According to the World Health Organization (WHO), cardiovascular diseases (CVDs) are the No. 1 cause of death globally, as 17.9 million people, die from CVDs each year. WHO reported that four out of five CVD deaths each year are due to heart attacks and strokes. In addition, one-third of these deaths occur prematurely in people under 70 years of age. Further, those at risk of CVD may demonstrate raised blood pressure, glucose and lipids, and may be overweight or obese.

Also, the leading cause of death for both men and women in the U.S., one person dies every 37 seconds in the U.S. from CVDs. Further, approximately 647,000 (one in every four) Americans die from heart disease each year, according to the Centers for Disease Control and Prevention (CDC).

And while prescription drugs are the common treatment, lifestyle changes and dietary supplements are not overlooked. “Cardiovascular disease continues to be a very serious concern for American consumers,” said Melanie Bush, director of berry science for Indiana-based Artemis International, Inc. “A few of the major risk factors for cardiovascular disease include high cholesterol and high blood pressure. Yes, there are pharmaceutical drugs that are designed to help lower these risk markers, but the side effects can take a toll, many consumers seek natural alternatives and/or adjuncts that are gentle and effective.”

The heart healthy nutritional supplement category is quite large and growing. According to Julia Díaz, head of marketing for Pharmactive Biotech Products, S.L. in Spain, the market for cardiovascular health is one of the largest in food supplements. “Globally, 1/6 [of] dollars spent on supplements sales is for heart health product1 and it is anticipated an excellent growth over the next decade, both in developed and developing economies (CAGR [compund annual growth rate] 6.5 percent for the period 2017-2023).2

The market will be affected by:

• The increase of life expectancy and global population older than 60 years old (is expected to double by 2050).3

• Heightened demand for natural products (considered safer and with fewer side effects).

• Increasing incidences of obesity, what leads to cardiovascular diseases.”

The heart health category is broad, as there a number of ingredients that address a range cardiovascular issues. “What do we mean by “cardiovascular health” anyway? Product manufacturers should consider that heart health is a broad category and what heart health benefit they are targeting,” noted Artemis President Leslie Gallo. “Is it lower blood pressure? Lower cholesterol? Better circulation? Artery health? There is no ‘one ingredient fits all’ in this space and some ingredients share significant shelf space so a manufacturer might want to branch out and look at newer/novel ingredients that might interest a consumer who has tried the usual and not reaped the expected benefits.”

For instance, according to Dr. Shavon Jackson-Michel, director of medical & scientific affairs for New Jersey-based DolCas Biotech, LLC, an important aspect of cardiovascular health consumers can easily relate to is vascular reactivity. “There are a number of ways to assess vascular reactivity, one that was used in our cardio support ingredient clinical was the reactive hyperemia index (RHI). It can be explained simply, since every adult has had their blood pressure taken and can easily contrast between the numbness of their fingers when the pressure is maximized and the relief they feel when the pressure goes down and blood flow returns to their extremity. This assessment compares one arm’s exaggerated pressure cuff occlusion to the non-occluded arm, ultimately measuring the flexibility of the arteries as well as the ability of the vascular system to release and quickly respond to nitric oxide (NO). RHI is often using in collaboration with other cardiovascular risk factors—but on its own provides great insight.

“The flexibility of the arteries, or lack thereof is strongly associated with adverse cardiovascular events like stroke and heart attacks,” Jackson-Michel continued. “There are many avenues that lead to improved vascular reactivity, including but not limited to better cholesterol and blood lipid metabolism, less oxidative stress, which can cause injury to the blood vessel lining, proper nitric oxide production, improved blood glucose control, etc.”

To that end, DolCas Biotech’s Bergacyn ingredient has shown significant improvement of, given its synergistic action on upstream aspects including improved liver health, lipid metabolism, oxidative stress and blood glucose control, Jackson-Michel noted.

