Cholesterol is a fatty substance made by our bodies and which is also found in our food. It is essential for the synthesis of many hormones, but also for the structure of the membrane that surrounds cells. Excess cholesterol is not a disease in itself but a risk factor for other diseases of the heart and blood vessels. After several years of too high a level, cholesterol gradually causes a loss of elasticity in the arteries and reduces their diameter. This is called atherosclerosis (or arteriosclerosis), a disease that can have serious consequences. The treatment of excess cholesterol is based on dietary measures and specific drugs.
WHAT IS CHOLESTEROL USED FOR?
Cholesterol is part of the family of lipids or fats, more commonly known as ‘fats’. “Cholesterol circulates in the blood. It is found in the membranes of all our cells, where it plays an important role in stability, fluidity, and more broadly in structure. In neurons, brain cells, it allows the synthesis of neurotransmitters and therefore helps the propagation of nerve impulses “, specifies Doctor Jean-Michel Cohen, nutritionist. And to add: “Finally, it is a precursor of synthesis for several important elements of our body: Hormones, also called steroids, including sex hormones, bile salts, and vitamin D.”
WHAT IS EXCESS CHOLESTEROL?
Excess cholesterol is not a disease in itself but a risk factor for other diseases of the heart and blood vessels. In fact, it is an excess of LDL cholesterol, also called bad cholesterol, which promotes the formation of deposits on the lining of the arteries. These deposits gradually cause the arteries to lose elasticity and reduce their diameter, which increases the risk of suffering from a heart attack, stroke or arteritis.
The other fraction of cholesterol, HDL cholesterol or “good cholesterol”, traps excess cholesterol in the blood and stimulates its elimination by the liver. Rather, it has the effect of reducing the rate of cardiovascular disease.
The level of cholesterol in the blood tends to increase with age. After several years of being too high, cholesterol forms deposits on the walls of the arteries called atheromatous plaques, which may contain other substances, such as calcium. This is called atherosclerosis (or arteriosclerosis). This disease does not cause any symptoms for years. However, the supply of oxygen and nutrients to affected organs sometimes drops dramatically, causing severe and sometimes sudden symptoms over time.
WHAT ARE THE SYMPTOMS OF TOO MUCH CHOLESTEROL?
Excess LDL cholesterol does not cause symptoms, but its deposit in the arteries can cause disease,, in particular those of the heart (coronary arteries). For example, angina pectoris, a contraction of the arteries of the heart, even a myocardial infarction. The plaques reduce the size of the arteries, making it more and more difficult for blood to pass through and can promote blood clots (thrombosis). When the blood stops flowing, the cells, deprived of oxygen, die. If the arteries of the brain are affected, paralysis, dizziness or speech disorders are possible, even a stroke. Finally, if the arteries in the legs are narrowed, arteritis causes intermittent calf cramps when walking. Erectile dysfunction is also observed.
WHAT ABOUT TRIGLYCERIDES?
Triglycerides make up most of the fat we eat and circulate in our blood. They are an essential source of energy for our body. It seems that too high a level of triglycerides in the blood promotes the development of cardiovascular disease, but opinions differ on this subject. The level of triglycerides in the blood is usually less than 1.5 g / l. An abnormally high level is often linked to too much alcohol, uncontrolled diabetes, being overweight, overloading the liver with fat, or taking certain medications.
WHAT ARE THE CAUSES OF EXCESS CHOLESTEROL?
There are a number of factors that can increase the level of LDL cholesterol in the blood:
- a diet too rich in animal fats and cholesterol;
- overweight and obesity;
- insufficient physical activity;
- gender (men have higher LDL cholesterol levels).
- Other disorders, for example diabetes, hypothyroidism, liver disease and kidney disease, can increase LDL cholesterol levels in the blood.
WHAT ARE THE COMPLICATIONS OF EXCESS CHOLESTEROL?
The signs of atherosclerosis are different depending on the organs affected. They happen when the blood flow is so reduced by the deposits of cholesterol that it prevents the proper functioning of the organs. If the arteries of the heart are affected, the patient may develop angina attacks (a contraction of the arteries that supply blood to the heart muscle) or even a myocardial infarction (the death of part of the heart muscle from lack of oxygenation). Plaque in the arteries in the abdomen can cause erectile dysfunction. If the arteries in the brain are blocked by atheroma plaques, paralysis, dizziness, speech disorders, etc. are possible. Sometimes pieces of plaque break off, migrate and will obstruct a small vessel downstream. It is one of the causes of stroke (“stroke”).
