Supplements that address a variety of heart health issues are catching on with consumers.

December 2016’s surprising losses of entertainment icons George Michael and Carrie Fisher to devastating heart conditions has disheartened millions of fans—many of whom in their 40s and early 50s and who have never had their cardiovascular status tested—may be wondering if somehow they may be at risk too.

At Green’s Nutrition in Stockton, CA, owner Eunice Green, NHD, related, “Although no one has come outright and said they have a greater concern about their heart problems because of the celebrity deaths, I do think that the awareness is increased when it happens to people of renown. When it comes to heart health, customers’ key concerns are high cholesterol and high blood pressure.”

The following are several of the most recent available statistics from the American Heart Association’s 2016 Heart Disease and Stroke Statistics Update:

• From 2003 to 2013, the death rate from heart disease has fallen about 38 percent—but the burden and risk factors remain alarmingly high.

• Heart disease strikes someone in the U.S. about once every 42 seconds.

• Heart disease is the No. 1 cause of death in the United States, killing more than 370,000 people a year.

• Heart disease is the No. 1 killer of women, taking more lives than all forms of cancer combined.

• About 750,000 people in the U.S. have heart attacks each year. Of those, about 116,000 die.

• Approximately 550,000 people in the U.S. have a first-time heart attack each year, and about 200,000 have recurrent heart attacks.

With all the conditions you can help customers support with supplements, heart health should be prominent, as unlike several other systems, is multi-factorial, and one customer’s primary heart condition (high blood pressure), may be different from the next’s (circulation). And still others have more than one, or have cardiometabolic issues (metabolic syndrome). Equally, a customer who is inactive and overweight and who wants to get into healthier shape will need cardiovascular support supplementation.

Ross Pelton, RPh, PhD, CCN scientific director, Texas-based Essential Formulas Inc., emphasized that heart disease is still the leading cause of death for both men and women in the United States. “Key heart-healthy nutritional supplements are effective at helping reduce risks to cardiovascular disease,” he said, underscoring the need for prominence of this condition-specific category all year around.

In fact, pointed out Jay Levy, director of sales, California-based Wakunaga of America Co., Ltd., “One in every four Americans has been diagnosed with some form of cardiovascular disease. Because of its prevalence—and because it encompasses so many conditions including high cholesterol, hypertension, atherosclerosis, heart failure and more—cardiovascular disease has justifiably become a major health category among dietary supplements. What’s more, many of the pharmaceuticals that target the various risk factors for cardiovascular disease come with a long list of side effects that make them less-than-desirable for patients. This has led many consumers to seek out natural, yet effective, alternatives.”

Dan Chapman, founder and CEO, Redd Remedies, Illinois, noted that many cardiovascular-health shelves are loaded with single ingredients such as CoQ10 and fish oil, but “the heart is much more complex than that.” Chapman said that providing condition-specific formulas that address the variety of issues such as healthy blood pressure, cholesterol profiles and circulation would be highly attractive for customers.

Overall, according to Marci Clow, MS, RDN, at Rainbow Light, your cardiovascular section should include supplements containing what she believes are the best-researched singular ingredients/compounds that promote cardiovascular wellness. These include:

• Omega-3 EFAs: Fish oil has been shown to lower triglycerides to prevent clot formation and plaque buildup, and also improve blood pressure and increase HDL.

• Psyllium: Psyllium is a sound source of soluble fiber, and is prominent in many bulk laxatives. Psyllium studies have shown modest reductions in blood levels of total cholesterol and LDL cholesterol.

• Coenzyme Q10: CoQ10 facilitates energy production and is a powerful antioxidant. “Oxidation of circulating LDL is thought to play a key role in the pathogenesis of atherosclerosis, which is the underlying disorder leading to heart attack and ischemic strokes,” Clow noted. “Certain cholesterol-lowering drugs (statins) are known to inhibit the body’s natural production of CoQ10, which is why supplementation is often recommended for statin users.”

• Phytosterols: Many studies have demonstrated that consuming dietary plant sterols decreases total cholesterol and LDL. As phytosterols travel through the GI tract, they prevent cholesterol from being absorbed into the bloodstream.

• Niacin/B-complex: Niacin raises HDL and lowers triglycerides. The B-vitamins folic acid, B6 and B12 are all involved in lowering blood levels of homocysteine, an amino acid that’s been linked to heart disease.

Green said she often suggests Michael's Cholesterol Factors and Blood Pressure Factors. “Another product I suggest a lot is Ignite,” she added. “This is a powder that you mix in water; it has L-arginine and L-citrulline which create nitric oxide. Nitric oxide is wonderful for any heart concerns as it is a vasodilator and it also keeps the endothelium soft and supple. It also gives a subtle energy without stimulants and helps with endurance.”

