title: Anti-Atherosclerotic Effects of a Phytoestrogen-Rich Herbal Preparation in Postmenopausal Women.
abstract: The risk of cardiovascular disease and atherosclerosis progression is significantly increased after menopause, probably due to the decrease of estrogen levels. The use of hormone replacement therapy (HRT) for prevention of cardiovascular disease in older postmenopausal failed to meet expectations. Phytoestrogens may induce some improvements in climacteric symptoms, but their effect on the progression of atherosclerosis remains unclear. The reduction of cholesterol accumulation at the cellular level should lead to inhibition of the atherosclerotic process in the arterial wall. The inhibition of intracellular lipid deposition with isoflavonoids was suggested as the effective way for the prevention of plaque formation in the arterial wall. The aim of this double-blind, placebo-controlled clinical study was to investigate the effect of an isoflavonoid-rich herbal preparation on atherosclerosis progression in postmenopausal women free of overt cardiovascular disease. One hundred fifty-seven healthy postmenopausal women (age 65 ± 6) were randomized to a 500 mg isoflavonoid-rich herbal preparation containing tannins from grape seeds, green tea leaves, hop cone powder, and garlic powder, or placebo. Conventional cardiovascular risk factors and intima-media thickness of common carotid arteries (cIMT) were evaluated at the baseline and after 12 months of treatment. After 12-months follow-up, total cholesterol decreased by 6.3% in isoflavonoid-rich herbal preparation recipients (p = 0.011) and by 5.2% in placebo recipients (p = 0.020); low density lipoprotein (LDL) cholesterol decreased by 7.6% in isoflavonoid-rich herbal preparation recipients (p = 0.040) and by 5.2% in placebo recipients (non-significant, NS); high density lipoprotein (HDL) cholesterol decreased by 3.4% in isoflavonoid-rich herbal preparation recipients (NS) and by 4.5% in placebo recipients (p = 0.038); triglycerides decreased by 6.0% in isoflavonoid-rich herbal preparation recipients (NS) and by 7.1% in placebo recipients (NS). The differences between lipid changes in the isoflavonoid-rich herbal preparation and placebo recipients did not reach statistical significance (p > 0.05). Nevertheless, the mean cIMT progression was significantly lower in isoflavonoid-rich herbal preparation recipients as compared to the placebo group (6 μm, or <1%, versus 100 μm, or 13%; p < 0.001 for the difference). The growth of existing atherosclerotic plaques in isoflavonoid-rich herbal preparation recipients was inhibited by 1.5-fold (27% versus 41% in the placebo group). The obtained results demonstrate that the use of isoflavonoid-rich herbal preparation in postmenopausal women may suppress the formation of new atherosclerotic lesions and reduce the progression of existing ones, thus promising new drug for anti-atherosclerotic therapy. Nevertheless, further studies are required to confirm these findings.
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan I-20138, Italy. veronika.myasoedova@gmail.com.|Institute of General Pathology and Pathophysiology, Moscow 125315, Russia. veronika.myasoedova@gmail.com.
authors.forename: Veronika A
authors.initials: VA
authors.lastname: Myasoedova
authors.affiliation: Institute for Atherosclerosis Research, Skolkovo Innovative Center, Moscow 143025, Russia. t-gorchakova@mail.ru.
authors.forename: Tatyana V
authors.initials: TV
authors.lastname: Kirichenko
authors.affiliation: Institute of General Pathology and Pathophysiology, Moscow 125315, Russia. zavod@ifarm.ru.
authors.forename: Alexandra A
authors.initials: AA
authors.lastname: Melnichenko
authors.affiliation: Institute for Atherosclerosis Research, Skolkovo Innovative Center, Moscow 143025, Russia. varvaraao@gmail.com.|Russian Cardiology Research and Production Complex, Moscow 121552, Russia. varvaraao@gmail.com.
authors.forename: Varvara A
authors.initials: VA
authors.lastname: Orekhova
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan I-20138, Italy. alessio.ravani@ccfm.it.
authors.forename: Alessio
authors.initials: A
authors.lastname: Ravani
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan I-20138, Italy. paolo.poggio@ccfm.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Poggio
authors.affiliation: Institute of General Pathology and Pathophysiology, Moscow 125315, Russia. sobenin@cardio.ru.|Russian Cardiology Research and Production Complex, Moscow 121552, Russia. sobenin@cardio.ru.
authors.forename: Igor A
authors.initials: IA
authors.lastname: Sobenin
authors.affiliation: Institute of General Pathology and Pathophysiology, Moscow 125315, Russia. y.bobryshev@unsw.edu.au.|Faculty of Medicine, School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia. y.bobryshev@unsw.edu.au.|School of Medicine, University of Western Sydney, Campbelltown, NSW 2560, Australia. y.bobryshev@unsw.edu.au.
authors.forename: Yuri V
authors.initials: YV
authors.lastname: Bobryshev
authors.affiliation: Institute of General Pathology and Pathophysiology, Moscow 125315, Russia. a.h.opexob@gmail.com.|Institute for Atherosclerosis Research, Skolkovo Innovative Center, Moscow 143025, Russia. a.h.opexob@gmail.com.|Department of Biophysics, Biological Faculty, Moscow State University, Moscow 119991, Russia. a.h.opexob@gmail.com.
authors.forename: Alexander N
authors.initials: AN
authors.lastname: Orekhov
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000097:blood / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007529:Isoflavones / Q000627:therapeutic use; D008875:Middle Aged; D048789:Phytoestrogens / Q000627:therapeutic use*; D028321:Plant Preparations / Q000627:therapeutic use*; D017698:Postmenopause / Q000187:drug effects*; D014280:Triglycerides / Q000097:blood
chemical_list: D007529:Isoflavones; D048789:Phytoestrogens; D028321:Plant Preparations; D014280:Triglycerides
keywords: atherosclerosis; herbal preparation; intimal medial thickens; isoflavonoids; menopause; phytoestrogens; prevention