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Should Statins be Available for Everyone?

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They lower cholesterol and heart attack risk and may hold promise against other diseases, including cancer. Doctors consider broadening their use.
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Should statin drugs be put in the water, or what? ¶ More than 13 million Americans are taking these medications to lower their cholesterol and hopefully stave off heart disease — a job the drugs appear to excel at. Statins can lower “bad” LDL cholesterol by 20% to 60%. Over time, this can lower the risk of having a heart attack by about the same amount. ¶ For many years, it was believed that statins worked solely by reducing blood cholesterol, which can build up in sticky plaques in the arteries that supply blood to the heart, potentially blocking blood flow and causing heart attacks. But evidence is mounting that the drugs reduce heart disease risk through more than just their cholesterol-lowering effects. New research suggests they may be beneficial even for people with cholesterol in the normal range. ¶ This has doctors and medical researchers debating whether many more people should be on statins than currently fall under treatment guidelines. Some drug companies and doctors have even argued that low doses of the drugs should be available over the counter, as they are in the United Kingdom.

At the same time, other studies are reporting that statins might help prevent or treat a number of noncardiovascular conditions — including multiple sclerosis, cancer and Alzheimer’s disease. With all this news, many may be wondering, “Should I take a statin, just in case?”

Experts, for the most part, will say only, “Maybe.”

Most of the people at high risk of cardiovascular disease “are going to be safer and live longer if they’re on a statin than if they’re not,” says Nathan Wong, director of the UC Irvine Heart Disease Prevention Program. But that doesn’t hold for people whose risk for heart attacks is very low to begin with, he adds. “I’m not saying that everyone is going to be better on a statin. They need to be used with discretion.”

All six statins available today — atorvastatin (Lipitor), rosuvastatin (Crestor), simvastatin (Zocor), lovastatin (Mevacor), pravastatin (Pravachol) and fluvastatin (Lescol) — work by blocking an enzyme called HMG-CoA reductase.

In the liver, blocking this enzyme shuts down cholesterol production and increases the amount of cholesterol the liver takes out of the bloodstream.

But statins also block HMG-CoA reductase in the cells lining blood vessels, where, among other things, they can reduce inflammation.

Dramatic results
The anti-inflammatory effect of statins has been on many heart experts’ minds since the Nov. 9 announcement of the results of a clinical trial called JUPITER. The trial showed that statin treatment can reduce the risk of heart disease in people with normal cholesterol levels but high levels of inflammation as measured by blood levels of a marker called C-reactive protein (CRP).

A team led by Dr. Paul Ridker of Brigham and Women’s Hospital in Boston and Harvard Medical School found that in 8,901 people with high blood CRP levels, rosuvastatin (Crestor) reduced the risk of a heart attack by 54% and the need for bypass surgery or angioplasty by 46% compared with an equal number of people taking a placebo.

There were 68 heart attacks and 131 bypass surgeries/angioplasties in the placebo group, but only 31 and 71, respectively, in the group taking the statin. There were 48% fewer strokes — 64 versus 33. These effects were so dramatic that regulators stopped the trial, slated to go for four years, after less than two. AstraZeneca, the company that makes Crestor, funded the JUPITER trial.

The results raise an obvious question: Are the cholesterol-lowering effects or the inflammation-reducing effects of statins more important?

Dr. Christopher Cannon, a cardiologist at Brigham and Women’s, says they both play a part: “You have to have some cholesterol get into the arteries [and cause damage]. And if you have inflammation that damages the lining of the arteries, the cholesterol gets in more easily.”

Inflammation can also encourage plaques to rupture, causing clots that block blood flow. “Both [cholesterol buildup and inflammation] are happening simultaneously, and both are inhibited simultaneously with statins,” Cannon says.

Currently, more than 13 million people take statin drugs for elevated LDL cholesterol, and at least 47 million more have cholesterol levels high enough to make them eligible by current National Heart, Lung, and Blood Institute cholesterol guidelines.

Ridker estimates an additional 4 million to 6 million people would be added to the mix if everyone who would have qualified for the JUPITER trial (men over 50, women over 60, LDL cholesterol below 130 mg/dL and CRP above 2 mg/L) started taking a statin.