Finally, if the arteries of the legs are narrowed, we observe intermittent cramps of the calf during walking: it is the arteritis of the legs. This disease is all the more important as the cramps and the pains occur after a very short distance. traveled or that they appear at rest. Severe arteritis of the legs can be the cause of gangrene (the death of areas that are no longer supplied with water) requiring amputation. Ultrasound can be used to assess the decrease in blood flow in the artery and to diagnose arteritis.
HOW IS EXCESS CHOLESTEROL DETECTED?
The screening for excess cholesterol is done by a blood test (performed on an empty stomach) which assesses the levels of LDL, HDL and total cholesterol, as well as that of triglycerides. From the age of 50, a systematic cholesterol test is carried out every five years in women and every three years in men. This dosage may be more common in patients with multiple cardiovascular risk factors. When a blood test shows values that are too high, the doctor will have a second blood test done on an empty stomach to confirm the results of the first.
Atherosclerosis can be detected during a medical examination, especially by examining the neck, groin or abdomen. The doctor looks for a noise of breath reflecting the narrowing of the arteries. Taking the pulse can also assess the extent of the decrease in blood flow.
HOW TO READ THE BLOOD TEST RESULTS?
From a blood test, the analysis laboratory measures the parameters that make up the patient’s lipid profile.
The term total cholesterol includes HDL and LDL cholesterol levels, as well as one-fifth of triglyceride levels. This rate is usually less than 2 g / l.
Also called bad cholesterol. In the blood, the vast majority of total cholesterol is made up of LDL cholesterol. In a patient, the desirable LDL cholesterol level is determined by the physician based on the presence of cardiovascular risk factors. In the absence of a risk factor, an LDL cholesterol level is considered normal when it is below 1.6 g / l. If the patient has one or more risk factors (for example, a man over 50 years old), this limit value is 1.3 g / l. Beyond that, therapeutic measures must be taken.
Also called good cholesterol, its role is to trap excess cholesterol in the blood and lead it to the liver to be eliminated with the bile. The HDL cholesterol level is considered too low when it is less than 0.35 g / l. A high level of HDL cholesterol (more than 0.60 g / l) protects against cardiovascular disease and cancels out a cardiovascular risk factor. Thus, a 50-year-old man (a risk factor) who has an LDL cholesterol level of 1.5 g / l and an HDL cholesterol level of 0.65 g / l will not be considered as requiring treatment. medical.
Triglycerides make up most of the fat in the blood, which is not found as cholesterol. Triglyceride levels rise after a rich, well-watered meal, with liver disease, or after taking certain medications. The link between high triglyceride levels (over 1.5 g / L) and the risk of cardiovascular disease has not been clearly established.
THE CT / HDL RATIO
Dividing the total cholesterol (CT) level by the HDL cholesterol level gives the CT / HDL ratio which is used to assess the risk of cardiovascular disease. This report is less used today.
IN PREGNANT WOMEN
Blood pressure naturally drops during pregnancy. However, there is a risk of high blood pressure during pregnancy. High blood pressure affects about 10% of pregnant women. If high blood pressure is not controlled, it can cause placental abruption or blood clotting disorders (see article Preeclampsia).
PREGNANT WOMEN WHO HAVE HIGH BLOOD PRESSURE BEFORE PREGNANCY
If you have high blood pressure and are planning to become pregnant, you must tell your doctor. Be careful, some antihypertensive drugs are not recommended for pregnant women. Your doctor may need to change your treatment. ACE inhibitors and angiotensin II inhibitors are contraindicated in the second and third trimesters of pregnancy and their termination should be considered. Diuretics are also not recommended as they may cause delayed growth of the fetus. The most commonly used antihypertensives during pregnancy are methyldopa, some beta blockers and some calcium channel blockers.
Pregnant women whose arterial hypertension is unbalanced or complicated should be treated in a maternity hospital in conjunction with a specialist in the management of hypertension.
HIGH BLOOD PRESSURE RELATED TO PREGNANCY
Pregnancy-related high blood pressure, called hypertension of pregnancy, usually occurs after the 4th month (20th week of amenorrhea). It is due to an abnormality in the blood vessels of the placenta. There is little or no loss of protein in the urine, unlike preeclampsia. Blood pressure normalizes after childbirth. Rest and dietary advice may be recommended. Sometimes drug treatment is prescribed. Regular monitoring helps to ensure that hypertension does not progress to preeclampsia.
