ACC Cardio EXTRA STRENGTH

Research and Summary Comments

ACC Cardio Extra Strength

Ingredients:

CoQ10 (Ubiquinone), Red Yeast Rice (Monascus purpureus), Lycopene, L-Arginine, Garlic, Magnesium, Vitamin D3 (as Cholecalciferol), Vitamin K2 (as Menaquinone-7), Cinnamon extract (Cinnamomum cassia), Curcumin C3 Complex® (Turmeric extract standardized to 95% Curcuminoids), Glycine Propionyl-L-Carnitine HCl, Acetyl-L Carnitine

Coenzyme Q10 (Ubiquinone)

1. Overview of the use of CoQ10 in cardiovascular disease.

The clinical experience in cardiology with CoQ10 includes studies on congestive heart failure, ischemic heart disease, hypertensive heart disease, diastolic dysfunction of the left ventricle, and reperfusion injury as it relates to coronary artery bypass graft surgery. Supplemental CoQ10 alters the natural history of cardiovascular illnesses and has the potential for prevention of cardiovascular disease through the inhibition of LDL cholesterol oxidation and by the maintenance of optimal cellular and mitochondrial function throughout the ravages of time and internal and external stresses.

Takeaway:

• Supplementation with CoQ10 (Ubiquinone) has deep history with regard to cardiovascular disease. Its primary benefits relate to inhibition of LDL cholesterol oxidation and by the maintenance of optimal cellular and mitochondrial function.

2. Role of coenzyme Q10 (CoQ10) in cardiac disease, hypertension and Meniere-like syndrome.

Coenzyme Q10 (ubiquinone) is a mitochondrial coenzyme which is essential for the production of ATP. Being at the core of cellular energy processes it assumes importance in cells with high energy requirements like the cardiac cells which are extremely sensitive to CoQ10 deficiency produced by cardiac diseases. CoQ10 has thus a potential role for prevention and treatment of heart ailments by improving cellular bioenergetics. In addition it has an antioxidant, a free radical scavenging and a vasodilator effect which may be helpful in these conditions. It inhibits LDL oxidation and thus the progression of atherosclerosis.

Takeaway:

• Verification of CoQ10’s importance to heart health, with additional insights, which speak to its benefits as an antioxidant, free radical scavenger and CoQ10’s vasodilating effect, all of which contribute to the inhibition of LDL oxidation and progression of atherosclerosis.

Red Yeast Rice (Monascus purepureus)

3. The effect of red yeast rice (Monascus purpureus) in dyslipidemia and other disorders.

Red Yeast Rice (RYR) is a traditional Chinese food that is fermented and obtained after red yeast (Monascus purpureus) is grown on rice. RYR contains Monacolin K (Lovastatin) and other active ingredients that are thought to play a role in the management of cholesterol levels. Recently, many clinical trials have focused on the uses of RYR, including for dyslipidemia, coronary heart disease, diabetes, osteoporosis, cancer, non-alcoholic fatty liver disease, fatigue, and memory.

The primary objective of this review is to evaluate the effectiveness of RYR on the management of dyslipidemia. Studies reviewed show that RYR significantly lowered LDL cholesterol and total cholesterol. Effects on triglycerides and HDL cholesterol were also observed in some studies. Compared with statins, RYR was shown to have an equal efficacy to statins when combined with or without other dietary supplements. RYR also appeared to be superior to placebo in preventing nonfatal myocardial infarction, total coronary heart disease events, and total deaths.

Takeaway:

• Red Yeast Rice has a long history with regard to its use for CVD. The specific focus and strongest evidence points to its use for the management of dyslipidemia.

Lycopene

4. Lycopene Deficiency in Ageing and Cardiovascular Disease.

The recent body of evidence suggests that plasma concentration of lycopene is not only a function of intestinal absorption rate but also lycopene breakdown via enzymatic and oxidative pathways in blood and tissues. Oxidative stress and the accumulation of reactive oxygen species and nitric oxide may represent a major cause of lycopene depletion in ageing, cardiovascular disease, and type 2 diabetes mellitus. It has been shown recently that low carotenoid levels, and especially decreased serum lycopene levels, are strongly predictive of all-cause mortality and poor outcomes of cardiovascular disease. Hence, it is very unlikely that nutritional intervention alone could be instrumental in the correction of lycopene and carotenoid deficiency. Therefore, new nutraceutical formulations of carotenoids with enhanced bioavailability are urgently needed.

