Blood Vessel Health, Part II - Haelan LifeStream Center

This Valentine’s Day Journal writing continues to explore general cardiovascular health via some research based information about modifiable risk factors which influence heart and blood vessel health. I want to present information which helps to round out the earlier Journal commentary which focused on the all-important microanatomy and function of the blood vessel lining.

The scope of the cardiovascular system includes the heart and the many thousands of miles of blood vessels which the heart acts through. The great 19th-20th century physician, Sir William Osler, considered the heart and blood vessels to be one organ.

Dr. Osler also believed that a person is only as young, or old, as their blood vessels. In 1892 he said, “Longevity is a vascular question. A man is as old as his arteries.”

We can rightly infer from this bit of truth that we age as our blood vessels age and in our later years we prosper or suffer in parallel with the health status of the cardiovascular system. What Osler said in 1892 is as true in 2024 as it was 132 years ago. In consideration of factors, such as the degradation of food and the food industry, the prevalent consumption of processed foods, and a variety of other toxic lifestyle habits, the incidence of cardiovascular disease is number 1 in all morbidity and mortality statistical charts of almost all of the world’s 195 countries; especially so in western countries and in so-called “civilized” countries.

The information presented below expands on the prior Journal writing, Blood Vessel Health, Part I, where the microanatomy of the blood vessel wall and its lining, known as the vascular endothelial glycocalyx (EGX), is presented. The integrity of this delicate inner blood vessel lining is the most foundational consideration in how our blood vessels age. As that Journal writing indicates there are important risk factors to consider in the pursuit of good blood vessel health. This current writing looks at recent research which reveals more refined considerations of how we can stratify the important considerations for promoting blood vessel health.

Modifiable Risk Factors in Cardiovascular Disease

Authors of an October 5, 2023 paper published in The New England Journal of Medicine considered pooled data from diverse population groups which had been previously considered in 112 cohort studies conducted in 34 countries across six continents and 8 geographical regions, encompassing over 1.5 million participants, with a median age of all participants at 54.4 years, of which 54 percent were women.

The researchers found that the over 50% of incidence of cardiovascular disease and approximately 20% of deaths from any cause may be attributable to five modifiable risk factors: body mass index (BMI), systolic blood pressure, non-HDL cholesterol, current smoking, and diabetes.

The researchers of this Global Cardiovascular Risk Consortium concluded that addressing lifestyle factors is the best way to reduce cardiovascular risk and improve overall health. The research suggests that prioritizing certain risk factors over others is warranted for those who are unable to change everything simultaneously.

Deeper consideration of the study’s findings reveal that these five risk factors are associated with very different risks for both cardiovascular disease (CVD) and all-cause mortality. Compared to BMI, non-HDL cholesterol, and systolic blood pressure, the hazard ratios associated with diabetes and current smoking are far higher, with diabetes more than doubling the risk among certain age groups.

Along with a growing body of other evidence these findings indicate that focusing on reversing type 2 diabetes and its underlying insulin resistance may be a more helpful strategy for preventing or reducing the incidence of CVD, as opposed to using non-HDL cholesterol as a key marker of cardiovascular health.

Furthermore, when compared to non-HDL cholesterol (even at levels above 200 mg/dL), BMI, systolic blood pressure, and diabetes all appeared to confer far greater risk for all-cause mortality. Since obesity, hypertension, and elevated glucose are part of the diagnostic criteria for metabolic syndrome, addressing this – rather than targeting elevated cholesterol – may have a bigger positive impact on health.

The Endothelial Glycocalyx

The website writing Blood Vessel Health, Part I detailed the importance of the microanatomical membrane which lines the inner blood vessel wall. This delicate membrane, known as the endothelial glycocalyx, or EGX, regulates the homeostasis and physiology of the inner endothelial “skin” of the blood vessel where nutrients and oxygen are absorbed on the arterial side, and the body’s waste material and CO2 are discharged on the venous side of the heart’s circulatory system.

If the EGX becomes damaged by any one of a host of toxicities the underlying vascular endothelium will degrade into various forms of atherosclerosis and/or aneurysm formation and/or thrombosis.

Damage to the EGX and underlying endothelium is most commonly caused by nicotine use, hypertension, elevated blood sugar, oxidative damage, and inflammatory biochemistry. Tobacco use can be stopped and these other risk factors can be mitigated by improved dietary choices and habits.

It is now known and accepted that the EGX is a highly dynamic membrane which responds with immediacy to the harmful agents, but it also responds immediately in a regenerative manner to beneficial agents. The website writing linked above further details the importance and efficacy of a new nutritional supplement known as Arterosil HP which is currently thought to be the most effective endothelial glycocalyx regenerating compound.

