The evolving landscape of cardiovascular health

blackboard1965 - Stock.adobe.com

According to the Centers for Disease Control and Prevention (CDC), one in five people in the U.S. died from heart disease in 2022¹. While the prevalence of being diagnosed with heart disease grows after age 45 (0.9% in 18-44 year olds to 5.9% in 45-64 year olds), heart health concerns people of all ages, as our diet and exercise habits directly impact cardiovascular health long-term.²

“In general, we’re seeing more people taking supplements from a younger age as consumers are increasingly taking a proactive and preventive approach to long-term health and well-being—and heart health plays a major role here,” says Thies Ripcke, director of business development and strategic marketing, K2Vital, Balchem Human Nutrition and Health (Montvale, NJ). “This changing demographic tells us that shoppers are becoming more aware of just how important it is to take care of their heart from an early age.”

“The heart health market continues to grow as consumers prioritize cardiovascular wellness and preventive care. The global cardiovascular health supplements market is projected to grow from $11.68 billion in 2024 to $18.76 billion by 2032,³ exhibiting a CAGR of 6.1% during the forecast period,” says Sébastien Bornet, vice president of global sales & marketing for Horphag Research (Geneva, Switzerland). According to Bornet, there is an increased demand for natural solutions that support health and wellness, and heart health is certainly top of mind for many people.

“The benefits offered by evidence-based natural cardiovascular health supplements—such as high energy, vitality, and increasing blood circulation—have contributed to their growing adoption,” explains Bornet. “While individuals who have a history of heart conditions in their family and individuals over the age of 50 are the main buyers of heart health products, there is also an emerging consumer demographic who is getting more invested in their heart health in their 20s and 30s, seeking ways to support cardiovascular health before problems arise.”

Consumers are also increasingly more informed about the value and effectiveness of certain products. “During times of financial strain, consumers are making more deliberate decisions about the products they buy, carefully evaluating whether they truly deliver real value,⁴” says Ripcke. “This is reflected in the growing trend for consumers doing their own research, scrutinizing product labels to ensure they include high-quality ingredients with demonstrated benefits, with a substantial 63% of users actively seek out science-backed supplements with superior effectiveness.⁵This focus on science will be a key driver for the nutrition industry in 2025, and heart health products are no exception.”

Additionally, consumers are increasingly seeking out multi-benefit formulas, says Ripcke.“Products that provide these broad benefits and can be easily integrated into their daily routines are highly appealing to shoppers,” he explains. “Formulating with a combination of ingredients can be a way for brands to differentiate their offering and stand out in a competitive market.”

For example, Balchem recently launched a product concept, called Vital Trio, that offers support for immune health, cardiovascular health, and bone health. That concept features vitamin K₂, magnesium, and vitamin D₃. “As more consumers are actively researching health products before purchasing,⁵ we are seeing a surge in popularity of ingredients with science-backed benefits for heart health, like vitamin K₂ and magnesium,” Ripcke explains. “Studies have demonstrated a direct connection between a higher intake of vitamin K₂ and a lower risk of coronary heart disease,⁶ while magnesium has been shown to help lower blood pressure, thereby enhancing cardiovascular efficiency.”^7,8

A recent study called the Aortic Valve Decalcification Trial (AVADEC study) that featured Balchem’s branded vitamin K₂, K2Vital Delta, investigated the impact of daily vitamin K₂ and D supplementation on the progression of coronary artery calcification (CAC). “This is the first clinical trial documenting an effect of vitamin K₂ directly on calcium deposits in the coronary arteries,” explains Ripcke. “The study included a subgroup analysis of participants at high-risk of CAC and found that two years of supplementation with K2VitalDelta and vitamin D significantly slowed down the progression of the CAC score.”⁹ Ripcke continued, “To confirm the results of the AVADEC research, we have initiated a follow-up multicenter study called the Danish Coronary Decalcification (DANCODE) trial.”¹⁰

Looking to further examine the effects vitamin K₂ may have on heart health, Ripcke informed Nutritional Outlook, that they are currently conducting a large study with healthy volunteers. “We hope this work will add to the growing body of scientific evidence demonstrating the vital role of vitamin K₂ in cardiovascular health,” said Ripcke.

Another notable heart health ingredient is nattokinase, which is derived from a vitamin K₂-rich fermented soybean dish consumed in Japan, called natto. Nattokinase is an enzyme present in the dish. According to Vincent Hackel, CEO of JBSL-USA (Walnut Creek, CA), “You have less cardiovascular disease, fewer heart attacks and strokes, fewer cases of Alzheimer’s, and dementia in the areas where natto is consumed.”

