Nitric Oxide and Your Heart

February 12, 2023

Nitric Oxide and Your Heart

Half of us will die of cardiovascular disease. Hmm. We are as old as our arteries. What causes our arteries to age? Simple, the lack of nitric oxide. We lose about 12% of our nitric oxide per decade.

We have talked about cholesterol for decades, without really getting anywhere. The question is, what starts the damage to the artery wall that starts the process. The vague term "oxidative stress" is used but doesn't mean much to you. What is that? Essentially it is that very first step of the surface of your artery called the endothelium becoming "dysfunctional". In effect, sticky! And that is driven by lack of sufficient NO. You have too many "reactive oxygen species". You can't clear and get rid of them. You set off inflammatory cytokines (internal signaling messages) that something is amiss. Those three together: oxidative stress, inflammation, and reactive oxygen species are the three elements necessary to start artery damage.

Here is the problem. Nitric oxide declines with aging. By age 40, we are down about 50%. Then, when we exercise we increase blood flow which increases shearing stress on our arteries. In a healthy artery with sufficient NO, that stress is easily withstood. But if your artery is sticky, you get a tiny bit of damage. White cells start to stick, then LDLs and your artery is off to the races

An athlete depends on NO for peak performance. NO increases in robust athletes. If NO drops on exercise, you, by definition will have vascular trouble going on.

Once you have a sticky endothelium, you start getting white blood cells migrating to the injury and LDLs sticking and penetrating the endothelial wall. That's the injury that starts heart disease.

So, can you prevent all that? Well, by all means, yes. You need more NO. We know there are two pathways to make NO. The endogenous pathway goes through L-arginine and two major studies showed that you make people sicker when you give exogenous L-arginine. Oops. Can't do that. That accounts for 50% of our NO production but we can't front-end load until we understand that pathway better.

But the dietary pathway that provides the other 50% of our NO supply, does that work? Well, yes. In a groundbreaking study by Stokes published in 2009 showed that people on an atherogenic diet will have demonstrated white blood cells sticking to their arteries, and when NO is supplied, suddenly the blood flow is fully restored and there is much less sticking, despite the lousy diet.

What is the core of the lousy diet that makes trouble? Simply put, the American Fast Food Diet. Saturated animal fat, sugar, and refined carbohydrates. A trip to whatever burger joint, pizza palace, or ice cream parlor of your choice. Bummer, we like that stuff.

Can we protect ourselves with more NO? Animal studies show that you can occlude an artery for a full hour and show minimal damage to the heart if the animal has sufficient NO. Not only that, there was little damage to the liver either. The study was done in animals that had NO production genetically knocked out proving NO to have a distal endocrine effect in addition to its local chemical effect.

www.What will Work for me. This is mind-boggling. I hear quotes like, "Repairing your NO is the most important health action you can take". I've been flailing around with various beetroot supplements and making teeny, tiny changes from D- all the way up to D+. Hardly a passing grade. But I bought NO supplement from the N1O1 company with 220 mg of NaNitrite per lozenge. My spit test shows I'm up to a C+, B- after the second dose. Ten minutes after it, it showed A-. I'm going to stick with this.

References:Cardiovas Res, Frontiers in Phys, Redox Biology, Circulation, J SportsMed Phys FitPNAS, Jr Heart and Circ Physiology, PNAS, PNAS

Pop Quiz

1. The first step in vascular injury, that kills 50% of us is high cholesterol. T or F. Answer: False. That is way down the road. The first step is endothelial dysfunction.

2. What does endothelial dysfunction mean?                               Answer: You have overwhelmed your body's ability to protect you from oxidative stress/inflammation/reactive oxygen species....all driven by insufficient NO. What then happens is your arteries can't relax when they are meant to relax. So you get high blood pressure.

3. Does endothelial dysfunction (ED) have an effect on the other ED?                        Answer: Yes, in fact, the link between male ED and artery disease is very powerful. Repair of NO gives ED some hope for men and women. (Did you get that?)

4. Are you telling me that the treatment of my NO insufficiency may be more important than my taking my statin?                              Answer: Yup. This is the upstream real cause of heart disease. Cholesterol is a simple money-making adjunct.

5. And last week we talked about mouthwash and PPI drugs both wiping out my ability to make NO? Is that right?                              Answer: Yup. Stop washing your mouth with germ-killing mouthwashes. Brush, floss, water bacteria-killing chemicals. They kill the bacteria in the crypts of your tongue that make nitrite.