I’ll now turn to other lifestyle practices and nutritional supplements which assist blood vessel health and the modifiable risk factors outlined in the opening comments. The following will improve blood vessel health.

Lifestyle Recommendations

Here are my recommendations for blood vessel health. Any lifestyle activity which promotes blood vessel health will improve health in all organ systems.

Avoid tobacco in all forms.
Limit or avoid sugar and sugar containing foods. After nicotine, sugar is the most potent toxin of the EGX.
Avoid processed foods which contain sugar, industrialized fats, and chemical additives. These foods create inflammatory chemistry which damages the EGX, the underlying endothelium, and the vascular smooth muscle in the blood vessel wall. Eat only whole foods. The Mediterranean diet and the related Paleo diet are probably the best all around diets to support and enhance blood vessel health, as well as overall good health.
Move your body. Exercise is a potent positive booster of cardiovascular health. Some qualifying comments follow below.
Improve your sleep routine. During sleep our body regenerates at all levels.
Adopt a positive attitude of optimism. Stress, anxiety, depression, and loneliness erode cardiovascular health.
Expose yourself to nature as much as possible on a daily basis. Nature is one of the best healers and teachers.

Exercise

Regarding exercise, please consider the following points, which I have adopted and adapted from recent writings by Joseph Mercola, D.O.

Sedentary people who begin to exercise experience a “dose-dependent” decrease in mortality, diabetes, high blood pressure, coronary disease, muscle loss, depression, osteoporosis, falls, and much more.
Those doing high volume vigorous exercise can lose longevity benefits. For example, those doing triathlons in their 40s and 50s increase their risk of atrial fibrillation by 500% to 800% in later years.
Moderate exercise, defined as exercising to the point where you’re slightly short of breath but can still carry on a conversation, is felt to be one of the very best forms of exercise, and it cannot be overdone.
There is a 10% to 15% reduction in all-cause mortality with every 1000 steps taken daily. The benefits of walking plateau out at about 12,000 (6 miles) a day.
Strength training adds another 19% reduction in all-cause mortality on top of the 45% reduction from one hour of moderate exercise per day. However, benefits cease beyond one hour per week. 20 to 40 minutes of strength training two to three times a week is optimal. Going much beyond 60 minutes per week diminishes the benefits of strength training.

For more detail about these fine points of exercise, please see the article Training Strategies to Optimize Cardiovascular Durability and Life Expectancy, written by James O’Keefe, M.D., et al, in the journal Missouri Medicine, published in April, 2023. In addition to their research analyses, the authors make some nice points about being outside in natural environments to experience the benefits of Nature Therapy. The Japanese practice of shinrin-yoku (forest-bathing) is nicely referenced. Dr. O’Keefe and his co-authors have individually published extensively on exercise physiology and other health topics. The range of their various research writings can be appreciated by clicking on their linked names.

In another recent study, the benefits of isometric exercise are also promoted. See Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomised controlled trials. This study was published in The British Journal of Sports Medicine on July 25, 2023. The article poses this conclusion: “Various exercise training modes improve resting blood pressure, particularly isometric exercise. The results of this analysis should inform future exercise guideline recommendations for the prevention and treatment of arterial hypertension.”

Based on this study some points about isometric exercises are noted here.

Simple isometric exercises offer a natural strategy to lower blood pressure.
Out of multiple forms of physical activity, isometric exercise came out on top as “the most effective mode in reducing both systolic and diastolic blood pressure.”
Broken down to individual exercises, wall squats (isometric) were the most effective for reducing systolic blood pressure while running (aerobic) was most effective for reducing diastolic blood pressure.
About eight minutes of isometric training three times a week may be enough to significantly lower blood pressure.
Wall squats, planks, glute bridge and the overhead hold are examples of simple isometric exercises you can do virtually anywhere.

Here is an article from the Cleveland Clinic explaining some of these isometric exercises…5 Isometric Exercises You Should Be Doing and Why.

Nutritional Supplements

The nutritional supplement line I recommend is Designs for Health (DFH). These products are backed by reliable research, pure ingredients, and effective formulations.

Here is the DFH suite of the core supplements which support cardiovascular health.

By clicking on the product name or image you will be taken to the webpage for purchasing the supplement. On these webpages a Patient Education sheet on that product can be viewed with another click. Rather than attempt to describe and explain each of these supplements, I will refer you to the Patient Education pages for each where the actions of their biochemistry is explained.

Regarding the 3 products which feature red yeast rice I will make some comments. Red yeast rice (RYR) is the botanical compound from which all of the statin drugs are made, and patented. Using RYR compounds is a safer alternative to statins for those who want to lower cholesterol numbers. Statin drugs can have considerable complications.