If the lifestyle and dietetic measures are insufficient to lower blood pressure, drug treatment is implemented. It can use several families of drugs. Five classes of antihypertensive drugs are preferred: diuretics, beta blockers, calcium channel blockers, ACE inhibitors and angiotensin II antagonists. These drugs have been shown to be effective in preventing cardiovascular events in people with hypertension.
DIURETICS IN THE TREATMENT OF Hypertension
They are the oldest and best evaluated drugs. They have proven to be effective in the long term. These drugs help the kidneys remove water and salt and decrease the volume of fluid that circulates in the arteries, lowering the pressure on their walls. They may be the only treatment to take for patients who have no problem other than high blood pressure. They usually have few side effects. They increase the volume of urine, especially at the start of treatment. Some of them are responsible for low potassium levels in the blood which must be monitored.
Hydrochlorothiazide is a diuretic very often present in combinations of antihypertensive drugs. It can cause increased sensitivity of the skin to the sun (photosensitization) and cause skin reactions (sunburn, burns) with even low exposure to ultraviolet rays. It also increases the risk of certain skin cancers occurring: these are not melanomas, but localized cancers that develop very slowly and are therefore not very threatening. Skin monitoring during prescription refills is necessary and sufficient to avoid serious complications.
CHOLESTEROL DISEASE MANAGEMENT
Management of hypertension contributes to longer life expectancy. It is based on hygeonodietetic measures and possibly drug treatment. It aims to lower systolic pressure below 14 and diastolic pressure below 9. When blood pressure is effectively controlled with these treatments, the risk of stroke and heart disease is reduced.
OVERALL CARDIOVASCULAR RISK ASSESSMENT
The doctor chooses the treatment based on the severity of the hypertension and the patient’s overall cardiovascular risk. To assess this risk, it takes into account certain factors:
age: over 50 for a man, over 60 for a woman;
family history: heart attack or sudden death in a first-degree relative (before age 55 in a male parent, before 65 in a female parent) or stroke (attack) before age 45 regardless of the parent’s sex;
smoking (or stopping it for less than three years);
an LDL cholesterol level greater than 1.60 g / l or an HDL cholesterol level less than 0.40 g / l;
possibly abdominal obesity (in the stomach area), kidney failure, lack of regular exercise, or excessive alcohol consumption.
This assessment is supplemented by testing for disease in organs that can be damaged by high blood pressure: heart, arteries, kidneys and retina.
WHAT ARE THE TREATMENTS FOR HIGH BLOOD PRESSURE?
The treatment of arterial hypertension is based on lifestyle measures and possibly drug treatment. Among the measures to be adopted are:
the practice of regular physical activity;
weight loss in case of overweight or obesity;
reduced alcohol consumption;
reducing salt intake below 6 grams per day;
a diet favoring the consumption of fruits, vegetables, cereals and foods low in animal fats.
WHAT PLACE FOR ADAPTED PHYSICAL ACTIVITY IN THE MANAGEMENT OF ARTERIAL HYPERTENSION?
Adapted physical activity (APA) is part of the non-drug treatment for high blood pressure. Indeed, regular physical activity helps maintain blood pressure at a physiological level.
Many sporting practices have adapted to be practiced by people with moderate high blood pressure: for example, athletics, basketball, canoeing, football, karate, swimming, taïchi chuan and qi gong, and table tennis .
In the context of arterial hypertension, the attending physician can now prescribe APA by specifying the objectives sought (blood pressure control, stress reduction, etc.) and the patient’s specific contraindications. In the clubs that offer these disciplines, educators trained in the practice of healthy sports are responsible for defining fitness and training protocols adapted to each particular case. The costs incurred, often modest, are sometimes covered by complementary insurance (“mutual”) or town halls / departments.
Patients who use these adapted activities show physical benefits (for example on autonomy and endurance), but also psychosocial benefits (fight against isolation, better self-image).
THE CHOICE OF DRUG TREATMENT AND ITS FOLLOW-UP
The choice of treatment also takes into account the contraindications of each patient. It is difficult to predict whether a treatment will work for a particular patient: a drug that works well for one may not be enough for the other. Medicines for hypertension are fully effective after 4 to 6 weeks of treatment. Sometimes, temporary fatigue is felt at the start of treatment.