Medical research continues to provide illumination into previously obscure areas of heart health [See “Extra! Extra!” at vitaminretailer.com.] And research evidence and conclusions often stimulate new trends in how the health care community works with the patient population, as well as in product formulation.

Levy elaborated that the heart health category has grown extensively over the past five years as science has uncovered new nutrients or nutrient combinations with cardiovascular benefits targeting specific issues. As an example, he pointed to one study (published in the International Journal Cardiology) that focused on the importance of reducing calcium aggregation (coronary artery calcification or CAC) inside arteries including the aorta, causing them to narrow and stiffen. This study shows that a combination of aged garlic extract (AGE), vitamin B12, folic acid, vitamin B6, and arginine can favorably alter the ratio of brown to white adipose (fat) tissue surrounding the heart muscle. “This unique combination of nutrients also helps thwart atherosclerosis by reducing homocysteine levels and slowing the progression of CAC,” he added.

According to Rob Maru, vice president of innovation and brand development for Florida-based Reserveage Nutrition, the trend toward a more comprehensive approach to cardiovascular wellness will positively impact the category. “New research indicates that simply lowering total cholesterol has little if any impact on heart health and longevity,” he stated. Improving lipid ratios, lowering LDL and increasing HDL, along with managing triglycerides, blood sugar and inflammation, provide a more sound and balanced strategy for improving and maintaining cardiovascular health.”

Levy agreed, noting that recent studies have found that cholesterol profile isn’t as much of a risk factor as previously thought. Some researchers have shown that LDL levels in and of themselves were less impactful than the LDL particle size and whether or not the LDL was oxidized. Additionally, another risk factor—Lipoprotein(a) [“Lp(a)”], a small, dense, highly inflammatory sub-fraction of a cholesterol particle—emerged as critical in the development of atherosclerosis. Lp(a) is manufactured in the liver as the body’s way of patching up tiny fissures that develop in the lining of arterial walls. The “patching” process entails the production of both cholesterol and Lp(a); the latter is many times more potent than cholesterol in its patching ability as it tends to quickly attract more Lp(a) particles. Aggregation of Lp(a) particles forms plaque, thus narrowing the arteries and reducing blood flow, thereby increasing the risk of a future heart attack. “Preliminary studies suggest that omega-3 fatty acids and nattokinase can help reduce Lp(a) levels,” he said.

As 2017 gets into high gear, Maru said that “continued research that focuses on contributing factors beyond cholesterol management will help to evolve the category and expand the selection of heart health ingredients and thus finished products.”

Cardio Care Considerations

Beyond the generic supplements mentioned above for your shelves, manufacturers provide an array of products tailored for a wide range of consumers’ heart concerns. Everyone’s Omega Fish and Flax from Rainbow Light is, as its name describes, universally suitable for overall healthy cardiovascular function. “It uniquely combines benefits from both fish and organic flax oil,” Clow said. “One soft gel daily delivers the American Heart Association’s dietary recommendation for omega from fish, plus 200 IU vitamin D.”

Redd Remedies has a trio of distinctive offerings in this arena. Heart Strong, said Chapman, is a foundational cardiovascular supplement. It offers nutritional and herbal support for the entire cardiovascular system—both the cardiac muscle itself (the heart) and the circulatory system. Specifically, it contains magnesium, the adaptogen white panax ginseng, acetyl L-carnitine and CoQ10 to promote energy creation within the heart muscle.; and hawthorn and arjuna extracts to support heart muscle function and healthy blood flow.

Cholesterol D-fense supports healthy metabolism of cholesterol via liver and kidney support as well as antioxidant protection for the blood vessels. Chapman explained, “Adaptogenic mushrooms reishi and cordyceps send messages to balance the endocrine system providing precursors to vitamin D, supporting healthy cholesterol metabolism, along with a healthy stress and inflammatory response that protects CoQ10 levels. Whole food red yeast rice provides nourishing whole body support, and green tea extract protects the arterial lining against free radical damage. Cholesterol D-fense is designed to maintain cholesterol to your unique level, rather than just driving levels lower, which may cause the body to work harder simply to produce more.”

For customers whose main concern is healthy vascular conditioning, Redd Remedies’ Circulation VA supports blood vessel health, promoting vascular strength, tone, circulation, and healthy platelet aggregation, according to Chapman. Circulation VA features MenaQ7, “the only clinically supported natural vitamin K2 shown to promote arterial flexibility and cardiovascular health,” he pointed out. The blend also contains grape vine leaf extract, organic grape juice powder and blueberry fruit powder to provide antioxidant protection, ginger root to support blood flow and promote healthy inflammatory pathways, and horse chestnut to promote healthy vascular strength and tone, particularly in the veins.

