The vascular system plays an important role in the functioning of other body systems, including the respiratory system, digestive system, and kidneys and urinary system. Vascular disease is the weakening or blocking of blood vessels, which affects blood flow, and can affect many parts of the body, including the brain, the lungs, the eyes, the kidneys, the GI tract, and of course, the heart.¹ Use these strategies to keep your blood vessels strong, flexible, and free flowing.

First things first: diet & lifestyle

As you may suspect, the same diet and lifestyle habits that support overall health are the same ones that will support vascular health: regular movement (walking is great!²), manage stress, don’t smoke, minimum alcohol consumption, and a diet loaded with colorful plant foods that supply plenty of antioxidants and anti-inflammatory compounds. Beets are a particularly good choice for vascular health—there are phytonutrients in beets that increase the body’s natural production of nitric oxide (NO), one of the most important compounds for blood vessel health. NO regulates vascular tone and blood flow, helps relax blood vessels, which lowers blood pressure, reduces arterial stiffness, and inhibits platelet adhesion, which plays a role in the development of atherosclerotic lesions.^{3 4} One study including hypertensive subjects found that just a little over a cup of beetroot juice each day improved blood pressure, endothelial function, and reduced arterial stiffness over the course of four weeks.⁵

Another note on diet and vascular function: It is important to eat in a way that maintains healthy blood sugar balance—chronically elevated blood sugar is highly damaging to blood vessels. For example, some of the most common complications that arise from diabetes include vascular complications of the kidneys and eyes, peripheral vascular disease, and cardiovascular disease. Even those without diabetes but with poor glucose control have a higher risk of stroke, indicating vascular dysfunction.⁶

Build a healthy foundation with diet and lifestyle, and supplement it with these research-backed nutrients. Bonus: Beyond vascular health, each one of these nutrients promotes health in multiple other ways, including reducing inflammation and oxidative stress, supporting optimal brain and immune function, gut health, detoxification, and energy production.

EPA & DHA

The omega-3 fats EPA and DHA are well known to support cardiovascular health, and one of the ways in which they do this is via their action on the vascular system. EPA and DHA reduce inflammation and oxidative damage within the blood vessels, improve endothelial function (the endothelium is a thin membrane that lines the inside of blood vessels and controls vascular relaxation and contraction, blood clotting, and platelet adhesion), may reduce the formation of blood clots that can lead to heart attack and stroke, and may prevent or reduce the formation of plaque.^{7 8 9} Aim to get 3,000 mg combined EPA and DHA daily.

OPCs

An easier way to say “oligomeric proanthocyanidins,” OPCs belong to the family of antioxidants called polyphenols and are most commonly found in plant sources we can’t eat, like pine bark (Pycnogenol^® is the trademarked name) and grape seeds. OPCs are unique because they preferentially bind to capillary walls, where they promote capillary strength, healthy function, peripheral circulation, and decrease permeability.

Research has shown that supplementation with OPCs improves venous insufficiency, a condition in which blood pools in the legs, causing aching pain, heaviness, swelling, and varicose veins, increases venous tone in patients with varicose veins, and improves diabetic retinopathy (vascular disease of the eyes). Human studies have found efficacy with a dose of 100 to 300 mg daily.¹⁰

Resveratrol & Quercetin

These phytonutrients belong to the family of antioxidants called flavonoids, and are found in plant foods (grapes and wine in the case of resveratrol, and onions and apples in the case of quercetin). Both of these flavonoids have been shown to be especially beneficial when it comes to vascular health. Like beets, resveratrol increases the production of nitric oxide in the endothelium, while inhibiting the production of endothelin-1. Endothelin-1 is a potent vasoconstrictor that causes fibrosis (thickening) of the vascular cells and increases inflammation and the production of reactive oxygen species (ROS), which cause oxidative damage; overproduction of endothelin-1 is implicated in the development of vascular disease and atherosclerosis.^{11 12}

Like resveratrol, quercetin also reduces both oxidative damage and inflammation in the endothelium and inhibits the production of endothelin-1. Research has also found that it inhibits platelet aggregation (blood clots), improves vasodilation, reduces high blood pressure, and improves overall endothelial function. Interestingly, initial research is showing that quercetin may also mitigate the accumulation of senescent (aging) endothelial cells; these aging cells can drive endothelial dysfunction.¹³ While doses in studies of both resveratrol and quercetin vary, an average dose is 250-500 mg daily.

