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Cardiovascular Health

First it was blood cholesterol that could give you an early warning that a heart attack might be around the corner. Then came c-reactive protein. And now that doctors can get a better look at what's inside your heart arteries, they are taking a new interest in something they have always known was present in problem vessels: calcium. Hospitals, clinics and even gyms are touting quick and easy scans that can measure the amount of calcium in your coronary arteries in minutes.

Calcium can then build up in the vessels and stiffen them, laying the foundation for heart disease. Getting one's calcium score is simple, either by electron beam computed tomography (EBCT) or by multidetector CT. Studies show that in every age group people with higher vascular calcium levels have a greater risk of heart attack than do people of the same age with lower scores.

Calcium is essential for every cell in the body and plays a number of important roles other than just being used in bone. For example, calcium is necessary for skeletal muscle functions and other muscle tissues such as the smooth muscles in arteries. Imagine your pulse and how the arteries expand and contract. Normal metabolic processes utilize and clear excess calcium from the body. Excess calcification of cells lining the arterial vessel walls can play a role in increasing their stiffness and fragility, impeding normal blood flow to and from the heart.

For over half a century, K vitamins were recognized solely as needed for normal blood clotting. However, during the last decades they have been the subject of significant research. At the same time, protein research identified matrix Gla protein (MGP) associated with soft tissue calcifications. Soon it was realized that MGP was dependent upon vitamin K for activation. MGP is the most potent inhibitor of vascular calcification known, and it is actively involved in recycling calcium22

The Rotterdam Study (2004)23 shows that high dietary intake of vitamin K2 – but not vitamin K1 - has a strong protective effect on cardiovascular health. This population-based study, which took place over a 10 year period, followed 4807 initially healthy men and women >55 years of age from start. Findings from the study indicate that eating foods rich in natural vitamin K2 (at least 32 mcg per day) results in 50% reduction of arterial calcification, 50% reduction of cardiovascular death and 25% reduction of all cause mortality.

These findings was in 2008 supported by another population-based study with 16,000 persons from the Prospect-EPIC cohort population. All the women participating in this project, who were aged 49-70 at the start of the study, were followed up for 8 years and were free of cardiovascular diseases at the baseline. The results from this study show that high intake of natural vitamin K2 – but not vitamin K1 – over a 8 year period protect from cardiovascular events26. The researchers (Gast et.al) found that for every 10mcg vitamin K2 (MK-7, MK-8 and MK-9) consumed, the risk of coronary heart disease was reduced by 9%.

Another study24 which looked at the relation between vitamin K1 and vitamin K2 intake and coronary calcification among 564 post-menopausal women showed decreased calcification associated with vitamin K2 intake (specifically MK-7, MK-8 & MK-9) but not with vitamin K1 intake.25

An interesting double blind placebo-controlled bone health study from New Zealand where 1471 postmenopausal women received 1000 mg calcium daily reported a high frequency of cardiovascular events. Judged from the information given, it seems that the daily intake of vitamin K2 was very low in these women. Inadequate vitamin K2 supplementation seems to be a contributing factor to this cardiovascular problem27.

Unfortunately, the western diet does not contain sufficient vitamin K2 and supplementing with MenaQ7, the natural vitamin K2, is therefore recommended by experts.

Arterial calcification

Calcification was once believed to be an irreversible process and a result of aging. However, it is now known that calcium accumulation is an actively regulated process also involving vitamin K2-dependent MGP. Healthy arterial tissues have shown to contain 20-50 times more vitamin K2 than unhealthy arteries. The amount of calcium in the arteries is a risk factor for cardiovascular health. Significant calcification makes one older than what the birth certificate states; while with little or no calcification one can deduct up to 10 years from one's chronological age.

In short, you are as old as your arteries.




 
 

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The Calcium Paradox
 
Impaired calcium metabolism results in simultaneous bone tissue degradation and excessive calcium accumulation in the vessel walls. This is known as the Calcium Paradox. While bones are in need of calcium, excessive calcification may occur in arteries and soft tissues including skin. Vitamin K2 is an essential co-factor involved in calcium utilization by activating proteins responsible for removing circulating mineral from the arteries and binding it to the bone matrix.
 
Matrix Gla Protein’s role
 
Matrix Gla Protein (MGP) is a key inhibitor of soft vascular tissue calcification – it can be measured in blood, but exerts its effect in tissues where it binds calcium, preventing it from depositing in the vessel walls. In collaboration with other soluble factors and cells MGP thus helps remove calcium from the arteries, and thereby keep them elastic and flexible.

In order to properly perform its inhibitory function, MGP must be activated by vitamin K during a process called carboxylation. Vitamin K2 deficiency results in undercarboxylation of MGP (ucMGP) and impairs their biological function. Without adequate vitamin K2 in the vessel walls ucMGP accumulates at the sites of calcium deposition but is basically inert as it cannot inhibit calcification, which in turn increases the risk of fatal cardiovascular events.



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