Takeaway:

• Given the relationship between serum lycopene levels and cardiovascular disease outcomes, it is important to introduce supplemental Lycopene given that levels typically decline with aging.

5. Lycopene intervention reduces inflammation and improves HDL functionality in moderately overweight middle-aged individuals.

The management of overweight subjects by interventions aimed at reducing inflammation is highly desirable. To date, observational studies have identified a link between increased dietary antioxidant intake and reduced cardiovascular morbidity. However, direct trial evidence regarding the ability of antioxidants to influence inflammation is lacking. Therefore, this study examined lycopene’s ability to lower systemic and high-density lipoprotein (HDL)-associated inflammation in moderately overweight middle-aged subjects.
These results demonstrate that in moderately overweight, middle-aged subjects, increasing lycopene intake leads to changes to HDL(2&3), which we suggest enhanced their antiatherogenic properties.

Takeaway:

• Lycopene has heart-protective properties given its ability to inhibit atherogenesis (oxidation of LDL).

L-Arginine

6. l-Arginine Supplementation Alleviates Postprandial Endothelial Dysfunction When Baseline Fasting PlasmaArginine Concentration Is Low: A Randomized Controlled Trial in Healthy Overweight Adults with Cardiometabolic Risk Factors.

We sought to determine the effects of a low dose of a sustained-release (SR) l-arginine supplement on postprandial endothelial function in healthy overweight adults with cardio metabolic risk factors and to investigate whether this effect may vary by baseline arginine status.

In a randomized, double-blind, 2-period crossover, placebo-controlled trial (4-wk treatment, 4-wk washout), we compared the effects of 1.5 g SR-l-arginine 3 times/d (4.5 g/d) with placebo in 33 healthy overweight adults [body mass index (BMI, in kg/m2): 25 to >30] with the hypertriglyceridemic waist (HTW) phenotype [plasma triglycerides > 150 mg/dL; waist circumference > 94 cm (men) or > 80 cm (women)]. Supplementation with low-dose SR-arginine alleviates postprandial endothelial dysfunction in healthy HTW adults when the baseline plasma arginine concentration is relatively low.

Takeaway:

• L-Arginine’s benefit here – in this study, low dose arginine offsets postprandial endothelial dysfunction in healthy HTW adults when the baseline plasma arginine concentration is relatively low

Garlic

7. The effect of aged garlic extract on blood pressure and other cardiovascular risk factors in uncontrolled hypertensives: the AGE at Heart trial.

Hypertension affects 30% of adults worldwide. Garlic supplements have shown promise in the treatment of uncontrolled hypertension, and the mechanism of action is biologically plausible. Our trial is the first to assess the effect of aged garlic extract on central blood pressure and arterial stiffness, regarded as important risk factors for cardiovascular morbidity.
A total of 88 general practice patients and community members with uncontrolled hypertension completed a double-blind randomized placebo-controlled trial of 12 weeks investigating the effect of daily intake of aged garlic extract (1.2 g containing 1.2 mg S-allylcysteine) or placebo on blood pressure, and secondary outcome measures of central-hemodynamics and other cardiovascular markers, including cholesterol, homocysteine, platelet function, and inflammatory markers.

Mean blood pressure was significantly reduced by 5.0±2.1 mmHg (P=0.016) systolic, and in responders by 11.5±1.9 mmHg systolic and 6.3±1.1 mmHg diastolic compared to placebo (P<0.001). Central hemodynamic-measures tended to improve in the garlic group more than in the placebo group, including central blood pressure, central pulse pressure, mean arterial pressure, augmentation pressure, pulse-wave velocity, and arterial stiffness. Our trial suggests that aged garlic extract is effective in reducing peripheral and central blood pressure in a large proportion of patients with uncontrolled hypertension, and has the potential to improve arterial stiffness, inflammation, and other cardiovascular markers in patients with elevated levels. Aged garlic extract was highly tolerable with a high safety profile as a stand-alone or adjunctive antihypertensive treatment. Takeaway:

• Garlic’s primary contribution is as a safe and effective means of addressing hypertension. This study also revealed potential, other benefits – improved arterial stiffness, inflammation, and other cardiovascular markers in patients with elevated levels.

Magnesium

8. Circulating and dietary magnesium and risk of cardiovascular disease: a systematic review and meta-analysis of prospective studies

We performed a systematic review and meta-analysis to investigate prospective associations of circulating and dietary magnesium with incidence of CVD, IHD, and fatal IHD. Circulating magnesium was significantly associated with a lower risk of CVD, with trends toward a lower risk of IHD and fatal IHD. Dietary magnesium was associated with a significantly lower risk of IHD and showed a nonlinear association with fatal IHD.

