Kamal Patel is a director of Examine.com, the research-based resource on supplementation and nutrition, and a nutrition researcher with an MPH and MBA from Johns Hopkins University. He is based in San Francisco, California.
Cardiovascular disease is one of the leading causes of mortality globally and is caused by obesity, high blood presses and high cholesterol. A lack of exercise, a poor diet and overall physical and emotional well-being are also accepted factors in determining how long you live, and how good your quality of lift is as you age. If you’re reading this then you are already working out and following a healthy diet, but there are some proven supplements that can help improve heart health, and improve the efficiency of your cardiovascular system.
Procyanidins are a class of flavonoids, or plant secondary metabolites , and can improve blood flow and circulation by helping maintain nitric oxide (NO) levels. Low NO levels can cause blood vessels to narrow resulting in reduced blood flow. This makes procyanidins a good preventative supplement for high blood pressure, and a way to alleviate high blood pressure caused by low NO levels. But bear in mind that not all cases of hypertension, or high blood pressure, are related to NO.
Procyanidins include the polyphenols in cocoa, grape seed extract, and the brand name product Pycnogenol, also known as pine bark extract. Pycnogenol is the most well researched procyanidin source, though it is also the most expensive. Grape seed extract is a similar compound. It has less evidence for its effects, but is also less expensive. Cocoa has a different set of procyanidins but provides similar benefits.
How to take it The standard procyanidin dosage depends on the form of supplementation. To supplement Pycnogenol, take 100mg-200mg a day. Doses as low as 40mg-60 mg have also been used, though they provide fewer benefits. To supplement grape seed extract, take 150mg–300mg a day. The standard dose for cocoa polyphenols is 1,000mg. To get cocoa polyphenols through the diet, eat approximately 2g of dark chocolate a day. This is not needed if you choose one of the other procyanidin options. Milk or white chocolate are not a source of polyphenols.
Garlic is known for its ability to boost the immune system and provide a variety of cardiovascular benefits, including improving blood flow without affecting blood pressure. This is because of its dietary sulfur content, which can improve hydrogen sulfide signaling and leads to better circulation. Garlic also supports NO signalling, which can improve the effects of procyanidins. People with normal blood pressure will experience improved blood flow from eating garlic, while people with high blood pressure will also experience a reduction in blood pressure, in addition to the improved blood flow.
Garlic is also good for people with abnormal cholesterol levels. It can reduce low-density lipoprotein (LDL) cholesterol and increase high-density lipoprotein (HDL), which is sometimes called ‘good’ cholesterol. Garlic protects arteries from plaque buildup and calcification, preventing excess minerals from stiffening the blood vessels. It also has blood-thinning and antiplatelet effects so should be taken with caution if you are on blood-thinning medication.
How to take it Garlic can be eaten or supplemented and both methods of ingestion provide the same benefits. To maximize garlic’s benefits, eat three cloves a day, split between several meals. The cloves may be eaten raw or cooked, but they should not be boiled or otherwise heated before they are cut. Crushing garlic before heating will activate its bioactive compounds. Supplementation is recommended for people that dislike the smell or taste of garlic, and aged garlic extract will prevent the bad breath that comes from eating garlic cloves. Take 600mg-1,200mg per day, split into several doses and taken with meals.
Nitrates are a dietary compound found in beets and leafy green vegetables. They break down into nitrites after they’re ingested and circulate around the body and turned into NO as needed. Elevated NO levels are associated with improved exercise performance, blood flow, and reduced blood pressure.
Nitrates are one of the major reasons that green vegetables are recommended for reducing the risk of hypertension and other circulatory disorders. Improved blood flow can even prevent cognitive decline because blood flow to the brain is not impaired as people get older. Because of restrictions surrounding sodium nitrate, a compound often added to meat, supplements containing effective doses of nitrates are not legal so nitrates must be consumed through food products.
How to take it The best way to consume nitrates is through leafy greens and beets. The standard dose for nitrates is between 6.4mg–12.8mg per kilo of bodyweight. About 500g of fresh lettuce, rocket, swiss chard, crown daisy, spinach, kale, or beets a day will maximize nitrate’s benefits. Cooking does not appear to reduce the bioavailability of nitrates from beets. If you eat a lot of cruciferous vegetables, like spinach and kale, consider adding iodine to your diet by increasing your consumption of iodized table salt. These vegetables contain goitrogens, which are compounds that can disrupt the thyroid if consumed in high quantities like the dose described above.
Coenzyme Q10 (CoQ10) is a molecule found in mitochondria and is very important to the process of energy production. Though the body already produces CoQ10, supplementation can offer benefits to people with cardiac tissue damage. People who have suffered a heart attack will experience the most benefit from CoQ10 supplementation, which can reduce the risk of further heart complications. Statin medications can deplete CoQ10 levels in the body so if you are taking statins talk to your doctor about supplementing CoQ10. Further research is needed to determine if CoQ10 supplementation can benefit people with less severe cardiac damage.
How to take it To supplement CoQ10, take 70mg–90 mg once a day with a meal containing fatty acids. Higher doses in the 200mg–300mg range result in higher levels of CoQ10 in the body but further research is needed to determine if higher levels provide more benefits than the standard dose.
5 Fish oil
Fish oil is made up of two fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Fish oil is the most reliable supplement for reducing triglyceride (blood lipid) levels. The effects of supplementing fish oil varying depending on the individual. At the recommended dose is not harmful and when supplemented by people with normal triglyceride levels, it can reduce high blood pressure and may also alleviate inflammation. This benefits cardiovascular health by reducing plaque formation and the risk of atherosclerosis, a disorder characterized by narrow arteries. Consuming fish oil through food will provide the same benefits as supplementation.
How to take it To supplement fish oil, take 4g of combined EPA and DHA, either once per day with a meal (to reduce the risk of the taste repeating on you) or divided into several daily doses. As a general cardiovascular health supplement take 300mg–600mg of fish oil a day, which is equivalent to adding fatty fish to the diet several times a week.
6 Vitamin K
Vitamin K is a fat-soluble essential vitamin that can prevent haemorrhaging. Supplementation can also increase levels of osteocalcin, which is a protein that can remove calcium build-up in arteries. Reducing arterial stiffness can prevent cardiovascular injury. More research on vitamin K’s effects is needed before it can be recommended as an essential base supplement.
How to take it The optimal dose for vitamin K is 1,000mcg, which is much higher than the recommended daily intake (RDI) in many countries, and it should be supplemented alongside a meal containing dietary fat sources for improved absorption. Vitamin K can be supplemented through vitamin K1 (the plant form) and vitamin K2 (the animal form). Vitamin K2 is actually a series of molecules, designated by labels like MK-4 and MK-7. Vitamin K1 and vitamin K2 MK-7 are both recommended over Vitamin K2 MK-4. To supplement vitamin K1, take 1,000mcg. To supplement vitamin K2 MK-7, take 200mcg. Do not supplement vitamin K if you are taking Warfarin or blood-thinning medication.