Anti-inflammatory:

Statins may be good for more than just fighting heart disease.

Very preliminary studies suggest that the anti-inflammatory effects of statins could help treat autoimmune diseases. A small, nine-month study of 36 patients with multiple sclerosis published in April in the journal PLoS One showed that statin treatment, either alone or combined with standard MS treatment, reduced the number of brain lesions characteristic of the disease by 24% and reduced their size by about 12%.

Another pilot study of just seven people, published in September 2007 in the Journal of the American Academy of Dermatology, showed that a statin reduced the severity of the skin disease psoriasis

A combined analysis of 19 studies, published in August in the International Journal of Cancer, found that statin use reduced the risk of advanced prostate cancer by 23%.

And a study published in November in the Journal of the National Cancer Institute showed that men prescribed statins had a 4.1% decline in their blood levels of prostate-specific antigen (PSA), a marker of prostate cancer.

There is some evidence that statins can lower the risk of developing Alzheimer’s disease. An October study of almost 7,000 people in Rotterdam, Netherlands, found that people taking a statin had about a 50% lower risk of Alzheimer’s compared with those who had never used cholesterol-lowering medication. Other studies, however, have failed to find an effect of statins on the risk for dementia or Alzheimer’s disease.

As the benefits of these drugs are experienced by more people, the risks will be too. Though statins are generally considered safe, they do have side effects.

Drugs’ side effects:-
The most commonly reported adverse event associated with statins is muscle pain. A 2006 analysis of seven clinical trials published in Medscape General Medicine found that 2.5% to 6% of patients taking statins reported aches and pains related to their drugs.

Rhabdomyolysis, a breakdown of skeletal muscle that can lead to kidney failure and sometimes death, has also been linked to statins. According to the 2006 Medscape report, less than 0.1% of patients taking statins reported rhabdomyolysis. There was only 0.15 death from rhabdomyolysis per 1 million prescriptions.

Liver effects are also seen in some patients taking statins. In less than 1% of patients taking moderate doses of statins, and in about 2% to 3% of those taking high doses, liver enzyme levels are abnormally high. But the enzyme changes usually subside after discontinuing statin use or switching to a different statin, says Dr. Antonio Gotto, dean of Weill Cornell Medical College in New York.

In 2007, the Food and Drug Administration conducted an investigation into whether statins increase the risk of the fatal neurodegenerative disease amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, when the agency received a higher than expected number of reports of the disease in people taking statins. Although an analysis of 41 long-term controlled clinical trials reported in September detected no such link, the FDA has said it plans to continue studying the issue.

Dr. Scott Grundy, a professor of internal medicine and director of the Center for Human Nutrition at the University of Texas Southwestern Medical Center at Dallas, says he thinks the drugs, on balance, are safe. But he adds that caution is still warranted, especially when it comes to considering a broad expansion of their use or prescribing them earlier in people’s lives.

Statins have been in use only since the late 1980s, he notes, and so there hasn’t been enough time yet to learn what might happen if someone were to be on the drugs for 30 or 40 years. “It is possible that some of these rare side effects might turn out to be quite important if [statins are] started early in life and continued for years and years,” he says.

Whether statin use is substantially expanded may depend on how the results of the JUPITER trial and other recent research are incorporated into new cholesterol guidelines slated to be released next year by the National Heart, Lung and Blood Institute.

If CRP testing becomes part of the standard battery of tests that guide risk assessment and statin treatment decisions, millions more Americans could find themselves filling a prescription.

Currently, most doctors use CRP testing as a sort of tie-breaker when they are on the fence as to whether a patient is at high enough risk of heart disease to warrant statin therapy. Patients might, for example, have intermediate cholesterol levels but a family history of heart attacks or some other risk factor.

Dr. Mary Malloy, co-director of the adult lipid clinic and director of the pediatric lipid clinic at the UCSF Medical Center, does not think this should change, even though she characterizes the JUPITER results as “very impressive.”

