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  • Resveratrol And A Woman’s Heart

    January 2, 2019: by Bill Sardi

    Main points:

    • Women experience a different form of heart disease than males, largely ischemic (oxygen-deprived) heart disease.  This can lead to heart failure.  This form of heart disease occurs in the post-menopause and is more prevalent with advancing age.  Men generally experience disease of the coronary arteries that supply the heart with oxygenated blood.
    • Many women fear breast cancer more than heart disease even though cardiovascular disease kills 7 times more women every year than does breast cancer.
    • Women experience loss of calcium from bone as estrogen production declines.  That calcium is deposited in arteries, making them less flexible and elastic.  That can lead to a decline in the pumping of oxygenated blood to the heart (diastolic blood pressure) and eventual death of the heart itself.
    • Estrogen therapy is posed as a protective factor but many women are wary of estrogen replacement.  Estrogen produces elevated levels of an intra-arterial gas known as nitric oxide that dilates (widens) arteries.  Resveratrol exhibits the same nitric oxide activation as estrogen.
    • Resveratrol, an estrogen-like molecule (1/7000 the hormonal activity of estrogen) is reported to be as or more effective as a common drug used to treat heart failure and doubles as a preventive for breast cancer.  In the animal lab, female rodents experience a more favorable response from resveratrol than males in regard to heart health.

    A bias in research has been to use male animals and humans to study heart disease.  The reason given for this is that researchers don’t want to deal with the changing biological landscape women pose with their menstrual cycles.  This has led to an obvious weakness in the prevention and treatment of heart disease in women since they have an entirely different form of heart disease than men.

    Men are subject to iron and calcium accumulation after they have achieved full physical growth (~age 18) and develop disease of the four coronary arteries that supply the heart with oxygenated blood.  Women, on the other hand, experience heart failure due to loss of elasticity of the aorta, the first blood vessel outside the heart.

    Women are generally protected from heart disease due to estrogen secretion from their ovaries during their child-bearing years.  Women donate calcium to their offspring and dispose of iron via their monthly menstrual blood loss and do not accumulate iron and calcium as males do.

    The onset of menopause changes all that.  So does an early hysterectomy.  Iron begins to accumulate and calcium is lost from bone (osteoporosis) and is deposited in arteries.  The calcified aorta (the first blood vessel outside the heart) loses its elasticity and ability to pump oxygenated blood to the heart itself (diastolic blood pressure).  The heart then lacks oxygen (ischemia) resulting in heart failure and eventual death of the heart[1]. This is the common form of heart disease in women.

    A misdirection is advising women to augment their diet with supplemental calcium to avoid osteoporosis which worsens the problem.  Calcium supplementation in postmenopausal females is associated with increased risk for a mortal heart attack[2].  Women are never told they have calcium heart disease.  What women need isn’t calcium supplementation in post-menopause but rather estrogen, or an estrogen-like molecule, to restore the signal to hold calcium in bone.

    Men age 45-64 who have experienced a heart attack have an 8% risk of dying over a 5-year period compared to an 18% risk for women.  During age 40-54, males with heart failure have a 16-fold risk of dying within 1 year whereas women in the same age group have a 27-fold increased risk of dying within 1 year[3].  These are very large differences between the sexes.  Women often initially experience a stroke or heart failure rather than a heart attack.

    Women fear breast cancer more than they do heart disease.  However, in Canada cardiovascular disease kills 7 times more women every year than does breast cancer.  In the US cardiovascular disease affects ~47.8 million women while breast cancer affects only 3.3 million3.

    Women who experience heart attacks generally tend to experience ruptures of arterial plaque (calcium cap on top of cholesterol plaque) whereas men experience a thrombosis (clot) in a coronary artery3.

    One of the ways estrogen protects the heart is that it produces higher levels of nitric oxide, a transient gas that dilates (widens) arteries.  Resveratrol mimics this by provoking nitric oxide.

    Canadian researchers report that resveratrol is as effective as a ACE inhibiting drug (perindopril, lisinopril) in the prevention of cardiac dysfunction, scarring and inflammation3.

    Resveratrol also addresses the iron accumulation that begins to occur among women in post-menopause who no longer menstruate.  Iron accumulation leads to bone loss, a problem that is reversed by resveratrol[4].

    Resveratrol also exerts strong preventive effects against breast cancer, and also acts like estrogen to rebuild and hold calcium in bone[5], thus addressing three main health fears among women (heart failure, breast cancer and osteoporosis).

    Because of resveratrol’s high safety profile and absence of changes in the uterus[6], researchers now ask if resveratrol would potentially be a better agent for hormone replacement than estrogen3.

    Resveratrol has also been shown to increase bone mineral density in obese males as well[7].

    Resveratrol may well be a better option for postmenopausal women who no longer have the protection afforded by estrogen.  Resveratrol is currently recommended or prescribed to few if any postmenopausal women.

    [1] Seely, S. Ischaemic heart failure: a new explanation of its cause and prevention.  International Journal Cardiology 86(2-3) 259-63, 2002.

    [2] Reid, IR, et al, Does widespread calcium supplementation pose cardiovascular risk?  Yes: the potential risk is a concern. American Family Physician. 87 (3); 2013.

    [3] Lieben Louis LX, et al, Are the cardioprotective effects of the phytoestrogen resveratrol sex dependent?  Canadian Journal Physiology Pharmacology Dec 21, 2018.

    [4] Zhao, et al, Effects of dietary resveratrol on excess-iron-induced bone less via antioxidative character.  Journal Nutritional Biochemistry 26 (11), 1174-82, 2015.

    [5] Tou JC, Evaluating resveratrol as a therapeutic bone agent: preclinical evidence from rat models of osteoporosis.  Annals New York Academy Science 134 (1), 75-85, 2015.

    [6] Zhao, H, et al, Long-term resveratrol treatment prevents ovariectomy-induced osteopenia in rats without hyperplastic effects on the uterus.  British Journal Nutrition 111 (5); 836-46, 2014.

    [7] Ornstrup J+MJ, et al, Resveratrol increases bone ineral density and bone alkaline phosphatase in obese men: a randomized placebo-controlled trial.  Journal Endocrinology Metabolism 99 (12), 4720-29, 2014.

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