Another antioxidant-support supplement is Essential Formulas Inc.’s Reg’Activ CardioWellness, which contains Lactobacillus fermentum ME-3 a probiotic that produces glutathione. “Boosting glutathione increases detoxification and antioxidant protection,” Pelton described. “ME-3 also reduces inflammation; in a human clinical trial, individuals taking ME-3 exhibited a 16 percent reduction in oxidized LDL-cholesterol.”

And, noted Pelton, Dr. Ohhira’s Probiotics are formulated to create and maintain a healthy microbiome, which will positively impact overall cardiovascular status. Here’s how, explained Pelton: researchers have shown that dysbiosis causes inflammation, which increases “leaky gut,” or intestinal permeability. When intestinal linings are permeable, this results in increased levels of circulating lipopolysaccharides, which increases systemic inflammation, thus increasing cardiovascular disease risks. “Therefore, maintaining a healthy microbiome with Dr. Ohhira’s Probiotics helps reduce intestinal inflammation and cardiovascular disease risks,” he stated.

Reserveage provides several more simplistic supplements for consumers who prefer this approach versus more complex formulations. Its Bergamot Cholesterol Support features Bergamonte bergamot. Studies on this patented ingredient have shown it to encourage healthy cholesterol profiles by increasing HDL, and decreasing total cholesterol, LDL and triglycerides. The studies also showed it to support healthy inflammatory response and balance blood sugar.

The brand also offers Resveratrol for consumers who want to healthy inflammation support, manage insulin and blood sugar, boost circulation and protect the endothelial lining; and Ubiquinol, which Maru described as “the advanced form of CoQ10,” has the ability to reduce side effects associated with statin use, such as fatigue and muscle cramps. Also, its likely physicians are telling those customers that statins can lower CoQ10.

Aged garlic extract (AGE) anchors numerous cardiovascular-support supplements under the venerable Kyolic brand, from Wakunaga of America. Levy noted, “the ingredients in the supplements were chosen based on published studies, many of which are double-blind, placebo-controlled and randomized.” The Kyolic line includes: Formula 100 Cardiovascular, Formula 104 Cholesterol, Formula 106 Circulation, Formula 107 Phytosterols/Cholesterol Support, Formula 108 Total Heart Health, Formula 109 Blood Pressure Health, Formula 110 CoQ10, Red Yeast Rice plus CoQ10, Omega-3, and ModuChol Daily Heart Support.

Newer for the cardio-care department are two entries from New York-based NÜD—Vitamin D3 to help support healthy blood pressure, and Omega-3 EFAs to help maintain healthy heart function. Naomi Ostrove, COO, commented, “Both of these products come in our patented stackable bottles and have the human body on it highlighting the areas it helps. This makes it easier for consumers to pick out the right products for them.”

Ostrove and the team at NÜD will assuredly grab your customers’ attention to the heart health aisle due to riveting packaging, but there’s more to ensure you ring up cardio-care supplement sales. Green said she writes educational articles for local media, and she also provides discounts on heart-health products. Further, she posts heart-health tips on the store’s Facebook page and e-blasts as well.

For in-store educational endeavors, Wakunaga of America provides retailers with third-party articles and educational booklets. “We also participate in sampling programs and health fairs across the country,” Levy noted.

Because heart health is multifactorial with proper diet, physical activity, lifestyle habits, hydration and stress are key factors that must be considered, Clow said “that store tours or educational seminars that incorporate these fact-ors are a creative way to educate consumers. Education not only fosters credibility for the retailer, but the more reliable information consumers have, the more likely they are to purchase products that may support heart health.”

Clow added that consumers are more likely to attend an event featuring credentialed speakers and desirable giveaways. She presented several ideas wherein a sponsored gift basket of supplements for heart health can be given:

• A grocery store tour led by a dietitian in which consumers are given heart healthy dietary options throughout the store, ending with how to navigate the supplement section to best support heart health

• An in-store seminar presented by a naturopath who specializes in optimizing heart health

• A cooking demo from a dietary chef featuring heart healthy recipes

Another idea Clow offered to promote heart health during heart health month (February) is a 30-day challenge that could incorporate all of the key educational components, and include product giveaways, recipe tips, tips about exercise and stress management, and how to navigate the internet for credible health-focused resources.

When you can help your customers change their lifestyles for the better—proper diet, exercise, proper supplementation and stress management, that’s a heartening accomplishment. VR

For More Information:
Essential Formulas Inc., (972) 255-3918
NUD, (855) NUD-TRITION
Rainbow Light, (800) 475-1890
Redd Remedies, (888) 453-5058
Reserveage Nutrition, (800) 553-1896
Wakunaga of America, (800) 421-2998

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