“I am personally not ready to corral everyone over 35 and do CRP testing,” she says.

Wong says it’s important that people take into account a person’s absolute risk when judging whether or not a patient needs a statin.

Of the JUPITER trial, he says, “There was a 44% reduction in cardiovascular events. This sounds very dramatic, and it is.” But the risk of heart attack in those patients was pretty tiny to begin with — 2.8%. The 44% drop took it down to 1.6%.

The bottom line is that monetary cost as well as potential side effects of statins must be weighed against the potential benefits.

Wong’s biggest concern is that people will get the idea that statins are a cure-all — and they’ll stop bothering about habits that could affect their heart health just as much.

“People think statins are magic pills,” he says. “You can’t forget about other risk factors like smoking, diabetes and blood pressure. . . . you have to make sure all these things are adequately controlled.”

Sources: Los Angles Times

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Featured

The Real Villain

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Avoiding bad cholesterol may help burn extra flab more than anything else.

If you’re obese and also high on cholesterol, there is some bad news for you. Scrimping on food or hitting the gym regularly will be less helpful in dislodging the fat tucked away in the tummy if the level of low-density lipoprotein (LDL), or bad cholesterol, increases considerably in your body.

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The nexus between LDL and reduced burning of fat was discovered recently by a team of researchers from the Swedish medical university Karolinska Institutet, Stockholm.

Higher order animals like humans retrieve energy stored as fat — free fatty acids — in a layer under the skin when there is a drop in the availability of glucose, the body’s primary source of energy. But the process gets hampered badly when there are higher levels of bad cholesterol in the body, showed the Swedish scientists who studied the inhibitory role of cholesterol in fat turnover in lab-cultured human human tissues and mice.

“Our study clearly shows that bad cholesterol inhibits the breakdown of fat stored in the adipose cells in the body,” said Johan Björkegren, who led the study. The study appeared recently in the journal PLoS ONE.

“Scientists have long known that when food intake is restricted, the liver sends signal to the white adipose tissues to release free fatty acids at higher rates.” Such fat is processed in the liver to meet the energy requirement of the body. The process also results in the production of cholesterol. In a healthy person, there is always a fine balance between the production of cholesterol and the release of fats from the adipose tissues.

But, much to their surprise, the Swedish scientists found that when there is a higher level of cholesterol, the release of fat from the tissues may remain the same but the liver will process less fat. The excess fat, then, will remain in the bloodstream, triggering the synthesis of more cholesterol. “This forms a vicious cycle,” Björkegren told Knowhow.

But, the Swedish researcher said, there is no need to lose heart. Cholesterol-busting medication such as statins can increase the turnover of fat. Similarly, cutting the intake of bad cholesterol from food may benefit an obese person on two counts: he or she may be able to reduce the risk of heart diseases such as atherosclerosis, and it enhances the process of weight reduction.

While the Swedish study clearly indicated the negative role played by cholesterol in obesity, another study reported at a recent meeting of the American Heart Association showed how cholesterol clogged the arteries of obese children, making the blood vessels look more like those of 45-year-olds.

………………………………………….
WHY DIETING FAILS:Dieting summons ready energy from fat deposits in the body but the liver lacks the ability to process more fat. The result: the extra fat stays in the blood, producing more cholesterol.
“There’s a saying that ‘you’re as old as your arteries,’ meaning that the state of your arteries is more important than your actual age in the evolution of heart disease and stroke,” said Geetha Raghuveer, associate professor of paediatrics at the University of Missouri-Kansas City School of Medicine. The scientists, who used ultrasound to measure the thickness of the inner walls of the carotid arteries in the neck that link the brain to the heart, were surprised to see the fatty build-up of plaque. Such plaque deposit — called carotid artery intima-media thickness (CIMT) — within arteries feeding the heart muscle and the brain can lead to heart attacks and strokes, Raghuveer, who led the study, said.

The scientists studied 70 boys and girls with an average age of 13. Most of these children had abnormal levels of one or more types of cholesterol — elevated levels of LDL or low levels of good cholesterol (HDL) or high triglyceride levels.

