Cardiovascular disease kills one person every 34 seconds in the United States. Heart disease, one type of cardiovascular disease, is the leading cause of death in the United States and accounts for $229 billion in annual healthcare costs. You cannot afford to ignore cardiovascular disease. Fortunately, many cardiovascular disease risk factors are preventable and modifiable. Early detection and treatment of these risk factors significantly reduce the risk of cardiovascular disease and its related health complications. Read on to learn about various evidence-based herbs and supplements that functional medicine doctors routinely prescribe when treating cardiovascular health conditions. (1)

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What is Cardiovascular Disease?

Cardiovascular disease (CVD) is a group of diseases affecting the heart and blood vessels. CVDs are the number one cause of death and disability globally. CVD includes many diseases, including peripheral artery disease, coronary artery disease, arrhythmias, heart failure, heart attack, and stroke. Many CVDs are related to atherosclerosis, which occurs when arteries narrow due to plaque buildup within them, and blood flow is restricted as a result.

What is Heart-Healthy Living?

Heart-healthy living involves understanding your risk for CVD and making conscious, healthy choices to limit your risk of disease. High blood pressure is the leading risk factor for CVD, and according to the CDC, it is responsible for causing 10 million deaths worldwide annually. Other risk factors for CVD include high cholesterol, diabetes, obesity, smoking, excess alcohol consumption, physical inactivity, a Western diet, aging, and obesity. (2-4)

Learning to advocate for and actively participate in your own health is a critical first step in creating a heart-healthy lifestyle. Asking your doctor to order risk assessment labwork (discussed below) and working with a trained functional medicine doctor to establish the foundations of cardiovascular health will help optimize lab results outside the functional reference ranges before a pathological disease can develop.

Heart-healthy living encompasses the following lifestyle habits:

Heart-Healthy Diet

The DASH and Mediterranean diets are commonly recommended as heart-healthy dietary plans because they have been shown to lower inflammation, blood pressure, and LDL cholesterol. Each of these emphasizes consuming a variety of multi-colored fruits and vegetables, whole grains, high-quality dairy, lean protein, and healthy monounsaturated and polyunsaturated fats. Additionally, these whole-food dietary approaches reduce the consumption of processed and refined foods, saturated and trans fats, added sugars, salt, and alcohol. (5)

Making changes to diet can be challenging and overwhelming. Working with a registered dietician or functional nutritionist can be helpful in the early stages of forming new dietary habits to ensure you meet caloric, nutritional, and health goals.

Physical Activity

Physical Activity Guidelines for Americans recommend the following exercise goals for adults (6):

• 150-300 minutes of moderate-intensity aerobic physical activity weekly
• 75-150 minutes of vigorous-intensity aerobic physical activity weekly
• A combination of moderate- and vigorous-intensity physical activity
• Moderate- to high-intensity muscle strength training at least twice weekly

Research has linked being inactive and sitting with a higher risk of heart disease, type 2 diabetes, colon and lung cancers, and early death. Conversely, less time spent sitting and more time being active is associated with a lower risk of disease, improved cognition, bone health, mental health, and weight management. (7)

Stress Management

Emotional stress and unhealthy coping mechanisms contribute to high blood pressure and other cardiovascular risk factors. Learning and utilizing heart-healthy mindfulness-based practices, such as counseling, meditation, exercise, and biofeedback, can improve mental and physical health. (8)

Smoking Cessation

If you smoke, find support to quit. Avoidance of secondhand smoke is also important. Smoking and exposure to smoke damage the endothelial lining of the blood vessels, contributing to CVD and heart attack risk. (9)

Sleep

Poor sleep is associated with a higher risk of increased body weight, a suppressed immune system, feelings of stress, high blood pressure, heart disease, and stroke (10).

It is recommended that adults get 7-9 hours of sleep nightly, and more than one-third report not meeting this goal. Establishing a consistent nighttime routine and sleep schedule can help you get enough good quality sleep. Small steps and changes can help, like spending time outside during the day, avoiding caffeine, going to bed and waking up at the same time every day, and avoiding screens the hour before bedtime. (10)

Top Evidence-Based Herb & Supplements For Heart Health

Maintaining a healthy heart is essential for overall health and well-being. In addition to a healthy diet and regular exercise, some supplements and herbs may benefit heart health. Here are a few options to consider:

Hawthorn Berry for Heart Health

Hawthorn (Crataegus spp.) is a plant used for centuries as a natural remedy for treating CVD. Research reveals that hawthorn berry extracts possess lipid-lowering, antioxidative, anti-inflammatory, and endothelium-protecting effects. These mechanisms make hawthorn a popular natural agent in treating atherosclerosis, high blood pressure, high cholesterol, and arrhythmias. (11, 12)

Omega-3 Fatty Acids for Heart Health

Omega-3s are essential unsaturated fatty acids associated with reduced systemic inflammation and cardiovascular disease. Studies show that replacing omega-6 fatty acids with omega-3 fatty acids to establish a 4:1 ratio (or less) of omega-6:omega-3 benefits cardiovascular health.

Fatty fish, sea algae, flaxseeds, and chia seeds are naturally rich in ALA, EPA, and DHA omega-3 fatty acids (13). Omega-3 supplementation, typically through fish oil, reduces cardiovascular mortality, non-fatal heart attack, coronary heart disease, and major cardiovascular events and improves blood flow (14).