After recommending the RYR compounds from DFH over the past 15 years, patients have not reported such complications. Here is a small randomized trial of 62 people reported in the Annals of Internal Medicine in 2009 who used RYR after experiencing complications from statin drugs. These patients did not have complications from the RYR usage.

The 3 RYR compounds are: 1) RYR Synergy, and 2) Lipotrienols RYR, and 3) Red Yeast Rice. Each of these formulations features 1200 mg. of RYR per 2 capsules. This is the statin dosing equivalent of 5 mg. of statin drug.

A tiered approach to improving blood vessel health for anyone over age 50 should start with learning about the EGX which lines the blood vessel inner wall, and doing the supplement and lifestyle recommendations explained in Blood Vessel Health, Part I. This should be followed by consideration and practices to improve insulin and glucose abnormalities combined with improving mitochondrial health and general metabolic health.

In addition to the 24 core supplements on the DFH cardiovascular health page, as is linked above, there are a variety of other products in this line which are very good considerations for metabolic and mitochondrial health. Such considerations will improve cardiovascular health.

The mitochondria is where the energy of all cells is produced. The maintenance of mitochondrial health is especially important in the most metabolically active cells in the body…the cells of the heart, which contain more mitochondria per cell than any other organ.

The role of the mitochondria can be explored in a past website writing, Minding your Mitochondria. The biochemistry and nutritional elements which support the energy production function of this all important cellular organelle are covered in this writing. There are 7 essential elements needed by the mitochondria to turn protein, fats, carbohydrates, and oxygen into the energy chemical of life known as adenosine triphosphate, or ATP. These 7 chemicals are available in the following DFH supplement categories:

A combination of select products from this list of 7 categories will help a recovery of mitochondrial performance 1) when it is important to reestablish a robust performance, such as is needed in mitochondropathy conditions, 2) when taking certain pharmaceutical classes of drugs, 3) when exposed to environmental toxins, and 4) in the face of most chronic disease conditions.

A separate composite product, Mitochondrial NRG contains almost all of the above, plus resveratrol and stabilized curcuminoids. These 2 additions assist in mitochondrial regeneration and biogenesis. This supplement is good for daily maintenance of healthy mitochondrial function. It does not contain the omega fatty acids, which would have to be used separately.

In consideration of the fact that high blood sugar levels are injurious to blood vessel health, another example of a cardiovascular supportive supplement would be any that supports healthy blood sugar levels. The main core product in this regard is Metabolic Synergy. I refer the reader to the Patient Education sheet for this supplement to learn more about some of the biochemistry built into Metabolic Synergy.

Other DFH supplements which support healthy glucose and insulin levels, as well as metabolism, are seen on the Endocrine-Metabolism page of products. After consideration of Metabolic Synergy, such supplements relevant to improving insulin and glucose metabolism are: Berberine Synergy, Berberine-Evail, GlucoSupreme Herbal, and Sensitol.

The previous Journal writing posted several days ago is Berberine, which covers the many impressive benefits gained by using this important medicinal herb.

Conclusion

The late great John F. Kennedy, who died at age 46, shared a lot of wisdom in his time here. One of my favorite JFK quotes is, “The time to repair the roof is when the sun is shining.”

Here is a nice interpretation of that quote.

Being inseparable from the interwoven fabric of Being, the heart is where breath, blood, and spirit merge to connect our lives with God’s presence in all things.

I wish you a happy and healthy heart.

Happy Valentine’s Day!

Signing off from Crestone and Beyond

Associated Readings

This first section of readings present interesting information on the life and contributions of Sir William Osler.

Sir William Osler (1849-1919)-The Uses of History and the Singular Beneficence of Medicine…”In his last public address, given at Oxford on May 16, 1919, in the aftermath of the Great War (in which his own beloved son, Revere, had been killed), Osler spoke on ‘The Old Humanities and the New Science.’ He closed his address with the wistful hope that, through the Hippocratic combination of the love of humanity (philanthropia), and the love of one’s craft (philotechnia), humankind would somehow acquire the requisite wisdom (philosophia) to survive and flourish and that science would prove a force for good rather than evil.”
About William Osler…this picture at the top of this short biography presents an image of the researcher, scholar, and writer of this great physician, clinician, and teacher of doctors.
The William Osler Papers…”Sir William Osler (1849-1919) was a Canadian physician often called “the father of modern medicine” for the central role he played in revolutionizing medical education via the internship and residency system at the Johns Hopkins School of Medicine, where medicine was taught ‘at the bedside.’ He was equally renowned as a superb diagnostician, a prolific author of medical and historical works (including his landmark textbook, The Principles and Practice of Medicine), an avid rare book collector, and an advocate for medical libraries.”

