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Nitric oxide, the heart-healthy chemical in your blood vessels, is a natural signaling molecule that signals blood vessels to widen, allowing more blood flow throughout the body, including to the brain and heart.

Adequate nitric oxide amounts support arterial walls, important for them being able to constrict and dilate as needed.  Arterial stiffness contributes to high blood pressure and other risk factors for cardiovascular disease.

As we age, your body’s own production of nitric oxide naturally decreases which can impact healthy vascular function.

Vascanox HP is a great companion product to Arterosil HP, a foundational supplement that supports the fragile inner lining of the entire vascular system (endothelial glycocalyx).

Vascanox HP is a complementary product that integrative cardiologists can use with patients.

Vascanox HP contains a proprietary formulation of plant extracts like beet root, black garlic and several berries, as well as vitamins C, D, B1, B12 and several minerals.

 Study Shows Vascanox HP Provides Nitric Oxide Support for Up to 24 Hours 

A recent study, (open-label IRB approved), showed that Vascanox HP provides nitric oxide support for up to 24 hours with a single dose. Saliva N.O. test strips were used to measure nitric oxide.

More ways to Increase Nitric Oxide Production

In addition to a nutrition supplement like Vascanox HP, here are some other ways to increase your nitric oxide production:

• Do deep breathing (take long deep breaths through your nose), yoga, and meditation
• Eat right and keep levels of cholesterol, triglycerides and blood sugar in mind
• Eat more fruits and vegetables, lean protein, whole grains, limit intake of saturated fat and sugar
• Incorporate foods that boost nitric oxide levels like beets, garlic, leafy greens like spinach, bok choy, cabbage, garlic, broccoli and citrus
• Keep moving and exercising regularly
• Aim for maintaining a healthy weight

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Key excerpts from this article:

“Nutrition can play a key role in how we help our patients achieve and maintain healthy vascular endothelium. Given the importance of NO [nitric oxide] in vascular endothelial function, we counsel our patients to eat foods high in arginine and citrulline, both of which are amino acids used in the production of NO.¹⁵

These foods include legumes, nuts, and watermelon. We also recommend foods rich in dietary nitrates, such as arugula, chard, other leafy greens, and beets. Patients in my practice are also counseled about the need for adequate sleep and exercise and the benefits of avoiding fast foods, processed carbohydrates, and excess sugar.”

“Based on the growing body of data supporting the cardiovascular benefits of these GRCs [glycocalyx regenerating compounds] and the fact that Arterosil is a natural product, we recommend it to patients in my practice as part of an integrative approach to enhancing their cardiac longevity. Combined with a diet rich in arginine, citrulline, and dietary nitrates; a healthy lifestyle that provides adequate sleep and exercise; and periodic ADMA or EndoPAT testing, physicians now have tangible ways to help patients achieve or maintain good EG and vascular endothelial health, which will help reduce their risk of future adverse cardiac events.”

Click to Access Full Article or read full article below.

Atherosclerosis and Aging — Insights Into the Role of the Endothelial Glycocalyx in Cardiovascular Health, by Joel Kahn, MD, Today’s Geriatric Medicine

“The development of atherosclerosis can result from multiple factors that influence the health and function of arteries supplying vital organs in the body. The risk of atherosclerosis rises with age, and aging is a dominant risk factor for the development of clinically relevant atherosclerotic plaques.1,2 This perspective may play a critical role in improving health outcomes because coronary artery disease, which results from the development of atherosclerotic plaques within the vessels that supply the heart with blood, is the leading cause of death worldwide and in the United States.3,4 Cerebrovascular stroke, which occurs when these plaques form in the carotid arteries or other vessels that supply blood to the brain, is the fifth leading cause of deaths in the United States.5

Recent findings demonstrate that the most potent factors in the progression of atherosclerosis are the various mechanisms that repair the endothelium lining of the blood vessels in response to endothelial damage and dysfunction.1 Despite being only one cell thick, the vascular endothelium is the body’s largest organ—it would cover six tennis courts. It plays a critical role in regulating blood pressure, immunity, and clotting and also in inhibiting plaque development. The progression of atherosclerosis appears to correlate with loss of endothelial function rather than the onset of high lipid levels.1 A decline in the integrity and function of the arterial endothelium, which occurs with aging over time, allows the formation of atherosclerotic plaques.