Because high blood pressure itself causes few symptoms, about a third of people treated do not follow their treatment carefully, reducing its effectiveness. Attention, people who take treatment for high blood pressure must be careful to follow their treatment, even in the absence of symptoms: hypertension is a silent disease that can have serious consequences on the arterial level. If you are having trouble taking the treatment prescribed for you, do not hesitate to tell your doctor; he may decide to prescribe another one, better suited to your sensitivity.
Follow-up visits should be made to ensure the effectiveness of the treatment. They usually take place three to four times a year. In addition, the patient can monitor his blood pressure himself. After six to twelve months during which the blood pressure is controlled, the doctor may decide to reduce progressively the doses and the number of drugs/medications.
Hygienodietetic measures WHAT ARE THE GOOD HABITS TO ADOPT?
In the fight against hypertension, lifestyle and dietetic measures play an essential role. They prevent its complications and help reduce drug treatment. Regular physical activity, stopping smoking, and making certain dietary choices are important.
REDUCE THE CONSUMPTION OF SALT: SODIUM AND HYPERTENSION
Sodium (salt) contributes to hypertension, to a varying degree depending on one’s sensitivity. People who suffer from obesity or type 2 diabetes, as well as the elderly, are more susceptible to the negative effects of eating too much salt.
In Finland, there were half as many cases of hypertension when the average salt intake was reduced by a third thanks to regulatory measures such as the partial substitution of sodium chloride with potassium chloride. In France, the average salt intake is 8 to 10 g per day, well above the recommended 5 g. Ten to 20% of us consume more than 12g per day, or two and a half times the recommended amounts! People with heart failure often need to follow a very low salt high blood pressure diet (4 to 6 g per day, or even less than 4 g per day).
One third of the salt we ingest is generally provided by the bread (a Parisian baguette contains 5 to 6 g of salt), by cold meats, cheeses, table salt, but also cooked dishes.
Beware of industrial ready meals and canned foods, which are often too salty.
Learn to read labels and go hunting for foods high in sodium (salt). Know the translation: 400 mg (0.4 g) of sodium corresponds to 1 g of salt.
Salt your dishes once on the plate or during cooking. To add flavor, use aromatic herbs, spices, lemon juice, for example.
EAT MORE BALANCED FOOD
Eat more fresh fruits and vegetables. Fruits and vegetables are high in potassium which counteracts the harmful effects of sodium. Favor bananas, dried fruits, grapes, among others.
Limit your intake of animal fat.
Eat semi-skimmed dairy products. They are rich in calcium, magnesium and potassium, which decrease the effects of sodium on high blood pressure.
Drink at least 1.5 liters of water every day. Be careful with mineral waters rich in sodium (more than 200 mg / l), such as Arcens, Arvie, Chateldon, Quézac, Vernière, Vichy Saint-Yorre or Vichy Célestins.
Limit your caffeine intake. Try not to drink more than three caffeinated drinks a day such as coffee, colas, cocoa, or tea, as caffeine can raise blood pressure.
Cut down on your alcohol intake. Alcoholic beverages raise blood pressure and interfere with the effectiveness of high blood pressure treatments. Plus, alcohol is high in calories. Consume a maximum of three drinks per day if you are a man and two drinks per day if you are a woman.
Sustained physical activity helps lower blood pressure and helps control stress. The optimal training to stay in shape is to do endurance activity three times a week for about 45 minutes (brisk walking, cycling, swimming, etc.). When doing endurance physical activity, there is a little trick to identifying the ideal intensity level: you should be able to keep talking (slow down if you’re too short of breath for that), but you should not be able to sing ( speed up if you can). Exaggerated shortness of breath, palpitations or unusual pain (especially in the chest) must lead to stopping the exercise and justify a medical consultation.
Tobacco increases blood pressure and damages blood vessels. When you have high blood pressure, it is essential to quit smoking, even if it takes several attempts. Your best ally in quitting smoking is your doctor.
REDUCE YOUR STRESS LEVEL
Get enough sleep, practice a hobby, sport or relaxation activity (yoga, tai chi, meditation, relaxation therapy, etc.). Take the time to relax and enjoy life.
DIETARY SUPPLEMENTS AGAINST CARDIOVASCULAR DISEASES (Use of food supplements)
The food supplements offered for the prevention of cardiovascular diseases are numerous, like the vast market that these diseases represent. Most are aimed at lowering LDL cholesterol levels in the blood, without affecting high blood pressure. While some of them enjoy some recognition from the health authorities, most have not been proven.