Note: It is estimated that 70%-80% of consumers are not meeting their recommended intakes of magnesium.

Takeaway:

• Given the established relationship between magnesium and CVD, and the data suggesting a nationwide deficiency, magnesium supplementation is recommended for those at risk as well as healthy subjects.

Vitamin D3 (as Cholecalciferol)

9. Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure?

This study was designed to evaluate the association between vitamin D status and congestive heart failure (CHF). Both groups of CHF patients had markedly increased serum levels of NT-proANP (p < 0.001), increased serum phosphorus levels (p < 0.001), and reduced circulating levels of both 25-hydroxyvitamin D (p < 0.001) and calcitriol (p < 0.001). The low vitamin D status can explain alterations in mineral metabolism as well as myocardial dysfunction in the CHF patients, and it may therefore be a contributing factor in the pathogenesis of CHF. Takeaway:

• This study raises the question and provides evidence that reduced levels of vitamin D may be related to CHF.

Vitamin K2 (as Menaquinone-7)

10. Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health.

Recent scientific evidence, however, suggests that elevated consumption of calcium supplements may raise the risk for heart disease and can be connected with accelerated deposit of calcium in blood-vessel walls and soft tissues.

In contrast, vitamin K2 is associated with the inhibition of arterial calcification and arterial stiffening.

An adequate intake of vitamin K2 has been shown to lower the risk of vascular damage because it activates matrix GLA protein (MGP), which inhibits the deposits of calcium on the walls. Vitamin K, particularly as vitamin K2, is nearly nonexistent in junk food, with little being consumed even in a healthy Western diet. Vitamin K deficiency results in inadequate activation of MGP, which greatly impairs the process of calcium removal and increases the risk of calcification of the blood vessels. An increased intake of vitamin K2 could be a means of lowering calcium-associated health risks.

Takeaway:

• Increased intake of vitamin K2 could be a viable means of reducing calcium – associated health risks, specifically CVD.

Cinnamon extract (Cinamomum casia)

11. Cinnamon and its Components Suppress Vascular Smooth Muscle Cell Proliferation by Up-Regulating Cyclin-Dependent Kinase Inhibitors.

Cinnamomum cassia bark has been used in traditional herbal medicine to treat a variety of cardiovascular diseases. However, the anti-proliferative effect of cinnamon extract on vascular smooth muscle cells (VSMCs) and the corresponding restenosis has not been explored. Hence, after examining the effect of cinnamon extract on VSMC proliferation, we investigated the possible involvement of signal transduction pathways associated with early signal and cell cycle analysis, including regulatory proteins.

Cinnamon extract inhibited platelet-derived growth factor (PDGF)-BB-induced VSMC proliferation and suppressed the PDGF-stimulated early signal transduction. In addition, cinnamon extract arrested the cell cycle and inhibited positive regulatory proteins. Correspondingly, the protein levels of p21 and p27 not only were increased in the presence of cinnamon extract, also the expression of proliferating cell nuclear antigen (PCNA) was inhibited by cinnamon extract. Besides, among the components of cinnamon extract, cinnamic acid (CA), eugenol (EG) and cinnamyl alcohol significantly inhibited the VSMC proliferation.

Overall, the present study demonstrates that cinnamon extract inhibited the PDGF-BB-induced proliferation of VSMCs through a G0/G1 arrest, which down-regulated the expression of cell cycle positive regulatory proteins by up-regulating p21 and p27 expression.

Takeaway:
The ability of Cinnamon extract to inhibit proliferation of VSMCs is a key factor in preventing atherosclerosis.

Curcumin C3 Complex® (Turmeric extract standardized to 95% Curcuminoids)

12. The Effect of Curcumin on some of Traditional and Non-traditional Cardiovascular Risk Factors: A Pilot Randomized, Double-blind, Placebo-controlled Trial

The objective of this trial was investigation of curcumin efficiency on some cardiovascular risk factors in patients with coronary artery disease (CAD). A total of 33 patients with CAD who fulfilled inclusion and exclusion criteria were entered the study. Patients were randomly assigned to receive curcumin (Curcumin C3 Complex) or placebo, 500 mg capsules, four times daily for 8 weeks. Lipid profile, blood glucose and high sensitive C-reactive protein (hs-CRP) levels were analyzed at baseline and two months after treatment.
The parameters evaluated during the trial (i.e. at baseline and at the end of the study) included fasting glucose level and lipid profile (total cholesterol, LDL-C, HDL-C and Triglycerides) along with liver and kidney function tests.