Bergacyn, a patented ingredient blend, consisting of bergamot polyphenols and fibers and cynara leaf extract, is the company’s newest ingredient innovation in the cardiovascular health category. “Bergamot has an affinity for both the liver and vascular system, demonstrating significant benefits as far as supporting healthy lipid levels. Artichoke is a familiar liver supportive, but its leaf is a potent source of cynaropicrin, a sesquiterpene with strong TNF-alpha inhibitory action,” Jackson-Michel said. “At least two clinical studies, one published and one underway evidence Bergacyn’s action in interfering in the development and progression of non-alcoholic fatty liver (NAFL). Those with NAFL, especially with the comorbidity of diabetes have a very increased risk of adverse cardiovascular events. Bergacyn, in this specific context was shown to decrease subjects adverse CV risks, by showing a statistically significant increase of the reactive hyperemic index (RHI).”

Other Ingredients

Because the heart health category caters to a wide range of issues, there are a number of ingredients that have long been used for various ailments. “Certainly, the heart health category is a crowded space, for good reason, populated with numerous substantiated ingredients,” said Bush. “Top of mind are cholesterol management ingredients such as soluble dietary fibers, unsaturated fatty acids, omega-3s, stanols and sterols; carotenoid ingredients, such as astaxanthin and lycopene; and powerful antioxidant/capillarotropic ingredients such as CoQ10/ubiquinol, and various flavonoids/polyphenols (anthocyanins, proanthocyanidins) derived largely from fruits/berries wherein Artemis specializes under our signature Berryceuticals portfolio.”

Artemis has been producing a line of berry extracts for use in the dietary supplement and functional food industries for more than 25 years. “Our Berryceuticals line, most popular for our ElderCraft ingredient line, includes our heart health extract, AroniaCraft—a high anthocyanin standardized extract that is targeting the cardiovascular health market,” explained Gallo. “A recent meta-analysis (submitted for publication) of Aronia Berry has shown conclusively that aronia offers significant benefits including lowering cholesterol as well as lowering blood pressure.”

Pharmactive’s most successful cardiovascular ingredient is ABG10+ (aged black garlic branded extract). According to Díaz, it is considered as an alternative to Monacolin K for cardio protection, due to the no side effects reported, multi-channel mechanism of action (including not only cholesterol levels balance, but triglycerides and hypertension balance) and superior antioxidant capacity.

“ABG10+ is DNA-certified for Allium sativum L. and organic certified,” she said. “The aging and extraction process are proprietary and uniquely concentrates and preserves the actives, meeting the highest quality standards.”

Confirmed Benefits

Consumers have a number of concerns when it comes to dietary supplements. On the top of that list is wanting to make sure that they are effective and safe.

“One of the main concerns among consumers of cardiovascular support supplements is ‘does this really work and does it do what it says it will do?’ Unfortunately, there are products on the market that include low-quality ingredients and have questionable efficacy,” Bush said. “And then there are products that might have actual clinical studies behind their claims, but the clinical studies may have had flaws that put the true clinical significance into question. That is why it is important for high-quality companies to seek out ingredients with authentic studies confirming their stated health benefits.”

Another consumer concern is delivery options, as a number of people that take supplements for heart health issues are older and either have issues swallowing larger pills, and/or want other delivery options.

“Product manufacturers should keep the eye on reducing sizes of oils capsules to benefit the consumers with swallowing difficulties and to improve the taste,” Díaz noted. “In this context, botanical extracts offer a differentiated value because, commonly they need shorter recommended daily doses compared to oils, are water-soluble (with exceptions) and the flavor is usually nicer.

“Finally, new galenic forms such as gummies are emerging strongly, and should be explored further as long as the consumer is getting used to new chewable approaches.” The cardiovascular category is important today, as it ever was, as CVDs are still a major health issue across the globe. “Today, cardiovascular category is one of the largest and is dominated by old friends very recognizable by consumers,” Díaz concluded. “The future of the category might be the inclusion of new ingredients (preferably botanicals), green labels, reduced side effects and clinically backed formulations.” NIE

References:

1 Natural Products Insider.

2 Global Heart Health Products Market Research Report- Forecast to 2023.

3 United Nations, Department of Economic and Social Affairs, Population Division (2017). World Population.

For More Information:

Artemis International, Inc., www.artemis-international.com
DolCas Biotech, LLC, http://dolcas-biotech.com
Pharmactive Biotech Products, S.L., http://pharmactive.eu/en/home-en/