Abstract

Simple SummaryThere is increasing evidence showing that the pathophysiology of several forms of cardiovascular disease (CVD) is characterized by microcirculatory dysfunction, which may in fact precede clinical manifestations. For several decades, food supplements have been explored with the aim of restoring microcirculation. Considering the increasing growth of the food supplement industry in recent years and the great impact that CVD has on human health, the present study aimed to provide an up-to-date review of the literature on the role of food supplementation in microcirculation. In this work, the main legal aspects in the European Union and the United States of America concerning food supplements and the beneficial effect that these supplements may have on the population for microcirculation are discussed. Although further studies are needed, especially in humans, there are some data that suggest the beneficial effect of the following supplements: Ruscus aculeatus L., Centella asiatica L., Ginkgo biloba L., Salvia miltiorrhiza Bunge, Crataegus spp., Ginseng, Mangifera indica L., Aesculus hippocastanum L., Hamamelis virginiana L., and Vitis vinifera L.(1) Background: Cardiovascular disease (CVD) is a major public health concern worldwide and a key cause of morbidity and mortality in developed countries. Accumulating evidence shows that several CVD forms are characterized by significant microcirculatory dysfunction, which may both cause and be caused by macrovascular disease, often preceding clinical manifestations by several years. Therefore, interest in exploring food supplements to prevent and restore microcirculation has grown. Given the continuous need to expand the available therapeutic arsenal for CVD, the food supplements market has recently grown and is expected to continue growing. (2) Methods: We provide an authoritative up-to-date comprehensive review of the impact of food supplementation on microcirculation by analyzing the European and American legal food supplements framework and the importance of food safety/food quality in this industry. We review the main literature about food bioactive compounds with a focus on microcirculation and some main food supplements with proven benefits. (3) Results: Despite a lack of scientific evidence, diet and microcirculatory function are clearly connected. The main food supplement examples in the literature with potential beneficial effects on microcirculation are: Ruscus aculeatus L., Centella asiatica L., Ginkgo biloba L., Salvia miltiorrhiza Bunge, Crataegus spp., Ginseng, Mangifera indica L., Aesculus hippocastanum L., Hamamelis virginiana L., and Vitis vinifera L. (4) Conclusions: Further clinical trials are necessary to better explore the effects of these food supplements.

Highlights

  • Microcirculation consists of a network of small blood vessels that establish a frontier with the interstitium and with lymphatic vessels, a functionally connected triad that collaborates in maintaining the homeostasis of tissues as well as of the entire cardiovascular system [1]

  • Despite the limited scientific evidence for the influence of diet on microcirculation, as far as the authors know, this is the first paper to provide a comprehensive review with considerations on both previous and the most recent literature centering on the impact that food supplementation may play in microcirculation

  • As there is likely to be an increase in the use of food supplements to improve personal health, developing a global consensus about their regulations before they are marketed is essential

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Summary

Microcirculation in Physiological Conditions

Microcirculation consists of a network of small blood vessels (small arteries, arterioles, capillaries, venules, and small veins) that establish a frontier with the interstitium and with lymphatic vessels, a functionally connected triad that collaborates in maintaining the homeostasis of tissues as well as of the entire cardiovascular system [1]. Small arteries and arterioles display myogenic activity by which they are able to change vascular tone in response to changes in blood pressure to guarantee that perfusion remains constant over time. Neurotransmitters released from the autonomic nervous system, as well as endocrine and local mediators, especially from the endothelium, contribute to changing the vascular wall tone of arterioles and venules, which changes both organ perfusion and blood pressure in the short term [3,4,5]. The microvascular endothelium expresses a low level of adhesion molecules that limits the adhesion of leucocytes and platelets, preventing inflammation and the occurrence of thrombotic phenomena. Microvascular dysfunction increases the risk of fibrosis of the vascular wall, vascular and tissue inflammation, and ischemic and thrombotic phenomena [1]

Food Supplementation
European and American Legal Framework of Food Supplements
Food Supplements with Beneficial Effects on Microcirculation
Hawthorn
Ginseng
Findings
Conclusions
Full Text
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