The Endothelial Glycocalyx: A Critical Mediator
For many years, it was believed that atherosclerotic plaques lead to cardiovascular complications, such as coronary artery disease and stroke, by narrowing the arteries and limiting blood flow to the heart, brain, and other organs.6 While this can happen in some patients, it’s become evident that the rupture of vulnerable plaque—plaque that has a large necrotic lipid core and thin fibrous cap—is responsible for 60% to 70% of acute coronary syndromes. The blood clots and inflammatory processes that result from plaque rupture are significant contributors to morbidity and mortality due to acute cardiovascular events.7,8

The increased focus on the physiology and function of the vascular endothelium has provided new insights into the critical role that the endothelial glycocalyx (EG) plays in arterial health. The EG, a slippery lining composed of a polysaccharide-proteoglycan matrix, protects and regulates several critical endothelial functions. As such, it’s the first line of defense against atherogenesis. Because it’s located between the bloodstream and the endothelium, the EG affects vascular permeability and limits the ability of certain molecules to reach the endothelium.9 Recent data show that the EG plays a key role in arterial health by regulating the accumulation of cholesterol within the endothelial lining as well as other vascular properties, including permeability, nitric oxide (NO) production, and adhesion of cells and other molecules.9,10

Additionally, a broad array of biologic molecules requires interaction with the EG to function properly.9 These include pro- and anticoagulation factors such as antithrombin III, heparin cofactor II, and tissue factor pathway inhibitor; growth factors such as vascular endothelial growth factor, transforming growth factor-, and fibroblast growth factor; mediators of cholesterol transport and metabolism such as lipoprotein lipase and LDL; and multiple interleukins that mediate chemotaxis of leukocytes into the subendothelium.9

The EG is extraordinarily dynamic and, while it collapses rapidly in response to high-glycemic diets, diabetes, hypertension, smoking, inflammation, stress, air pollution, and a variety of disease conditions, it takes longer to rebuild. EG damage is associated with a variety of pathologies, including atherosclerosis, stroke, diabetes, kidney disease, hypertension, and pulmonary edema.9,11 Results of a 2007 study suggest that LDL cholesterol accumulates in regions of the blood vessel in which the thickness of the EG is reduced.9

In vitro studies conducted under conditions that degrade the EG and reduce EG coverage of endothelial cells found that a lack of EG was apparent in the majority of cells that had increased uptake of oxidized LDLs.10 These findings suggest that degradation of the EG can initiate proatherosclerotic activity with endothelial cells. Additional in vitro studies also show that the EG plays critical roles in NO production as well as in determining the composition of the gap junctions through which endothelial cells communicate with each other—activities that are both relevant to vascular health and atherosclerosis.10

Assessing and Promoting Vascular Endothelial Health
As noted above, there’s a growing body of data underscoring the importance of maintaining a healthy vascular endothelium throughout our lives but especially as we age. Despite the potential benefits of targeting vascular endothelial health as a mechanism for reducing the risk of coronary artery disease and stroke, this approach is not widely pursued in today’s clinical practice. I believe a key reason for this gap is the mistaken belief that arterial health cannot be assessed or managed. In my clinical practice, however, we pursue an integrative approach to cardiac longevity that takes advantage of new approaches to assessing arterial health as well as foods and nutraceuticals that can promote vascular endothelial health.

Two biomarker blood tests measure levels of asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine. Elevations in these biomarkers can be indicative of damage to the endothelium. ADMA competitively inhibits the production of NO, a key mediator of endothelial homeostasis.12 A prospective study conducted in more than 1,900 patients with coronary artery disease found that high levels of baseline AMDA independently predict future cardiovascular risk.13

There’s also EndoPAT, a device cleared by the FDA in 2003 for assessment of endothelial function. EndoPAT measures a NO-mediated endothelial response and has been shown in clinical studies to be predictive of future major adverse cardiac events, even in patients with normal Framingham Risk Scores.14

Rather than waiting for patients to exhibit symptoms of cardiovascular disease, the ADMA and EndoPAT tests improve physicians’ ability to predict which patients are at risk of future major adverse cardiac events. These tests can enable physicians and patients to work together to establish nutrition and lifestyle programs that can protect or improve their vascular endothelial health.