B Vitamins

Homocysteine, an amino acid created by the body when it metabolizes other amino acids, can cause major damage to the arteries when elevated, and is considered a classic risk factor for cardiovascular disease, including heart disease, stroke, and atherosclerosis, where inflammation damages the lining of the arteries, leading to increased permeability and eventually, the formation of plaques.¹⁴ Enter the B vitamins. Specifically, vitamins B6, B12, and folate (folic acid) break down homocysteine, keeping levels in check. If you have elevated homocysteine, levels can be effectively reduced with supplemental B vitamins.¹⁵ One meta-analysis that included 7,474 stroke patients found that supplementation with the B vitamins significantly reduced homocysteine levels and “resulted in significant reduction in stroke recurrence as well as a combined incidence of vascular events, including recurrent strokes, myocardial infarctions [heart attacks] and vascular deaths.”¹⁶ Because the B vitamins work together, look for a B-complex supplement to ensure you get optimal amounts of all the Bs.

References

1. Johns Hopkins Medicine, Overview of the Vascular System https://www.hopkinsmedicine.org/health/conditions-and-diseases/overview…
2. Solan M. Harvard Health Publishing, Harvard Medical School. “High-intensity walking may reduce leg pain from artery disease.” July 1, 2021 https://www.health.harvard.edu/pain/high-intensity-walking-may-reduce-l…
3. Baião DDS, Silva DVTD, Paschoalin VMF. Beetroot, a Remarkable Vegetable: Its Nitrate and Phytochemical Contents Can be Adjusted in Novel Formulations to Benefit Health and Support Cardiovascular Disease Therapies. Antioxidants (Basel). 2020 Oct 8;9(10):960. doi: 10.3390/antiox9100960.
4. NIESWANDT, B., PLEINES, I. and BENDER, M. (2011), Platelet adhesion and activation mechanisms in arterial thrombosis and ischaemic stroke. Journal of Thrombosis and Haemostasis, 9: 92-104. https://doi.org/10.1111/j.1538-7836.2011.04361.x
5. Kapil V, Khambata RS, Roberston A, Caulfield MJ, Ahulwalia A. Dietary nitrate provides sustained blood pressure lowering in patients. Hypertension. 2015;65:320-327.  http://hyper.ahajournals.org/content/65/2/320.long
6. Urabe T, Watada H, Okuma Y, et al. Prevalence of abnormal glucose metabolism and insulin resistance among subtypes of ischemic stroke in Japanese patients. Stroke, 2009;40:1289-1295.
7. Daci A, Ozen G, Uyar I, et al. Omega-3 polyunsaturated fatty acids reduce vascular tone and inflammation in human saphenous vein. Prostaglandins & Other Lipid Mediators, November 2017; Vol 133, pgs 29-34 https://doi.org/10.1016/j.prostaglandins.2017.08.007
8. Liao J, Xiong Q, Yin Y, et al. The Effects of Fish Oil on Cardiovascular Diseases: Systematical Evaluation and Recent Advance. Frontiers in Cardiovascular Medicine, January 5, 2022. https://doi.org/10.3389/fcvm.2021.802306
9. Adili R, Hawley M, Holinstat M. Regulation of platelet function and thrombosis by omega-3 and omega-6 polyunsaturated fatty acids. Prostaglandins Other Lipid Mediat. 2018 Nov;139:10-18. doi: 10.1016/j.prostaglandins.2018.09.005. 
10. Fine, Anne Marie ND. “Oligomeric Proanthocyanidin Complexes: History, Structure, and Phytopharmaceutical Applications,” Alt Med Review; vol. 5; num 2, 2000. https://altmedrev.com/wp-content/uploads/2019/02/v5-2-144.pdf
11. Kowalczyk A, Kleniewska P, Kolodziejczyk M, Skibska B, Goraca A. The role of endothelin-1 and endothelin receptor antagonists in inflammatory response and sepsis. Arch Immunol Ther Exp (Warsz). 2015 Feb;63(1):41-52. doi: 10.1007/s00005-014-0310-1.
12. Li H, Xia N, Hasselwander S, and Daiber A. “Resveratrol and Vascular Function.” International Journal of Molecular Sciences. 2019; 20(9) https://doi.org/10.3390/ijms20092155
13. Dagher O, Mury P, Thorin-Trescases N, et al. “Therapeutic Potential of Quercetin to Alleviate Endothelial Dysfunction in Age-Related Cardiovascular Diseases.” Frontiers in Cardiovascular Medicine. March 30, 2021. https://doi.org/10.3389/fcvm.2021.658400
14. Ganguly P, Alam SF. Role of homocysteine in the development of cardiovascular disease. Nutr J. 2015 Jan 10;14:6. doi: 10.1186/1475-2891-14-6.
15. Fratoni V, Brandi ML. B vitamins, homocysteine and bone health. Nutrients. 2015 Mar 30;7(4):2176-92. doi: 10.3390/nu7042176. 
16. Wang L, Cui W, Nan G, Yu Y. Meta-analysis reveals protective effects of vitamin B on stroke patients. Transl Neurosci. 2015 Aug 20;6(1):150-156. doi: 10.1515/tnsci-2015-0014.