WHICH DIETARY SUPPLEMENTS AGAINST CARDIOVASCULAR DISEASES?
The substances contained in food supplements intended to protect against cardiovascular disease are of several types. They aim:
- either reduce the absorption of fat and cholesterol from the intestine;
- either to lower LDL cholesterol levels in the blood;
- or to thin the blood to prevent a clot from forming around an atheromatous plaque, thus blocking blood flow.
OMEGA-3 FATTY ACIDS IN FISH OILS AGAINST CARDIOVASCULAR DISEASES (food supplements)
Omega-3 fatty acids from fish oils are the subject of a large relapse prevention study after a heart attack or stroke (“attack”).
Since 2012, the European health authorities (EFSA, European Food Safety Authority and the European Commission) have pronounced on certain health claims of foods and food supplements containing omega-3 fatty acids from fish oils (EPA and DHA).
After examining the scientific data, they estimated that these products can claim to contribute to the normal functioning of the heart if and only if these products contain at least 40 mg EPA / DHA per 100 g and 100 kcal of product, and if they provide at least a daily dose of 250 mg of omega-3 fatty acids from fish oils (EPA and DHA).
Additionally, foods and dietary supplements containing DHA (or DHA and EPA) may be claimed to help maintain normal blood pressure in adults, as long as you provide at least 3g of DHA and EPA. per day, not to exceed 5 g per day.
In addition, these foods or food supplements can claim to help maintain normal triglyceride levels in adults, provided they provide at least 2 g of DHA and EPA per day (or 2 g of DHA), without exceeding 5 g per day.
On the other hand, foods and dietary supplements containing omega-3 fatty acids from fish oils (EPA and DHA) cannot claim to reduce LDL cholesterol levels in the blood, thin the blood, improve the quality of cholesterol, nor maintain heart health.
OMEGA-3 FATTY ACIDS IN VEGETABLE OILS AGAINST CARDIOVASCULAR DISEASES
Omega-3 fatty acids in vegetable oils have been little studied and there is a lack of data to determine their role in preventing cardiovascular disease. Since 2012, European health authorities have spoken out on certain health claims of foods and food supplements containing omega-3 fatty acids from vegetable oils.
After examining the scientific data, they estimated that these products can claim to contribute to the maintenance of normal blood cholesterol levels if and only if these products contain at least 0.3 g of alpha-linolenic acid per 100 g and 100 kcal of product. , and if they provide at least a daily dose of 2 grams of alpha-linolenic acid (ALA).
On the other hand, foods and dietary supplements containing alpha-linolenic acid (ALA) cannot be said to be important for the health of the heart and blood vessels, nor to help maintain normal blood pressure.
OMEGA-6 FATTY ACIDS AGAINST CARDIOVASCULAR DISEASES
Since 2012, European health authorities have issued opinions on certain health claims for foods and food supplements containing omega-6 fatty acids.
After reviewing the scientific data, they estimated that products that contain linoleic acid may claim to help maintain normal blood cholesterol levels if and only if these products provide at least 1.5 grams of linoleic acid per 100 grams. and 100 kcal of food, and if the person ingests at least 10 grams of linoleic acid per day.
On the other hand, foods and dietary supplements containing linoleic acid cannot be claimed to be important for healthy blood vessels. Additionally, foods and dietary supplements containing gamma-linolenic acid (GLA) cannot be claimed to maintain normal blood cholesterol levels, support cardiovascular health, or normalize blood pressure.
OMEGA-9 FATTY ACIDS AGAINST CARDIOVASCULAR DISEASES
Omega-9 fatty acids come from certain vegetable oils, especially olive oil. Since 2012, the European health authorities have pronounced on certain health claims of foods and food supplements containing omega-9 fatty acids.
After reviewing the scientific evidence, they found that foods that contain oleic acid may claim to help replace saturated fat with unsaturated fat (with the aim of maintaining normal blood cholesterol levels, but without effect on blood cholesterol levels. triglycerides) if and only if at least 70% of their fat is unsaturated and if they represent at least 20% of the total amount of calories in the food.
On the other hand, foods and dietary supplements containing olive oil cannot claim to contribute to the health of the heart and blood vessels, nor to help maintain normal blood levels of triglycerides or cholesterol.
PHYTOSTEROLS AND PHYTOSTANOLS AGAINST CARDIOVASCULAR DISEASES
Phytosterols and phytostanols are plant substances close to cholesterol. They work by blocking the absorption of some of the cholesterol from food into the gut.