Nutrition can play a key role in how we help our patients achieve and maintain healthy vascular endothelium. Given the importance of NO [nitric oxide] in vascular endothelial function, we counsel our patients to eat foods high in arginine and citrulline, both of which are amino acids used in the production of NO.15 These foods include legumes, nuts, and watermelon. We also recommend foods rich in dietary nitrates, such as arugula, chard, other leafy greens, and beets. Patients in my practice are also counseled about the need for adequate sleep and exercise and the benefits of avoiding fast foods, processed carbohydrates, and excess sugar.

Given that endothelial dysfunction is the starting point for most cardiovascular disease and the EG is the primary protector and regulator of the endothelium, maintaining a healthy EG may be one of the most important approaches to reducing cardiovascular risk and preventing cardiovascular disease. While there are no pharmaceutical products that directly target the EG, promising early data from a small study suggest that certain glycocalyx regenerating compounds (GRCs) may provide cardiovascular benefits. These GRCs mimic the building blocks the body requires to restore and maintain a healthy EG.

Research has shown that there’s an increase in the adhesion of leukocytes to the vascular endothelium following enzymatic removal of the EG.16 Data from a recent presentation demonstrate that this increase is normalized within minutes of exposure to certain GRCs. Promising early data from a small study using the same GRCs show a dramatic reduction in vulnerable plaque within 60 days.17 In this study, adults with carotid artery plaques confirmed by MRI-PlaqueView, the only FDA-approved software program used with MRI devices to analyze carotid plaque, received a GRC-containing nutraceutical, Arterosil, daily for two months and then underwent a second MRI. Preliminary data from the study demonstrate a 56% average reduction in the lipid-rich necrotic core of the assessed plaque, with a significant increase in lumen size.

Based on the growing body of data supporting the cardiovascular benefits of these GRCs [glycocalyx regenerating compounds] and the fact that Arterosil is a natural product, we recommend it to patients in my practice as part of an integrative approach to enhancing their cardiac longevity. Combined with a diet rich in arginine, citrulline, and dietary nitrates; a healthy lifestyle that provides adequate sleep and exercise; and periodic ADMA or EndoPAT testing, physicians now have tangible ways to help patients achieve or maintain good EG and vascular endothelial health, which will help reduce their risk of future adverse cardiac events.

Aging may be inevitable; atherosclerosis isn’t.”

— Joel Kahn, MD, is founder of the Kahn Center for Cardiac Longevity.

References
1. Head T, Daunert S, Goldschmidt-Clermont PJ. The aging risk and atherosclerosis: a fresh look at arterial homeostasis. Front Genet. 2017;8:216.

2. Wang JC, Bennett M. Aging and atherosclerosis: mechanisms, functional consequences, and potential therapeutics for cellular senescence. Circ Res. 2012;111(2):245-259.

3. Barquera S, Pedroza-Tobias A, Medina C, et al. Global overview of the epidemiology of atherosclerotic cardiovascular disease. Arch Med Res. 2015;46(5):328-338.

4. Coronary artery disease. MedlinePlus website. https://medlineplus.gov/coronaryarterydisease.html. Updated April 8, 2019.

5. Cerebrovascular disease or stroke. Centers for Disease Control and Prevention, National Center for Health Statistics website. https://www.cdc.gov/nchs/fastats/stroke.htm. Updated July 26, 2018.

6. Atherosclerosis. National Heart, Lung and Blood Institute website. https://www.nhlbi.nih.gov/health-topics/atherosclerosis. Accessed December 6, 2018.

7. Adamson PD, Dweck MR, Newby DE. The vulnerable atherosclerotic plaque: in vivo identification and potential therapeutic avenues. Heart. 2015;101(21):1755-1766.