JBSL-USA manufactures a nattokinase ingredient called NSK-SD. While vitamin K₂ is removed when nattokinase is manufactured, the ingredient tolerates the conditions of the gut, and is transported through the gut into blood plasma in active form.¹¹ Results have shown that nattokinase may be effective in managing healthy blood pressure. A 2016 study¹¹ found that supplementation with 100 mg of nattokinase for eight weeks resulted in a significant decrease in diastolic blood pressure when compared to placebo. Research on the ingredient continues to grow, says Hackel. “We already have eight human studies demonstrating reduction of hypertension, but it’s not sufficient to get a health claim in EFSA. So, we’re doing one more large study on that topic to satisfy EFSA health claim requirements,” he explains. “We’re [also] working on some of its other benefits, like improving circulation [in hands and feet].”

Not surprisingly, vascular health is an important aspect of heart health. Throughout the human body, veins, arteries, and other blood vessels work to carry blood all over the body. High blood pressure can narrow and damage the arteries supplying blood to the heart.¹² Cholesterol can be a contributing factor to high blood pressure. “Taking steps to reduce arterial plaque (made of fat and cholesterol) for instance can boost the supply of oxygen and nutrients to the brain, resulting in enhanced cognitive processing, focus and memory,¹³” explains Tom D’Hoore, chief commercial officer at HTBA (Barcelona, Spain). “The lowered and more consistent blood pressure associated with normal vascular function is also good news for the kidneys¹⁴ and immune system¹⁵, and can even help speed up wound healing by ensuring dead or damaged cells are quickly removed and replaced with new, healthy material.¹⁶”

Lifestyle change is the first big step toward better vascular health, says D’Hoore. “While we can’t control risk factors like age, family history or genetics, relatively small changes such as eating more fruits and vegetables, decreasing consumption of saturated fat, salt and sugar, engaging in regular exercise and quitting smoking can add up to a huge improvement,” he explains. “Those who are especially concerned with their cardiovascular health can also turn to supplements containing ingredients such as polyphenols, anthocyanins, flavonoids and B₁₂ vitamins to further support the system that supports every aspect of well-being.”

For its part, HBTA offers Cardiose, a sweet orange polyphenol extract that, according to D’Hoore, “has been shown to support arterial and endothelial health at a low dose of just 500 mg per day – making it as flexible in terms of delivery format as it is functional. Its status as a 100% natural, sustainably sourced ingredient derived from upcycled fruits gives Cardiose added appeal as a solution that’s not only good for the heart, but easy on the conscience too.”

The ingredient also helps to support the lifestyle change D’Hoore previously noted, as vascular health also pertains to active nutrition performance, which helps bring in younger and more active consumers. For example, a 2019 study in which 15 cyclists consumer either 500 mg of Cardiose or placebo prior to an exercise session found that supplementation with Cardiose may improve anaerobic exercise results.¹⁷

Another ingredient that has the potential to support both endothelial function and athletic performance is Pycnogenol French Maritime Bark Extract (distributed exclusively by Horphag Research). A 2015 study found that supplementation with 150 mg per day of Pycnogenol improved endothelial function in borderline hypertensive, hyperlipidemic, and hyperglycemic participants when compared to standard management alone and healthy control volunteers.¹⁸ Additionally, the ingredient was found to improve the performance of men and women training for an Army Physical Fitness Test, and male athletes training for a triathlon.¹⁹

“A robust cardiovascular system supports muscle function by enhancing blood flow, nutrient delivery, and waste removal, crucial for optimal performance and recovery,” says Bornet, who explains that the ingredient works by boosting nitric oxide levels to enhance blood flow and oxygen delivery to the muscles, while also managing oxidative stress and inflammation.

Dietary supplements are part of a tool kit for health that includes healthy diet and an active lifestyle. Consumers see the value in products that support multiple aspects of their health goals and at the end of the day, everything we do is intended to keep that heart pumping.

