Cardiovascular Health and Lipoprotein(a)
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Addressing a genetic issue and supporting cardiovascular health naturally
Anyone who has ever listened to his or her own heart with a stethoscope has likely found the lub-dub pattern reassuring. The rhythmic regularity of the heart at rest can lull us into meditation, much like it helps an infant go to sleep, while the intense beating after exercise further spurs our energy like a beating drum.
Lifestyle, genetics, and many other factors – some of which we can control and others we cannot – influence the development of cardiovascular disease. As we learn more from the information obtained with genetic assessment, we further understand these markers of risk, and more importantly, how to make use of them. One such marker in the blood is lipoprotein (a).
Elevated lipoprotein (a) levels are associated with increased risk of coronary heart disease, stroke, and peripheral vascular disease, and are primarily dependent on genetics. High lipoprotein(a) levels are not uncommon, with one in five Americans having levels that place them at risk, approximately tripling the likelihood of having a heart attack or stroke at a young age. Even the New York Times recently delved into a discussion of this risk marker, highlighting the story of Bob Harper, co-host of the hit show “The Biggest Loser,” who was found to have elevated levels of this protein after suffering a massive heart attack at the age of 52.
Despite the genetic predisposition for elevated lipoprotein(a), levels of this protein still can be modulated with the aid of natural supplements. Coenzyme Q10, commonly known as CoQ10, is an antioxidant well known for its support of cardiovascular health and lowering of lipoprotein (a) levels. In one well-designed clinical study, supplementation with CoQ10 was associated with a 31% reduction of lipoprotein (a), compared to an 8.2% reduction with placebo. Where cardiovascular health is concerned, CoQ10 has also been shown to improve endothelial function, reduce LDL oxidation, and to lower systolic and diastolic blood pressure.
In order to make its own CoQ10, the body relies on an enzyme known as HMG-CoA reductase, which is also responsible for cholesterol production. Statin medications work by inhibiting this enzyme, simultaneously lowering cholesterol levels and potentially depleting CoQ10 by up to 40%., CoQ10 supplementation may therefore be of value for those taking statin medications.
Supplementation with CoQ10 was associated with a 31% reduction of lipoprotein (a), compared to an 8.2% reduction with placebo
Tocotrienols are the lesser-studied family of the naturally-occurring forms of vitamin E, with the tocopherols, more often found in nature, dominating scientific research. However, tocotrienols are potent antioxidants, quoted in some research as having 40 – 60 times the antioxidant potential of tocopherols. As a fat-soluble antioxidant, they have an affinity for our lipid-containing cell membranes (including those lining our blood vessels) as well as cholesterol. Because of this, they confer a variety of benefits relevant to cardiovascular health. In addition to helping reduce lipoprotein(a) levels, tocotrienols have been shown to improve total cholesterol and its fractions, reduce low-density lipoprotein (LDL) oxidation, and improve arterial compliance, that is, the ability of arterial walls to be flexible which directly impacts blood pressure.
Elevated lipoprotein(a) is associated with an increased risk of cardiovascular disease in part through its relationship with fibrinogen, a component in the blood that plays a role in clot formation. Nattokinase and lumbrokinase are two potent enzymes used for supporting a healthy balance of circulation and coagulation. Both can help decrease fibrinogen and disintegrate clots by breaking down fibrin, promoting healthy blood flow in both the arteries and small capillaries., This can be helpful for reducing risk of a clot or dissolving an existing one, and also for supporting healthy circulation. (Note: Parameters associated with bleeding should be monitored during nattokinase and lumbrokinase use.)
Lipoprotein (a) is a biomarker of cardiovascular disease risk. Despite the genetic predisposition for elevated lipoprotein(a), levels of this protein can be modulated with certain natural supplements including CoQ10 and tocotrienols. These potent antioxidants also support blood lipid metabolism and vascular health.
Nattokinase and lumbrokinase are enzymes found in nature that can help support a healthy balance of circulation and coagulation.
Cardiovascular health is critically important, and for many, addressed all too late. Taking proactive measures to evaluate and support cardiovascular health will help to reduce the risk of future detrimental events. So, take heart, and support your heart health!
Click here to see References
 Emerging Risk Factors Collaboration, et al. Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality. JAMA. 2009 Jul 22;302(4):412-23.
 Hopewell JC, et al. Lipoprotein(a) genetic variants associated with coronary and peripheral vascular disease but not with stroke risk in the Heart Protection Study. Circ Cardiovasc Genet. 2011 Feb;4(1):68-73.
 Boerwinkle E, et al. Apolipoprotein(a) gene accounts for greater than 90% of the variation in plasma lipoprotein(a) concentrations. J Clin Invest. 1992 Jul;90(1):52-60.
 Rallidis LS, et al. High levels of lipoprotein (a) and premature acute coronary syndrome. Atherosclerosis. 2017 Dec 7;269:29-34.
 Singh RB, Niaz MA. Serum concentration of lipoprotein(a) decreases on treatment with hydrosoluble coenzyme Q10 in patients with coronary artery disease: discovery of a new role. Int J Cardiol. 1999 Jan;68(1):23-9.
 Gao L, et al. Effects of coenzyme Q10 on vascular endothelial function in humans: a meta-analysis of randomized controlled trials. Atherosclerosis. 2012 Apr;221(2):311-6.
 Thomas SR, Neuzil J, Stocker R. Inhibition of LDL oxidation by ubiquinol-10. A protective mechanism for coenzyme Q in atherogenesis? Mol Aspects Med. 1997;18 Suppl:S85-103.
 Hodgson JM, et al. Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes. Eur J Clin Nutr. 2002 Nov;56(11):1137-42.
 Hargreaves IP, et al. The effect of HMG-CoA reductase inhibitors on coenzyme Q10: possible biochemical/clinical implications. Drug Saf. 2005;28(8):659-76.
 Ghirlanda G, et al. Evidence of plasma CoQ10-lowering effect by HMG-CoA reductase inhibitors: a double-blind, placebo-controlled study. J Clin Pharmacol. 1993 Mar;33(3):226-9.
 Peh HY, et al. Vitamin E therapy beyond cancer: Tocopherol versus tocotrienol. Pharmacol Ther. 2016 Jun;162:152-69.
 Prasad K. Tocotrienols and cardiovascular health. Curr Pharm Des. 2011;17(21):2147-54.
 Theriault A, et al. Tocotrienol: a review of its therapeutic potential. Clin Biochem. 1999 Jul;32(5):309-19.
 Rasool AH, et al. Arterial compliance and vitamin E blood levels with a self-emulsifying preparation of tocotrienol rich vitamin E. Arch Pharm Res. 2008 Sep;31(9):1212-7.
 Heinrich J, et al. Relationship of lipoprotein(a) to variables of coagulation and fibrinolysis in a healthy population. Clin Chem. 1991 Nov;37(11):1950-4.
 Hsia CH, et al. Nattokinase decreases plasma levels of fibrinogen, factor VII, and factor VIII in human subjects. Nutr Res. 2009 Mar;29(3):190-6.
 Cao YJ, et al. Oral fibrinogen-depleting agent lumbrokinase for secondary ischemic stroke prevention: results from a multicenter, randomized, parallel-group and controlled clinical trial. Chin Med J (Engl). 2013 Nov;126(21):4060-5.
 Milner M, Makise K. Natto and its active ingredient nattokinase: A potent and safe thrombolytic agent. Alt Comp Therapies. 2002 Jun 1;8(3):157-64.
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Dr. Carrie Decker
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