Among the lipid profile test, LDL-C levels were significantly reduced in Curcumin C3 Complex group. Also, levels of VLDL-C and serum triglyceride were also found to be reduced significantly in treatment group subjects.

Takeaway:
Curcumin C3 Complex was shown to be effective in the management of cardiovascular risk factors as demonstrated by its significant effect on cholesterol and triglyceride levels.

Glycine Propionyl-L-Carnitine HCl

13. Controlled study on the therapeutic efficacy of propionyl-L-carnitine in patients with congestive heart failure

A double-blind phase II study of propionyl-L-carnitine (CAS 17298-37-2) versus placebo was carried out on a group of 60 patients with mild to moderate (II and III NYHA class) congestive heart failure. The group was made up of men and women aged between 48 and 73 years in chronic treatment with digitalis and diuretics for at least 3 months and who still displayed symptoms.

Thirty of these patients were chosen randomly and for 180 days, 500 mg of propionyl-L-carnitine was orally administered, 3 times a day in addition to their usual treatment. At basal conditions and after 30, 90 and 180 days the maximum exercise time was evaluated using an exercise tolerance test performed on an ergometer bicycle and the left ventricular ejection fraction was tested by means of bidimensional echocardiography.

After one month of treatment, the patients treated with propionyl-L-carnitine, compared to the control group, showed significant increases in the values of both tests, increases which became even more evident after 90 and 180 days. At the stated times the increases in the maximum exercise time were 16.4%, 22.9%, and 25.9%, respectively. The ventricular ejection fraction increased by 8.4%, 11.6% and 13.6%, respectively.

Takeaway:
On the basis of these results, the authors conclude that propionyl-L-carnitine represents an option of undoubted therapeutic interest in patients with congestive heart failure, in whom it could be efficaciously administered along with a standard pharmacological therapy.

14. Improvement of cardiac function and beta-adrenergic signal transduction by propionyl L-carnitine in congestive heart failure due to myocardial infarction.

Earlier studies have revealed beneficial effects of metabolic therapy in animals with congestive heart failure (CHF) due to myocardial infarction. Because heart failure is also associated with attenuated response to catecholamines, we examined the effects of propionyl L-carnitine (PLC) (a carnitine derivative) therapy on the beta-adrenoceptor (beta-AR) signal transduction in the failing heart.

Heart failure in rats was induced by occluding the coronary artery and 3 weeks later the animals were treated with or without 100 mg/kg (intraperitoneally, daily) PLC for 5 weeks. The animals were assessed for their left ventricular function and inotropic responses to isoproterenol.

Animals with heart failure exhibited depressions in ventricular function, positive inotropic response to isoproterenol, beta-AR receptor density and basal AC activity; these changes were also attenuated by PLC treatment. The stimulation of AC activities with isoproterenol, 5′-guanyl imidodiphosphate, forskolin and sodium fluoride was decreased in the failing hearts and these changes were also prevented by PLC treatment.

Takeaway:
The results indicate that metabolic therapy with PLC not only attenuates the defects in heart function but also prevents changes in the beta-AR signal transduction in CHF due to myocardial infarction.

Acetyl-L Carnitine

15. Acetyl-l-Carnitine and Oxfenicine on Cardiac Pumping Mechanics in Streptozotocin-Induced Diabetes in Male Wistar Rats

In the treatment of patients with diabetes, one objective is an improvement of cardiac metabolism to alleviate the left ventricular (LV) function. For this study, we compared the effects of acetyl-L-carnitine (one of the carnitine derivatives) and of oxfenicine (a carnitine palmitoyltransferase-1 inhibitor) on cardiac pumping mechanics in streptozotocin-induced diabetes in male Wistar rats, with a particular focus on the pressure-flow-volume relationship.

When comparing the diabetic rats with their age-matched controls, the cardiodynamic condition was characterized by a decline in Emax associated with the unaltered Qmax. Acetyl-L-carnitine (but not oxfenicine) had reduced cardiac levels of malondialdehyde in these insulin-deficient animals. However, treating with acetyl-L-carnitine or oxfenicine resulted in an increase in Emax, which suggests that these 2 drugs may protect the contractile status from deteriorating in the diabetic heart. By contrast, Qmax showed a significant fall after administration of oxfenicine, but not with acetyl-L-carnitine. The decrease in Qmax corresponded to an increase in total vascular resistance when treated with oxfenicine.

