1. CoQ10
The efficacy of coenzyme Q10, or CoQ10, is a matter of controversy among scientists. A 2017 meta-analysis of clinical trials sought to gain clarity on the question by pooling together the results of previous studies evaluating the effect of using CoQ10 to treat patients with heart failure.
Researchers combed PubMed and other top medical databases for controlled trials of CoQ10, with 14 trials and 2,149 heart failure patients meeting inclusion criteria. Endpoints for the trials were death, left heart ejection fraction (a measure of the left ventricle’s ability to pump blood), exercise capacity, and a standardized measure of overall heart function after treatment.
The final analysis showed that patients with heart failure who were supplemented with CoQ10 had a lower death rate and a higher exercise capacity than placebo-treated patients. Other studies support CoQ10’s ability to help patients with heart failure decrease serious complications and avoid hospitalization, significant findings that were attributed to CoQ10’s ability to support mitochondrial function and provide energy to cells.
2. Ubiquinol
Ubiquinol (pronounced you-bik-win-all) is a recently developed form of CoQ10 that has only been commercially available for about 12 years. Considered the active form of CoQ10, ubiquinol is an antioxidant that plays a key role in creating cellular energy. CoQ10 comes in two forms: ubiquinone and ubiquinol, both of which are made naturally by the body. The body must convert ubiquinone into ubiquinol to create cellular energy.
Production of ubiquinol begins slowing down at around age 40, as does the body’s ability to convert ubiquinone into ubiquinol, which is better absorbed by the body. Studies have shown that ubiquinol is up to 70 percent more bioavailable than conventional CoQ10. For this reason, older adults may choose to supplement with ubiquinol to enhance the energy available to their cells.
A clinical trial on patients with congestive heart failure noted that patients who were given supplemental ubiquinone, at doses of up to 900 milligrams (mg) per day, failed to achieve adequate blood plasma levels of CoQ10. Researchers postulated that intestinal edema in these critically ill patients had prevented their bodies from being able to adequately convert the ubiquinone into active ubiquinol.
When patients were switched to ubiquinol (between 450 and 900 mg per day), plasma CoQ10 levels increased significantly and clinical improvement was noted as “remarkable.” Researchers concluded that “ubiquinol dramatically improved absorption in patients with severe heart failure” and noted that improvements in plasma CoQ10 levels correlated with both clinical improvement and better left ventricular function in the heart.
A 2019 study supports these findings. On 400 mg ubiquinol per day for three months, patients with heart failure and reduced ejection fraction had significant improvement in peripheral endothelial function when compared with placebo-treated patients.
3. Omega-3 and -6 Fats
The importance of including healthy fats in your diet has gained needed attention since the flawed logic of low-fat diets has been exposed. As it turns out, your brain and heart need fat to function. But it’s important to choose the right kinds of fat, including heart-healthy polyunsaturated fatty acids (PUFAs), like omega-3s and certain omega-6s.
While most people consume an overabundance of omega-6 fats from processed foods, a study published in the journal Lipids in Health and Disease found that low levels of dihomo-gamma-linolenic acid (DGLA), an omega-6 PUFA, circulating in the blood were associated with higher death rates in patients with heart failure. Conversely, higher levels of DGLA in the blood were associated with higher survival rates.
Another study on omega-3s found that dietary supplementation with fish oil increased plasma adiponectin (a protein that helps regulate insulin sensitivity), suppressed inflammation, and prevented cardiac dysfunction. Researchers didn’t observe the same cardioprotective properties in patients supplementing with flaxseed oil.
4. Hawthorn
Hawthorn is a plant in the rose family that’s native to the cooler Northern Hemisphere. Hawthorn (scientific name: Crataegus) has been used to make traditional medicine for hundreds—perhaps thousands—of years and has been most commonly applied in the treatment of diseases of the heart.
In an effort to substantiate centuries of use, the European Journal of Heart Failure published a study on the efficacy and safety of hawthorn extract in patients with heart failure, naming the study the SPICE trial. Researchers performed a large-scale morbidity/mortality trial encompassing 1,442 patients with congestive heart failure.
Supplementing with Crataegus extract was found to reduce sudden cardiac death by a whopping 39.7 percent at month 24 of treatment in patients with less compromised left ventricular function. The treatment also showed no significant adverse effects.
5. Berberine
Berberine is another plant-based medicine that has demonstrated impressive heart benefits. Anecdotally believed to aid in producing stronger heartbeats, berberine’s place in our herbal pantheon as a heart healer has received scientific validation.
In 2010, a berberine derivative was found to strengthen the heart by blocking calcium influx, a central cause of a failing heart, and exerting powerful antioxidant activity. Among berberine’s heart-boosting properties is anti-arrhythmic activity that has been shown to prolong the duration of ventricular action potential; in other words, it creates a stronger, more rhythmic heartbeat.
A 2020 study in Frontiers in Physiology seeking to identify the mechanism by which berberine works on the heart didn’t mince words: “Berberine has been verified to protect cardiac function in patients with heart failure.” Berberine’s effect on heart health is another example of the plant world’s deep symbiosis with the human body.
6. Magnesium
The mineral salt magnesium is critical for more than 300 enzyme systems in the body, as well as the regulation of blood pressure. Research has explored the use of magnesium in patients with heart disease, with some studies focusing on the role magnesium plays on endothelial dysfunction, a hallmark of heart failure in which the blood vessels of the heart constrict instead of opening or dilating.
One such study, published in the journal Congestive Heart Failure, found that oral supplementation with 800 mg per day of magnesium oxide for three months produced improved arterial function when compared to placebos in heart failure patients. The importance of lost minerals to heart health has been clearly ascertained, with low magnesium levels contributing to oxidative stress, compromised antioxidant defenses, tissue wasting, and more problems linked to heart failure.
7. Arginine
The amino acid arginine, also called L-arginine, is important for numerous bodily functions, including dilating and relaxing arteries. Though arginine is produced endogenously, it needs to be consumed to maintain adequate levels. Foods such as pastured red meat, fish, poultry, and dairy products are primary sources; vegetarians can look to whole grains, nuts, and seeds to boost arginine intake.
Arginine’s role in healthy heart function has been the focus of numerous studies in recent decades. Supplementation for six weeks was found to enhance exercise tolerance in heart failure patients, an important marker of heart stability. Adding arginine to a regimen of CoQ10 and vitamin D was found to be beneficial to both cardiac and endothelial cells that line blood vessels, due to a cooperative effect.
And a meta-analysis of more than 30 years’ worth of scientific studies on arginine found that oral supplementation exerts favorable effects in the prevention and treatment of a vast array of cardiovascular disorders, including mild-to-moderate heart failure.
Before starting any herb or supplement regimen, it’s important to talk to your health care provider about possible contraindications with current medication or prescribed treatment protocols.