The children’s “vascular age” — the age at which level of thickening would be normal for their gender and race — was about 30 years more than their actual age, she said.

“Vascular age was advanced the furthest in the children with obesity and high triglyceride levels. So the combination of obesity and high triglycerides should be a red flag to the doctor that a child is at high risk of heart disease,” Raghuveer said.

She said further studies are needed to determine whether artery build-up will decrease if children lose weight, exercise or are treated for abnormal lipids.

One factor that gives rise to hope, according to Raghuveer, is that unlike in adults these plaques haven’t hardened or calcified in children. So the same treatments that help improve vessel walls and blood flow in adults can help children even more, she observed.

Sources: The Telegraph (Kolkata, India)

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‘Good Cholesterol’ Might Not be Good

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Is ‘good cholesterol’ really good for you; not so, suggests a new study.

University of Chicago (U-C) researchers challenged popular notion that simply having high levels of good cholesterol (HDL) and low levels of bad cholesterol (LDL) is necessary for good heath.

Instead, they show that the good cholesterol has varying degrees of quality and that poor quality HDL is actually bad for you.

Cholesterol is a waxy, fat-like substance used by the body to maintain the proper function of cell membranes and is encapsulated within two types of proteins as it travels in the body – low density lipoproteins (LDL) and high-density lipoproteins (HDL).

High levels of LDL or total cholesterol are an indicator of increased risk for heart disease. High blood cholesterol elicits no physical symptoms, making medical screenings necessary for detection.

“For many years, HDL has been viewed as good cholesterol and has generated a false perception that the more HDL in the blood, the better,” said Angelo Scanu, pioneer in blood lipid chemistry from U-C and co-author of the study.

“It is now apparent that subjects with high HDL are not necessarily protected from heart problems and should ask their doctor to find out whether their HDL is good or bad,” he added.

The researchers came to this conclusion after reviewing published research on this subject. They found that the HDL from people with chronic diseases like rheumatoid arthritis, kidney disease, and diabetes is different from the HDL in healthy individuals, even when blood levels of HDL are comparable.

They observed that normal, ‘good’ HDL reduces inflammation, while the dysfunctional, ‘bad’ HDL does not, according to an U-C release.

“This is yet one more line of research that explains why some people can have perfect cholesterol levels, but still develop cardiovascular disease,” said Gerald Weissmann, editor-in-chief of The FASEB Journal, which published the study in its December edition.

“Just as the discovery of good and bad cholesterol rewrote the book on cholesterol management, the realisation that some of the ‘good cholesterol’ is actually bad will do the same,” he added.

US Centres for Disease Control and Prevention said approximately 17% of all American adults have high total cholesterol, putting them at risk for heart disease.

Sources:-The Times Of India

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Fruits & Vegetables Herbs & Plants

Cranberries

The Cranberry Harvest on the Island of Nantuck...
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Botanical Name:Vaccinium macrocarpon
Family:Ericaceae
Kingdom: Plantae
Division: Magnoliophyta
Class: Magnoliopsida
Order: Ericales
Genus: Vaccinium
Subgenus: Oxycoccos
Other names: North American cranberry, large cranberry

Parts Used: The ripe fruit of the cranberry is the part used in commercial and medicinal preparations

Habitat:Cranberries mainly thrive in sandy soil and bogs. They are mainly seen in the regions between Newfoundland, down to North Carolina, and also westwards to Minnesota. In terms of production, the state that produces the most cranberries in the US is Wisconsin, while Massachusetts comes a close second. Massachusetts alone produces about 2 million barrels of cranberries annually!

Description:
Cranberries are low, creeping shrubs or vines up to 2 m long and 5 to 20 cm in height;  they have slender, wiry stems that are not thickly woody and have small evergreen leaves. The flowers are dark pink, with very distinct reflexed petals, leaving the style and stamens fully exposed and pointing forward. They are pollinated by domestic honey bees. The fruit is an epigynous berry that is larger than the leaves of the plant; it is initially white, but turns a deep red when fully ripe. It is edible, with an acidic taste that can overwhelm its sweetness.
click to see the pictures..>….(01)...(1)...(2).……..(3)….(4)....
The cranberry plant-called a vine by growers–is a long-lived perennial less than eight inches high with trailing, thin, wiry stems that bear small, opposite, evergreen leaves. Cranberry flowers appear around the Fourth of July; these are white to light pink, downward-pointing, bell-shaped, axillary flowers. The common name cranberry is a modification of the colonial name “crane berry,” because the drooping flower looked like the neck and head of the sand crane, which was often seen eating the fruits.