8. Shah PK. Mechanisms of plaque vulnerability and rupture. J Am Coll Cardiol. 2003;41(4 Suppl S):15S-22S.

9. Reitsma S, Slaaf DW, Vink H, van Zandvoort MA, oude Egbrink MG. The endothelial glycocalyx: composition, functions and visualization. Pflugers Arch. 2007;454(3):345-359.

10. Mitra R, O’Neil GL, Harding IC, Cheng MJ, Mensah SA, Ebong EE. Glycocalyx in atherosclerosis-relevant endothelium function and as a therapeutic target. Curr Atheroscler Rep. 2017;19(2):63.

11. Tarbell JM, Cancel LM. The glycocalyx and its significance in human medicine. J Intern Med. 2016;280(1):97-113.

12. Palmer RM, Ferrige AG, Moncada S. Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor. Nature. 1987;327(6122):524-526.

13. Schnabel R, Blankenberg S, Lubos E, et al. Asymmetric dimethylarginine and the risk of cardiovascular events and death in patients with coronary artery disease: results from the AtheroGene Study. Circ Res. 2005;97(5):e53-e59.

14. Rubinshtein R, Kuvin JT, Soffler M, et al. Assessment of endothelial function by non-invasive peripheral arterial tonometry predicts late cardiovascular adverse events. Eur Heart J. 2010;31(9):1142-1148.

15. Nohria A, Gerhard-Herman M, Creager MA, Hurley S, MitraD, Ganz P. The role of nitric oxide in the regulation of digital pulse volume amplitude in humans. J Appl Physiol (1985). 2006;101(2):545-548.

16. Constantinescu AA, Vink H, Spaan JA. Endothelial cell glycocalyx modulates immobilization of leukocytes at the endothelial surface. Arterioscler Thromb Vasc Biol. 2003;23(9):1541-1547.

17. DeSilva D. The endothelial glycocalyx — a new therapeutic target for cardiovascular disease. Paper presented at: The American Academy of Anti-Aging Medicine (A4M) 26th World Congress; December 13, 2018; Las Vegas, Nevada.

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The condition of the arterial wall is directly dependent on the glycocalyx, a microscopic anti-adhesive lining of the arterial wall, recently discovered by scientists.

The endothelial glycocalyx is a micro-thin protective gel lining on interior of our blood vessels. It’s “non-stick” surface helps maintain endothelial function including arterial elasticity and healthy blood pressure. Many researchers consider the endothelial glycocalyx as a first line of defense against vascular diseases including atherosclerosis.

The glycocalyx inhibits platelets and other harmful particles like leukocytes from adhering to or penetrating the endothelial wall. When the glycocalyx lining is breached, it can leave the endothelium vulnerable to the formation of atherosclerotic plaque. This initiates the inflammatory response that leads to plaque formation and thrombotic events.

The endothelial glycocalyx of blood vessels is delicate and is easily damaged by many common conditions, such as high blood glucose, oxidative stress and inflammation.

Poor diet, disease, stress and aging can also compromise the glycocalyx lining.

You cannot have healthy arterial walls without a healthy endothelial glycocalyx (EGX).

How Do You Support this Lining of the Blood Vessels?

You can support and maintain the endothelial glycocalyx by having a healthy lifestyle, eating an anti-inflammatory Mediterranean type diet, reducing stress, and exercising regularly.

Conversely, factors that degrade the endothelial glycocalyx include smoking, a high sugar diet, physical inactivity, stress, air pollution, aging, and systemic inflammation.

In addition, the nutrition supplement Arterosil HP provides building blocks and antioxidants to support a strong and vital glycolayx.

Arterosil HP is a patented formulation that contains a glycocalyx-supporting compound — rhamnan sulfate — derived from a rare green seaweed (Monostroma nitidum) plus extracts of 22 antioxidant-rich fruits, vegetables and green tea.

Glycocalyx Role in Vascular and Micro-vascular Health 

Functions of the glycocalyx include:

• Regulating vascular permeability and fluid balance
• Providing a physical barrier against inadvertent adhesion of platelets, leukocytes and cholesterol to the vascular wall
• Regulating coagulation
• Regulating synthesis of nitric oxide (NO) in response to the blood flow

Cardiovascular Health is Total Body Health

Risk of cardiovascular disease (CVD) is largely determined by the condition of the vascular system. In addition, vascular health impacts many other conditions such as diabetic neuropathy and erectile dysfunction.

