Natural Approach to CVD

Question 1

Vitamin C

Answer 1

500 - 1000 mg 3x/day
* Downregulates NADPH oxidase, a key source of ROS in the vascular wall.
* Upregulates endothelial NO synthase (catalyses synthesis of NO from arginine).
* Lowers tendency for platelet aggregation.

Question 2

Vitamin E

Answer 2

400 - 800 iu/day
* Mixed tocotrienols and tocopherols —along with vitamin C protects the endothelium from ROS and supports NO synthesis.
* ↓ oxidation of LDL-C and deposition in arterial walls.
* Inhibits platelet aggregation and ↓clotting factors to support healthy blood viscosity.

Question 3

Vitamin D

Answer 3

600 - 1000 iu/day
* Modulates NO synthesis and influences cells involved in atherogenesis e.g., ED, VSMCs, monocytes and cardiac myocytes.
* Modulates RAAS and lowers BP.

Question 4

Omega-3 fatty acids

Answer 4

3-6g/day
* Improve lipid and lipoproteinprofiles.
* Involved in the synthesis of key regulators of inflammation, vasodilation and platelet aggregation.
* EPA stabilises cellular membranes allowing neutralisation of extracellular ROS.
* DHA supports membrane fluidity.

Question 5

Magnesium glycinate/taurate

Answer 5

500-800 mg/day
* Through regulation of ion transporters e.g., potassium and calcium channels, plays a central role in modulating neuronal excitation, intracardiac conduction and myocardial contraction.
* Helps regulate vascular tone and stabilise heart rhythm.

Question 6

Co-enzyeme Q10

Answer 6

60 - 300 mg/day
* Protects against endothelial dysfunction and reduces LDL oxidation
(↓atherosclerosis risk).
* Increases superoxide dismutase activity, which preserves the activity ofNO(↓risk of high BP).
*Supports mitochondrial health and production of ATP.

Question 7

Hawthorn (Crataegus laevigata)

Answer 7

1000 - 1500 mg/day
* Cardiac tonic; strengthens and improves vascular elasticity, has ACE-inhibiting actions (↓BP).
* Hawthorn reduces ET-1 and increases NO levels, hence having vasodilatory effects.
* Antioxidant (e.g., ↑ SOD), anti-inflammatory (inhibits NF-κB).

Question 8

Garlic (Allium satvum)

Answer 8

2-5g fresh bulb/day
* Antihypertensive effects by stimulating NO production in ED cells. Lowers homocysteine -> ↓ CVD risk.
* Decreases arterial calcification (stiffness).
* Reduces LDL cholesterol and LDL oxidation.
* Enhances glutathione and SOD.
* Protects against abnormal platelet aggregation.

Question 9

Nutrition and lifestyle

Answer 9

CNM Naturopathic Diet
Plant-based and Mediterranean-style diets
Exercise
Stress Management

Question 10

Plant-based and Mediterranean-style diets

Answer 10

Associated with significantly reduced CVD risk showing: ↓ inflammatory mediators, ROS and RNS; reduced adiposity (especially visceral) and risk of thrombosis; ↑ SCFA production, improved insulin sensitivity, ↑ adiponectin and improved ED function.

Question 11

Exercise

Answer 11

Regular physical activity and exercise significantly reduces CVD risk and is associated with a reduction in all-cause mortality.
– Leads to a more favourable lipoprotein profile; ↓TGs.
– Improves insulin sensitivity, and insulin signaling in the vascular endothelium, activating eNOS, which ↑ NO synthesis.
– Regular exercise promotes a net reduction in blood pressure at rest (cardiac output and BP transiently ↑ during exercise).

Question 12

Stress management

Answer 12

Encourage diaphragmatic breathing exercises, humming, singingto promote parasympathetic activity. Include herbal teas to relievestress e.g., chamomile, passionflower, lemon balm, lime flower tea.

Question 13

Drug/Nutrient interactions

Answer 13

• Statins: Block HMG CoA-reductase ↓ coenzyme Q10 synthesis.
  *Cholestyramine (↓ cholesterol): A bile acid sequestrant. ↓ absorption of fat-soluble vitamins and beta-carotene.
• Loop and thiazide diuretics: ↑potassium, calcium, thiamine and zinc (thiazide) excretion.
• ACE inhibitors: Bind with zinc preventing utilisation by the body.
• Beta-blockers: ↓ melatonin production by inhibiting adrenergic beta1 receptors; block the biological pathway of CoQ10-dependent enzymes.