Cranberries are a major commercial crop in certain American states and Canadian provinces (see “Cultivation and Uses” below). Most cranberries are processed into products such as juice, sauce, and sweetened dried cranberries, with the remainder sold fresh to consumers. Cranberry sauce is regarded an indispensable part of traditional American and Canadian Thanksgiving menus and European winter festivals.

Since the early 21st century within the global functional food industry, there has been a rapidly growing recognition of cranberries for their consumer product popularity, nutrient content and antioxidant qualities, giving them commercial status as a novel “superfruit”.

Species:
There are three to four species of cranberry, classified in two sections:

*Subgenus Oxycoccos, sect. Oxycoccos

*Vaccinium oxycoccos or Oxycoccos palustris (Common Cranberry or Northern Cranberry)
is widespread throughout the cool temperate Northern Hemisphere, including northern Europe, northern Asia and northern North America. It has small 5-10 mm leaves. The flowers are dark pink, with a purple central spike, produced on finely hairy stems. The fruit is a small pale pink berry, with a refreshing sharp acidic flavour.

*Vaccinium microcarpum or Oxycoccos microcarpus (Small Cranberry) occurs in northern Europe and northern Asia, and differs from V. oxycoccus in the leaves being more triangular, and the flower stems hairless. Some botanists include it within V. oxycoccos.

*Vaccinium macrocarpon or Oxycoccos macrocarpus (Large cranberry, American Cranberry, Bearberry) native to northeastern North America (eastern Canada, and eastern United States, south to North Carolina at high altitudes). It differs from V. oxycoccus in the leaves being larger, 10-20 mm long, and in its slightly apple-like taste.

Subgenus Oxycoccos, sect. Oxycoccoides
Vaccinium erythrocarpum or Oxycoccos erythrocarpus (Southern Mountain Cranberry) native to southeastern North America at high altitudes in the southern Appalachian Mountains, and also in eastern Asia.

Chemical Composition of Cranberries
Basically, cranberries have a very rich chemical composition. They are formed chemically of triterpinoids, a range of acids, such as benzoic acid, citric acid, malic acid, quinic acid, ascorbic acid, leptosine glycosides, glucuornic acid, catechin, as well as alkaloids and anthocyanin dyes. The different combinations of these are what provide the rich variety of medicinal benefits associated with cranberries.

Phytochemicals: The cranberry contains Catechins, Triterpenoids, Quinic Acid, Hippuric Acid, Anthocyanins

Medicinal Uses and Indications

Urinary tract infections
Cranberry is used to prevent urinary tract infections of the bladder and urethra (the tube that drains urine from the bladder). Several studies indicate its effectiveness. In one study of older women, cranberry juice significantly reduced the amount of bacteria present in the bladder compared to placebo. Another study showed that younger women with a history of recurrent UTIs who took cranberry by capsule significantly reduced the recurrence of UTI compared to those who took placebo.

However, evidence suggests that cranberry is not as effective against bacteria once they have attached to cells in the urinary tract. For this reason, cranberry is more effective at preventing UTIs than treating them. Instead, UTIs should be treated with conventional antibiotics.

Ulcers
A preliminary study suggests that cranberry may also prevent the bacteria Helicobacter pylori from attaching to stomach walls. H. pylori can cause stomach ulcers, so it is possible that cranberries may eventually prove to play a role in the prevention of this condition. However, more research is needed.

Heart disease
The antioxidants found in cranberry may protect from heart disease by lowering LDL (“bad”) cholesterol, relaxing blood vessels, and preventing plaque from building up in arteries. However, more research is needed.