The glycocalyx plays a critical role in cardiovascular health. As illustrated below, your vascular system has 60,000 miles of blood vessels — including arteries, veins and tiny capillaries. Every blood vessel in your body is protected by this smooth inner glycocalyx lining.

Read more about Arterosil HPand why it will likely be the next major breakthrough in cardiovascular medicine.

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Leading integrative cardiologists use Bergamet Pro+ , the highest potency bergamot nutrition supplement in their practices. Many report that adding Bergamet Pro+ enables them to use lower statin dosages with patients and still get the desired cholesterol reductions.

Bergamet Pro+ is clinically proven to assist in:

• reducing total cholesterol levels
• improving LDL and HDL cholesterol levels
• improving triglyceride levels
• decreasing blood sugar levels
• removing fatty deposits in the liver
• addressing metabolic syndrome

Clinical Application of Bergamot (Citrus bergamia) for Reducing High Cholesterol and Cardiovascular Disease Markers — Integrative Food, Nutrition and Metabolism, March 2019

Abstract

“The bergamot is a citrus fruit native to southern Italy with traditional uses that include improving immune response and cardiovascular function. There are a variety of phytochemicals that have been found in the bergamot including brutieridin and melitidin as well as other flavonoids, flavones O-glucosides and C-glucosides.

Multiple clinical trials have provided evidence that different forms of orally administered bergamot can reduce total cholesterol and low-density lipoprotein cholesterol [LDL].

In vitro mechanistic studies have provided evidence that polyphenols from the bergamot can alter the function of AMPK and pancreatic cholesterol ester hydrolase (pCEH). The use of bergamot in multiple clinical trials has consistently shown that it is well tolerated in studies ranging from 30 days to 12 weeks.

This mini-review reports on the clinical studies performed with different forms of bergamot along with their effectiveness in reducing total cholesterol and LDL cholesterol in patients with hypercholesterolemia.”

NOTE: Some medical doctors use Bergamet Pro+ with Arterosil-HP as part of a comprehensive cardiovascular support program that always includes the foundational components of a heart-healthy diet and regular exercise.

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Bacillus spore-based probiotics are gaining popularity due to their safety, survivability, and capacity to modulate the gut microbiome. Research continues to highlight the role of MegaSporeBiotic in supporting human health outcomes.

Approximately 1/3 of the population has elevated triglyceride levels (>150 mg/dL) in the bloodstream, or hypertriglyceridemia (HT). In addition to cholesterol levels like LDL and HDL, elevated levels of triglycerides are also commonly used as indicators for heart disease risk.

Due to the metabolic functions of the gut microbiome, an imbalance of gut bacteria (gut dysbiosis) leads to increasing serum triglycerides by increasing intestinal permeability and allowing for bacterial endotoxin translocation into circulation.

Excessive intake of certain dietary fats that stimulate triglyceride production in the liver can also increase triglycerides in the bloodstream.

As triglycerides circulate the body, they can contribute to plaque formation in arteries, fatty build-up around the liver and systemic inflammation.

Summary

This study examined the effects of gut microbiota modulation, using MegaSporeBiotic in reducing serum triglycerides. Researchers recruited 80 participants with non-fasting triglyceride levels greater than 150 mg/dL to complete the study.

The average baseline triglyceride levels were 207 mg/dL. Participants were randomly divided into 2 groups. The treatment group received two capsules of MegaSporeBiotic once daily, which were taken in the morning. The control group received a placebo pill containing rice flour. Triglyceride levels were measured at baseline, 6 weeks and 12 weeks of the experiment.

Results indicated that non-fasting triglyceride levels dropped by 25% in just 6 weeks and a whopping 38% after 12 weeks of MegaSporeBiotic probiotic supplementation.

This study is the second publication on MegaSporeBiotic that demonstrates a significant reduction in serum triglyceride levels. Serum triglycerides are a critical end-point for a probiotic, as they illustrate the ability of the probiotic to conduct several critical metabolic functions in the microbiome.

Read the complete study in Integrative Medicine: A Clinician’s Journal

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