In 2014, European health authorities established that products enriched with these substances help lower cholesterol in the blood. For these authorities, the consumer should be informed that the beneficial effect is obtained by the daily consumption of 1.5 to 3 g of plant stanols / sterols. Combined with a suitable diet, they can lead to a drop of 7 to 12.5% in the blood level of LDL cholesterol.
The magnitude of the effect can be mentioned only for foods of the following categories: fat spreads, dairy products, mayonnaise and salad dressings. When reference is made to the size of the effect, the “7-10%” range, for foods ensuring a daily intake of 1.5-2.4 g of plant stanols / sterols, or the range “from 10 to 12.5%”, for those guaranteeing a daily consumption of 2.5 to 3 g, as well as the duration necessary to obtain the effect (“in 2 to 3 weeks”) must be communicated to the consumer.
However, products containing phytosterols or phytostanols cannot state on their packaging that these products directly contribute to the prevention of cardiovascular diseases, in the light of the available data (ANSES recommendation 06/2014).
Phytosterols and phytostanols are most often added to dairy products and fats, such as yogurt or margarines. They are sometimes found in capsules or capsules that must be taken with meals.
POLICOSANOLS AGAINST CARDIOVASCULAR DISEASES
Policosanols claim the same properties as phytosterols on the absorption of fat from the intestine. They are used as a medicine for excess LDL cholesterol in several countries in Central and South America. However, there are not enough clinical studies to specify their conditions of use.
PECTINES AGAINST CARDIOVASCULAR DISEASES
Since 2012, the European health authorities (EFSA, European Food Safety Authority and the European Commission) have pronounced on certain health claims of food supplements containing pectins. After reviewing the scientific data, they estimated that these products can claim to help maintain normal blood cholesterol levels, provided you provide 6 grams of pectins per day, taken with meals.
POTASSIUM AGAINST CARDIOVASCULAR DISEASES
Since 2012, the European health authorities (EFSA, European Food Safety Authority and the European Commission) have pronounced on certain health claims of foods and food supplements containing potassium. After examining the scientific data, they considered that these products can claim to contribute to the maintenance of normal blood pressure if and only if these products contain at least 300 mg of potassium per 100 g, 100 ml or per package if the product does not contain than a portion.
RED RICE YEAST AGAINST CARDIOVASCULAR DISEASES
Red yeast rice is a microscopic fungus. Depending on its origin, it contains varying amounts of monacolin K, known in the medical world as lovastatin. This statin is used as a medicine in some countries, except France.
Clinical studies have shown that dietary supplements based on red yeast rice therefore have some efficacy in reducing LDL cholesterol levels in the blood.
Since 2012, the European health authorities (EFSA, European Food Safety Authority and the European Commission) have pronounced on certain health claims of food supplements containing red yeast rice. After reviewing the scientific data, they estimated that these products can claim to help maintain normal LDL cholesterol levels as long as they provide a daily dose of monacolin K (lovastatin) equal to 10 mg.
SOY PROTEINS AGAINST CARDIOVASCULAR DISEASES
Soy protein is extracted from soybeans, which is rich in protein and isoflavones. Studies have confirmed the effectiveness of soy protein, at a minimum dose of 25 g per day and combined with a suitable diet, to control blood LDL cholesterol levels and prevent cardiovascular disease. This property is recognized by the American health authorities who allow manufacturers to claim this property on packaging.
However, in 2012, for lack of convincing evidence of efficacy, European health authorities banned dietary supplements containing soy protein from claiming to help maintain normal blood cholesterol levels.
VITAMIN B3 (NICOTINIC ACID) AGAINST CARDIOVASCULAR DISEASES
Nicotinic acid, one of two compounds that is referred to as vitamin B3, has been shown to increase HDL cholesterol levels and lower LDL cholesterol and triglyceride levels. However, these effects have been observed at potentially toxic dosages and the use of vitamin B3 in this indication is strongly discouraged.
CHITOSANS AGAINST CARDIOVASCULAR DISEASES
Chitosan is a substance derived from chitin, the main component of the shell of insects and crustaceans. It is offered as a dietary supplement to decrease the absorption of fat and cholesterol from the intestine. But while positive results have been obtained in laboratory animals, they have never been extended to humans.
