafood. EPA and DHA can be synthesized through the intake of a plant-based omega‑3, alpha-lipoic acid (ALA)—but in small quantities. Omega‑3s influence cell-membrane structure and signalling and reduce inflammation due to the EPA. Additionally, omega‑3s can increase nitric-oxide release, resulting in blood-vessel dilation and reductions in blood pressure. Omega‑3s also normalize heart rhythm, lower triglycerides, and can help increase “good” HDL cholesterol. Studies looking at omega‑3 supplementation have shown reductions in cardiovascular events, including heart attack and stroke.[10], [11], [12]

Coenzyme Q10

CoQ10, or ubiquinone, is an organic molecule that is essential in the human body. CoQ10 is found inside the mitochondria, where it serves a crucial role in cellular energy production, of which the heart requires a lot. Aside from its role in energy production, CoQ10 is also an antioxidant as well as an anti-inflammatory, and the reduction of oxidative stress and inflammation are important processes in reducing the risk of atherosclerosis and hypertension. CoQ10 deficiency has been linked to an array of cardiovascular diseases including cardiomyopathy, heart failure, and ischemic heart disease. Supplementation with CoQ10 has been shown to reduce systolic blood pressure, decrease heart arrhythmia, reduce cardiomyopathy and cardiotoxicity, and reduce LDL cholesterol.[13]

Vitamin K

Vitamin K is a fat-soluble vitamin which occurs in two forms: vitamin K1 (phylloquinone), of which leafy green vegetables are the primary dietary source, and vitamin K2 (menaquinone), which is derived primarily from bacterial fermentation and is found in fermented foods such as cheese or natto. Both forms of vitamin K are associated with improvements in cardiovascular health by influencing calcium metabolism, reducing systemic inflammation, and reducing arterial calcification through activation of matrix Gla protein. Supplementation of vitamin K2 has been strongly associated with improved cardiovascular outcomes through decreasing systemic calcification as well as reducing arterial stiffness. A study demonstrated a 21% reduction in hospitalization due to atherosclerosis in participants with the highest intake of vitamin K1, and a 14% reduction of hospitalization in those with the highest vitamin K2 intake.[14], [15]

Magnesium

Magnesium is one of the most abundant minerals in the body. It plays a pivotal role in cardiovascular health, where it helps support mitochondrial function (the energy-producing organelle of the cell) and helps reduce oxidative stress, a key player in cardiovascular disease. Magnesium deficiency is associated with increases in inflammatory markers—including C‑reactive protein and nuclear factor kappa B (NF‑κB)—and platelet dysfunction resulting in thrombosis and an increase in stroke risk. Deficiency is also associated with endothelial (heart-cell wall) dysfunction, with resultant narrowing of artery walls and atherosclerosis. Magnesium supplementation can help reduce cholesterol and blood-sugar levels as well as normalize heart rhythm and reduce the risk of congestive heart failure.[16], [17]

Conclusion

Cardiovascular disease represents a major burden when it comes to the health of Canadians. While exercise and pharmaceuticals are mainstays for reducing the risk of adverse outcomes of cardiovascular disease, given it is the second leading cause of death, looking at other interventions including supplementation is warranted. While you may wish to consider supplementation to improve your cardiovascular risk profile, as always, for anyone with a preexisting cardiovascular disease and/or on prescription medication, it is imperative to first consult with your doctor or pharmacist prior to supplementation to avoid any adverse effects or contraindications.

Dr. Colleen Hartwick, ND

Dr. Colleen Hartwick is a licensed naturopathic physician practising on North Vancouver Island, BC, with a special interest in trauma as it plays a role in disease.

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