This next section of readings presents some of the writings on this website which directly relate to cardiovascular health.

This next section of readings contains articles of general health interest which also relate to cardiovascular health.

Physical Activity & CVD Risk…a nice summary of an April 23, 2024 publication in the Journal of the American College of Cardiology which correlates stress-related neural activity of resting amygdala to cortical metabolic activity with exercise and cardiovascular risk. The study revealed that reducing the stress-related activity in the brain through physical activity was partly responsible for lowering CVD risk.
Micronutrients to Promote Endothelial Integrity and Healthy Inflammatory Status…posted here on 3-1-24. This is a nice summary from 2-13-24 which references some of the biochemistry of vascular inflammation and the types of nutrients which neutralize inflammatory chemistry. Vitamin D, magnesium, rhamnan sulfate (in Arterosil HP), and lipoic acid are mentioned as important nutrients for vascular health.
Transform Your Stress and Create Better Health and Resilience…a short and simple brochure handout from the people at the HeartMath Institute who want to give us some techniques to practice to calm the heart, improve heart rate variability (HRV), and help the heart and brain synchronize into more harmony.
The Role of Mitochondria in Cardiovascular Disease…an extensive and technical article from 2020 detailing the role of mitochondrial health and non-health at every level of pathogenesis in cardiovascular disease conditions.
Targeting mitochondria for cardiovascular disorders: therapeutic potential and obstacles…a brief and readable summary posted in a 2019 edition of Nature Reviews Cardiology (complete with 342 references on this subject, should you be interested) which poses the following summary points: 1) Mitochondrial dysfunction is involved in the pathogenesis of multiple cardiovascular disorders, including myocardial infarction, cardiomyopathies of various aetiologies, arrhythmias, hypertension, and atherosclerosis. 2) Mitochondria are essential for the physiological activity of the cardiovascular system owing to their crucial role in bioenergetic and anabolic metabolism and their central position in intracellular Ca²⁺ fluxes. 3) In addition to losing their physiological functions, damaged mitochondria actively drive inflammatory responses and waves of regulated cell death that contribute to the pathogenesis of cardiovascular disease. 4) An intensive wave of investigation attempted to develop mitochondria-targeting agents for preventing or treating cardiovascular disorders in patients, with rather dismal results. 5) Molecules with improved pharmacological features, precise mechanistic insights into mitochondrial processes, and reconsidering the pathogenesis of some cardiovascular disorders are instrumental for the development of mitochondria-targeting agents with clinical use.
Mitochondrial dysfunction: A fatal blow in depression…a November, 2023 abstract published in Biomedicine and Pharmacotherapy gives credence to the role of mitochondropathy in the genesis of depression…”mitochondrial dysfunction is observed in various brain regions of patients with major depressive disorders. The accumulation of defective mitochondria accelerates cellular nerve dysfunction. In addition, impaired mitochondria aggravate alterations in the brain microenvironment, promoting neuroinflammation and energy depletion, thereby exacerbating the development of depression.” It is likely that mitochondropathy plays a similar role in all diseases.
Loren Cordain–Origins and Evolution of the Western Diet: Health Implications for the 21st Century…this is a very informative and interesting presentation by Dr. Loren Cordain, Ph.D., who is Professor Emeritus in the Department of Health and Exercise Science at Colorado State University. He is a great promoter of the paleolithic diet, another diet which promotes cardiovascular health, and is in alignment with the Mediterranean diet. He has traveled all over the world presenting his anthropological findings and conclusions about the diet and lifestyle of our paleolithic forebears. I first encountered Dr. Cordain in 2002 at a health seminar in Boulder, CO, where he presented such a lecture. I became an advocate of his book The Paleo Diet, now a book series, which I still recommend.
The Intelligent Inner Lining of Blood Vessels: Nutrients that Support Vascular Health…from Clinical Applications of Scientific Innovation (CASI) is this nice concise summary of the importance of the endothelial glycocalyx, referred to often in the main writing above as the EGX. Beneficial foods and supplements are mentioned in this brief.
A Functional Medicine Approach to Hypertension with Dr. Mark Houston…my friend and mentor Mark Houston is surely one of the world’s most brilliant and accomplished clinicians and health teachers. Read the summary presented on this page and take the time to view this 1 hour interview. You can learn more about Dr. Houston and his work at the Hypertension Institute, which is in Nashville, Tennessee.
Brief Review: Effects of Isometric Strength Training on Strength and Dynamic Performance…another article on isometric training published in the April 3, 2019 publication International Journal of Sports Medicine. This is a brief, well written, and very readable summary. Benefits include less fatigue and advantageous benefits to disadvantaged joints, as well as maintaining and improving muscle mass.

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