Takeaway:
Acetyl-L-carnitine, but not oxfencine, optimizes the integrative nature of cardiac pumping mechanics by preventing the diabetes-induced deterioration in myocardial intrinsic contractility associated with unaltered left ventricular internal resistance.

16. Ameliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: effects of acetyl-L-carnitine therapy.

Insulin resistance, a key component of the metabolic syndrome, is a risk factor for diabetes mellitus and cardiovascular disease. Acetyl-L-carnitine infusion acutely ameliorated insulin sensitivity in type 2 diabetics with insulin resistance.

In this sequential off-on-off pilot study, we prospectively evaluated the effects of 24-week oral acetyl-L-carnitine (1 g twice daily) therapy on the glucose disposal rate (GDR), assessed by hyperinsulinemic euglycemic clamps, and components of the metabolic syndrome in nondiabetic subjects at increased cardiovascular risk a priori segregated into 2 groups with GDR < or =7.9 (n=16) or >7.9 (n=16) mg/kg per minute, respectively.

Acetyl-L-carnitine increased GDR from 4.89+/-1.47 to 6.72+/-3.12 mg/kg per minute (P=0.003, Bonferroni-adjusted) and improved glucose tolerance in patients with GDR < or =7.9 mg/kg per minute, whereas it had no effects in those with higher GDRs. Changes in GDR were significantly different between groups (P=0.017, ANCOVA). Systolic blood pressure decreased from 144.0+/-13.6 to 135.1+/-8.4 mm Hg and from 130.8+/-12.4 to 123.8+/-10.8 mm Hg in the lower and higher GDR groups, respectively (P<0.05 for both; P<0.001 overall) and progressively recovered toward baseline over 8 weeks posttreatment. Total and high molecular weight adiponectin levels followed specular trends. Diastolic blood pressure significantly decreased only in those with higher GDRs. Takeaway:
Acetyl-L-carnitine safely improved arterial hypertension, insulin resistance, impaired glucose tolerance, and hypoadiponectinemia in subjects at increased cardiovascular risk.

Citation links:
1. https://www.ncbi.nlm.nih.gov/pubmed/10416041
2. https://www.ncbi.nlm.nih.gov/pubmed/19638284
3. https://www.ncbi.nlm.nih.gov/pubmed/23131380
4. https://www.ncbi.nlm.nih.gov/pubmed/26881023
5. https://www.ncbi.nlm.nih.gov/pubmed/22819555
6. https://www.ncbi.nlm.nih.gov/pubmed/27281800
7. https://www.ncbi.nlm.nih.gov/pubmed/26869811
8. http://ajcn.nutrition.org/content/98/1/160.full#ref-1
9. https://www.ncbi.nlm.nih.gov/pubmed/12570952?dopt=Abstract
10. https://www.ncbi.nlm.nih.gov/pubmed/26770129
11. https://www.ncbi.nlm.nih.gov/pubmed/26119954
12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4403064/
13. https://www.ncbi.nlm.nih.gov/pubmed/1445476
14. https://www.ncbi.nlm.nih.gov/pubmed/15201623
15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724909/
16. https://www.ncbi.nlm.nih.gov/pubmed/19620516

Standard Dose

Take 6 sprays by mouth, twice daily.

Higher Dose

Take 12 sprays by mouth, twice daily.

Optimal Use

• Spray, swish and swallow. You may take other Results RNA formulas immediately.
• Do not eat or drink for 2 minutes following.
• Take as recommended by your physician.

SERVING SIZE

Serving size: 12 Sprays
Servings Per Container: Approx. 60
AMOUNT PER SERVING
Proprietary Blend Tincture ~18000 mcg*

Ingredients

Glycine Propionyl-L-Carnitine HCl, Vitamin K2 (as Menaquinone-7), Curcumin C3 Complex® (Turmeric extract standardized to 95% Curcuminoids), Lycopene, Red Yeast Rice (Monascus purpureus), Coenzyme Q10 (Ubiquinone), Acetyl-L Carnitine, L-Arginine, Garlic, Magnesium, Vitamin D3 (as Cholecalciferol), Cinnamon extract (Cinamomum cassia), Peppermint Leaf (Mentha x piperita) and Natural Trace Minerals.

Other Ingredients: Ultra-Pure Deionized Water

* % Daily value not established

For Best Results:

Take ACC Cardio Extra Strength with ACS 200 and ACZ Nano Extra Strength to achieve optimal cardiovascular support and total body detoxification.