References

1. About heart disease https://www.cdc.gov/heart-disease/about/index.html (accessed Jan 27, 2025).
2. QuickStats: Percentage of Adults Aged ≥18 Years with Diagnosed Heart Disease, by Urbanization Level and Age Group — National Health Interview Survey, United States, 2020. MMWR Morb Mortal Wkly Rep 2022;71:778. DOI: http://dx.doi.org/10.15585/mmwr.mm7123a4
3. Cardiovascular Health Supplements Market Size, share [2032] https://www.fortunebusinessinsights.com/cardiovascular-health-supplements-market-109444 (accessed Jan 24, 2025).
4. FMCG Gurus. 2024 “Heart Health Approaches, Claims, and Categories in 2024 - FMCG Gurus.” https://fmcggurus.com/blog/heart-health-approaches-and-symptoms-in-2024/
5. Nutrition Business Journal (2024), Delivery Format Report.2023. https://store.newhope.com/products/2023-delivery-format-report?_pos=1&_sid=78db50d1b&_ss=r
6. Haugsgjerd, T. R., et al. Association of dietary vitamin K and risk of coronary heart disease in middle-age adults: The Hordaland Health Study Cohort. BMJ open, 2020, 10(5), e035953.
7. Borghi, C., & Cicero, A. F. Nutraceuticals with a clinically detectable blood pressure‐lowering effect: a review of available randomized clinical trials and their meta‐analyses. Br J Clin Pharmacol, 2017, 83(1), 163-171.
8. Iqbal, S., Klammer, N., & Ekmekcioglu, C. The effect of electrolytes on blood pressure: a brief summary of meta-analyses. Nutrients, 2019, 11(6), 1362.
9. Hasific, S., et al. Effects of vitamin K2 and D supplementation on coronary artery disease in men: a RCT. JACC: Advances, 2023, 2(9), 100643.
10. Hasific, S., et al. Effects of vitamins K2 and D3 supplementation in patients with severe coronary artery calcification: a study protocol for a randomised controlled trial. BMJ open, 2023, 13(7), e073233.
11. Jensen, G. S.; Lenninger, M.; Ero, M. P.; Benson, K. F. Consumption of nattokinase is associated with reduced blood pressure and von Willebrand factor, a cardiovascular risk marker: Results from a randomized, double-blind, placebo-controlled, Multicenter North American Clinical Trial https://pmc.ncbi.nlm.nih.gov/articles/PMC5066864/ (accessed Jan 27, 2025).
12. How high blood pressure can affect the body https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868 (accessed Jan 27, 2025).
13. L. R. Ellis, C. Boesch, L. Dye, Effects of Anthocyanins on Cognition and Vascular Function: A Systematic Review. Mol. Nutr. Food Res. 2024, 68, 2300502. https://doi.org/10.1002/mnfr.202300502 (accessed Jan 24, 2025)
14. https://www.hopkinsmedicine.org/health/conditions-and-diseases/renal-vascular-disease#:~:text=Surgery%20to%20remove%20the%20clot,be%20done%20in%20some%20situations.&text=Treatment%20of%20a%20renal%20artery,generally%20be%20treated%20with%20surgery.&text=Treatment%20may%20include%20medicines%20to,bypass%20the%20blocked%20renal%20artery(accessed Jan 24, 2025)
15. https://www.nhlbi.nih.gov/news/2024/immune-function-inflammation-and-cardiovascular-disease#:~:text=%E2%80%9CPatients%20often%20have%20comorbidities%20and,prevent%20and%20manage%20cardiovascular%20disease. (accessed Jan 24, 2025)
16. https://www.ncbi.nlm.nih.gov/books/NBK326431/#:~:text=Poor%20circulation:%20People%20with%20poor,blood%20can't%20circulate%20properly. (accessed Jan 24, 2025)
17. Martínez-Noguera, F. J.; Marín-Pagán, C.; Carlos-Vivas, J.; Rubio-Arias, J. A.; Alcaraz, P. E. Acute effects of Hesperidin in oxidant/antioxidant state markers and performance in amateur cyclists https://pmc.ncbi.nlm.nih.gov/articles/PMC6723516/ (accessed Jan 27, 2025).
18. Hu, S.; Belcaro, G.; Cornelli, U.; Luzzi, R.; Cesarone, M.R.; Dugall, M.; et al. Effects of Pycnogenol® on endothelial dysfunction in borderline hypertensive, hyperlipidemic, and hyperglycemic individuals: The borderline study - international angiology 2015 february;34(1):43-52 https://www.minervamedica.it/en/journals/international-angiology/article.php?cod=R34Y2015N01A0043 (accessed Jan 27, 2025).
19. Vinciguerra, G.; Belcaro, G.; Bonanni, E.; Cesarone, M.R.; Rotondi, V.; Ledda, A.; Hosoi, M.; Dugall, M.; Cacchio, M.; Cornelli, U.; Evaluation of the effects of supplementation with Pycnogenol® on fitness in normal subjects with the army physical fitness test and in performances of athletes in the 100-minute triathlon https://pubmed.ncbi.nlm.nih.gov/24247188/ (accessed Jan 27, 2025).