FLAVONOIDS AGAINST CARDIOVASCULAR DISEASES
Flavonoids are substances found in plants. The claims they make in the field of cardiovascular disease prevention have never been verified by clinical trials.
Since 2012, for lack of convincing evidence of efficacy, European health authorities have banned food supplements containing flavonoids (for example, rutin, diosmin or catechins in green tea) from claiming to help maintain normal blood cholesterol levels. , or contribute to the health of the heart and blood vessels.
COENZYME Q10 AGAINST CARDIOVASCULAR DISEASES
Coenzyme Q10 is one of the substances necessary for the production of energy in cells. In Japan and Israel in particular, coenzyme Q10 is a medicine for people with chronic heart failure.
Several studies seem to indicate that, during treatment against excess cholesterol with statins, the simultaneous administration of coenzyme Q10 could improve the effectiveness of the treatment in terms of lowering LDL cholesterol. It is prescribed for this purpose in countries where it is available as a medicine.
However, in 2012, for lack of convincing evidence of effectiveness, European health authorities banned dietary supplements containing coenzyme Q10 from claiming to help maintain normal blood cholesterol levels, normalize blood pressure or contribute to the health of the patient. heart and blood vessels.
WHEAT GERM AGAINST CARDIOVASCULAR DISEASES
Wheat germ contains phytosterols. In 2012, the European health authorities (EFSA, European Food Safety Authority and the European Commission) commented on certain health claims for products containing wheat germ oil. After reviewing the scientific evidence, they felt that dietary supplements containing wheat germ oil cannot claim to improve the health of the cardiovascular system by promoting elasticity of blood vessels or normalizing blood pressure.
ARE THERE RISKS WITH DIETARY SUPPLEMENTS TO PROTECT THE ARTERIES?
Taking potassium, in addition to that contained in foods and multivitamin supplements, is strongly discouraged without medical supervision. Too much potassium causes heart rhythm disturbances which can lead to death. Additionally, excess potassium can interact with many drugs.
Pregnant or breastfeeding women, as well as people with diabetes, heart and blood vessel disease, constipation or diarrhea, or taking treatment for high blood pressure, should be especially careful not to take any drugs. supplements rich in potassium without first referring to their doctor.
Pectins decrease the absorption of many other substances found in food: beta-carotene, lutein, lycopene, minerals such as zinc, calcium, magnesium or iron. Therefore, pectins should not be ingested for more than a few days at a time.
In addition, pectins should be ingested with plenty of water, enough for them to reach the stomach quickly. This precaution for use is intended to avoid choking which could occur if the pectins were ingested in too thick a solution. People who have difficulty swallowing should be particularly careful to dilute the pectins they take.
Chitosan is not recommended for people allergic to shellfish. In addition, it is believed to interfere with the absorption of many substances, including certain drugs. Its possible side effects are nausea and diarrhea.
People who take medicines for high cholesterol (especially statins) should check with their doctor before consuming foods fortified with phytosterols or phytostanols, or supplements containing policosanols or coenzyme Q10.
People with gluten allergy should not consume products containing wheat germ.
Red yeast rice should be used with the same precautions as a medicine and medical monitoring is essential. If cramps, muscle pain, tenderness or muscle weakness appear, immediate medical attention is required. In addition, red yeast rice can interact with many drugs, especially those designed to fight excess LDL cholesterol.
Soy protein products are contraindicated in women with a personal or family history of breast, uterine, ovarian cancer and in men with prostate problems. Soy protein can interact with many drugs such as blood thinners, thyroid hormones, and osteoporosis treatments.
Given the many risks associated with its use, vitamin B3 should never be used for therapeutic purposes.
People taking blood thinning medications should refrain from taking policosanols, coenzyme Q10, flavonoids, or supplements containing garlic, omega-3 or omega-9 fatty acids.
In 2014, an Australian study warned people with high blood pressure against taking vitamin C and flavonoids (polyphenols) at the same time. If taking 500 mg / day of vitamin C seems to reduce the blood pressure of people with hypertension, and taking 1000 mg / day of polyphenols extracted from grape seeds have no effect on their blood pressure, the concomitant intake of these two substances caused a significant increase in blood pressure in these hypertensive patients. An identical phenomenon was observed when taking 500 mg / day of vitamin E (tocopherols). Caution is therefore in order.
Finally, people with diabetes should seek advice before taking coenzyme Q10.
Information: Cleverly Smart is not a substitute for a doctor. Always consult a doctor to treat your health condition.