ReviewNutritional factors in the prevention and management of coronary artery disease and heart failure

- Nutritional factors such as magnesium, folic acid, vitamins B6 and B12, l-arginine, and polyunsaturated fatty acids (PUFAs) are beneficial for patients with coronary artery disease (CAD), and in the prevention and arresting the progression of heart failure (HF) and cardiac arrhythmias.
- Ingestion of adequate amounts of protein and maintaining normal concentrations of plasma albumin are essential for patients with CAD and HF.
- Magnesium, folic acid, and vitamins B12 and B6 interact with the metabolism of l-arginine-nitric oxide (NO) system, essential fatty acids and eicosanoids such that beneficial products such as NO, prostaglandin E1, prostacyclin, prostaglandin I3, lipoxins, resolvins, and protectins are generated.
- These nutrients and PUFAs and their products suppress synthesis of proinflammatory cytokines that leads to stabilization of CAD, cardiac arrhythmias, and HF.
- This implies that individuals at high risk for CAD, cardiac arrhythmias, and HF and those with these diseases need adequate amounts of magnesium, folic acid, vitamins B12 and B6, l-arginine, and various PUFAs.
- Hence, efforts made to enhance lipoxin A4, resolvins, and protectins and to decrease the levels of asymmetrical dimethylarginine (an endogenous inhibitor of NO), enhance plasma albumin levels, and suppress the formation of proinflammatory eicosanoids and cytokines could be of significant benefit in CAD and HF.

Nutritional factors such as magnesium, folic acid, vitamins B12 and B6, l-arginine, and polyunsaturated fatty acids (PUFAs) appear to be significantly beneficial for patients with coronary artery disease (CAD), and in the prevention and arresting the progression of HF and cardiac arrhythmias. Additionally, ingestion of adequate amounts of protein and maintaining normal concentrations of plasma albumin seem to be essential for these patients. These nutrients closely interact with the metabolism of l-arginine-nitric oxide (NO) system, essential fatty acids, and eicosanoids such that beneficial products such as NO, prostaglandin E1, prostacyclin, prostaglandin I3, lipoxins, resolvins, and protectins are generated and synthesis of proinflammatory cytokines is suppressed that results in platelet anti-aggregation, vasodilation, angiogenesis, and prevention of CAD, cardiac arrhythmias, and stabilization of HF. This implies that individuals at high risk for CAD, cardiac arrhythmias, and HF and those who have these diseases need to be screened for plasma levels of magnesium, folic acid, vitamins B12 and B6, l-arginine, NO, various PUFAs, lipoxin A4, resolvins, protectins, asymmetrical dimethylarginine (an endogenous inhibitor of NO), albumin, and various eicosanoids and cytokines and correct their abnormalities to restore normal physiology.