Magnesium for Heart Health

Low magnesium levels are associated with heart failure, arrhythmia, and high blood pressure (2). Research shows that high magnesium intake is associated with a lower risk of metabolic syndrome, diabetes, hypertension, stroke, and total cardiovascular disease (15).  

Garlic for Heart Health

Garlic is rich in allicin, an antioxidant responsible for its many positive cardiovascular effects. Supplementation with aged garlic extract (AGE) has been shown to modestly decrease total and LDL cholesterol by 10%, reduce blood clotting, and significantly lower blood pressure in people with hypertension by an average of 8.4/7.3 mmHg.  

Coenzyme Q10 (CoQ10) for Heart Health

CoQ10 is a powerful antioxidant required in high amounts by cardiac muscles for energy production. Low CoQ10 levels are associated with greater tissue damage to the heart and brain during heart attack and stroke, respectively. CoQ10 supplements improve lipid profiles and heart function. Supplementation is also associated with reduced cardiovascular inflammation, statin-induced muscle pain, deaths due to heart failure, and blood pressure. (16)

Red Yeast Rice (RYR) for Heart Health

RYR is the natural alternative to low-intensity statins for reducing serum cholesterol levels. Fermentation of RYR produces monacolin K, which inhibits the endogenous production of cholesterol. Research shows that RYR effectively lowers LDL cholesterol by 15-25%, total cholesterol, and triglycerides within 6-8 weeks, and has a lower risk of causing statin-induced muscle pain. (17-19)

B Vitamins for Heart Health

B vitamins are essential for energy production and red blood cell formation. Published studies have reported vitamin B1, B2, and B6 deficiencies in people with heart failure.

Additionally, homocysteine is an independent risk factor for atherosclerosis because it can induce negative changes to the vascular endothelium and arterial function. High levels of homocysteine can result from nutritional deficiencies in folate, vitamin B6, and vitamin B12. Some research has concluded that high dietary intakes of folate and vitamin B6 are associated with reduced mortality risk from stroke, coronary heart disease, and heart failure. (20, 21)

Green Tea for Heart Health

Epigallocatechin gallate (EGCG) is the antioxidant compound present in green tea associated with numerous cardiovascular benefits. EGCG is exceptionally anti-inflammatory and has been found to prevent atherosclerosis, heart attack, and diabetes. Meta-analyses have also concluded that green tea consumption significantly reduces blood pressure, LDL cholesterol, and triglycerides (22, 23). A study of over 40,000 Japanese adults found that people who drank more than five cups of green tea daily had a 26% lower risk of death from a heart attack or stroke and a 16% lower risk of all-cause mortality than people who drank less than one cup daily. (24)

Functional Medicine Labs to Order for Those Worried About Their Heart Health

Cardiovascular disease is preventable and treatable. The first step to disease prevention is clearly understanding your CVD risk. Functional medicine doctors can order advanced biomarkers to identify an individual's cardiovascular risk factors and recommend targeted therapies to correct underlying imbalances predisposing to CVD.

Advanced Lipid Panel

Although the basic lipid panel (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides) is important in diagnosing high cholesterol, recent research shows that other lipid markers are more sensitive in estimating cardiovascular risk. Lipid particle fractionation, apolipoprotein B (ApoB), and lipoprotein(a) (Lp(a)) qualify and quantify the subpopulations of cholesterol-carrying particles that increase the risk for CVD.

Cardiovascular inflammation is associated with higher CVD risk, measured by markers like hs-CRP, Lp-PLA2, and homocysteine, which can be added to an advanced lipid profile.

Comprehensive Thyroid Panel

Hypothyroidism and hyperthyroidism are both associated with poor cardiovascular outcomes. A complete thyroid panel screens for and diagnoses subclinical and overt thyroid dysfunction.  

Comprehensive Metabolic Panel (CMP)

A CMP is a valuable metabolic screening for blood sugar, electrolyte, kidney, and liver dysfunction. Abnormal results can reveal causes for high blood pressure, irregular heart rate/rhythm, insulin resistance, and diabetes and may indicate the need for additional testing.

Diabetes Panel

A comprehensive diabetes panel measures various markers important for diagnosing and managing insulin resistance and diabetes.

Nutritional Assessment

A comprehensive nutritional assessment, such as the NutrEval, provides an in-depth analysis of important electrolytes, antioxidants, micronutrients, and omega-fatty acids required for optimal cardiovascular and metabolic function.

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Summary

The prevention, early detection, and treatment of cardiovascular disease are critical for health outcomes and quality of life. While there are non-modifiable factors that contribute to CVD risk, like age, gender, and genetics, the majority of CVD risk stems from behavioral and lifestyle factors.

Functional medicine plays an integral role in the prevention and management of CVD. Specialty labs measuring functional biomarkers of cardiometabolic health reflect how lifestyle habits directly impact the heart and blood vessels. A heart-healthy lifestyle, emphasizing good nutrition, plenty of exercise, quality sleep, and healthy stress reduction techniques, is foundational for everyone to support cardiovascular health. Many evidence-based natural agents are effective independently or in conjunction with pharmaceutical therapies to prevent and treat cardiovascular disease for those seeking an integrative approach to health management.