Cancer
In some test tube studies, cranberry appears to inhibit the growth of cancer cells. It is too early to say whether the herb will have the same effect in humans.

Oral hygiene
Studies also suggest that cranberries may help prevent bacteria from adhering to gums and around the teeth, helping to prevent cavities. Researchers caution, however, that cranberry juice is often high in sugar and should not be used for oral hygiene.

Available Forms
Cranberries are available fresh or frozen and in juice and concentrate forms. Dried berries are also available in tablet or capsule form. Pure cranberry juice is very sour, so most cranberry juices contain a mixture of cranberries, sweeteners (which may reduce the healthful effects of the juice), and vitamin C. Look for a brand of cranberry juice that has the lowest amount of added sugar or is sugar-free.

How to Take It
Pediatric
There is not enough evidence to establish a safe dose for children prone to UTIs. A child with a UTI should be under the care of a qualified health care provider.

Adult
Juice: 3 or more fluid oz. of pure juice per day, or about 10 oz. of cranberry juice cocktail
Capsules: 300 mg to 400 mg, 6 per day in divided doses
Fresh or frozen cranberries: 1.5 ounces


Precautions:

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a healthcare practitioner.

Cranberry juice and supplements are generally considered safe with no serious side effects, even for pregnant women.

Cranberry contains relatively high levels of oxalate, chemicals that may increase the risk of kidney stones. People who have or have had kidney stones should talk to their doctor before taking cranberry supplements or drinking large amounts of cranberry juice.

Cranberry should not be used as a substitute for antibiotics during a UTI.

Because most cranberry juice contains added sugar, people who have diabetes should look for brands of juice that are artificially sweetened or should limit their consumption of regular juice.

Possible Interactions
A preliminary report suggests that cranberry may interfere with the effects of the blood-thinning drug warfarin. If you take warfarin, do not take supplemental cranberry and limit your consumption of cranberry juice.

Research Reviews:
*A flavonoid fraction from cranberry extract inhibits proliferation of human tumor cell lines
*Inhibition of Helicobacter pylori and associated urease by oregano and cranberry phytochemical synergies. *Cranberry for Prevention of Urinary Tract Infections
*What’s the use of cranberry juice?

Abstracts:
*Cranberry and the Urinary Tract
*Anti-Adhesion Properties of Cranberry
*Cranberry and Dental Health
*Cranberry and Stomach Ulcers
*Influence of Cranberry on Heart Disease
*Anti-Cancer Properties of Cranberry Phytochemicals
*Phytochemicals in Cranberry

Click to see :->How Cranberries Grow

How to grow Cranberrie

Americans Discover the Bacteria-Blocking Properties of Cranberries

Medicinal uses of Cranberrie.

Disclaimer:The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider.

Resources:
http://www.botgard.ucla.edu/html/botanytextbooks/economicbotany/Vaccinium/index.html
http://www.furtherhealth.com/article/54_2_Cranberry-Facts/
http://www.umm.edu/altmed/articles/cranberry-000235.htm#Medicinal%20Uses%20and%20Indications
http://www.phytochemicals.info/plants/cranberry.php

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Herbal Care News on Health & Science

Olive Leaf Extract Lowers Blood Pressure

Taken by Nick Fraser in 2005. The fruit of an ...
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The leaves of the olive tree have been used for medicinal purposes since ancient times, and research has suggested that olive leaf extracts have antibacterial, anti-inflammatory and antioxidant properties. Now it also appears that a supplement containing olive leaf extract could help lower blood pressure and cholesterol.

A study looked at 20 sets of identical twins with “borderline” hypertension — blood pressure that is above the optimal level of 120/80, but below the cutoff of 140/90 used to diagnose high blood pressure. One member of each twin pair was given tablets containing olive leaf extract, while the other received no supplements but did get lifestyle advice on lowering blood pressure.

After eight weeks, supplement users taking 1,000 mg of olive leaf extract per day showed a substantial dip in their blood pressure overall, and lowered levels of LDL or “bad” cholesterol. The twins who received no supplements showed no significant change in their blood pressure and a smaller improvement in cholesterol.

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