Chokeberry-flavonoid extract reduces CRP, interleukin-6, and blood pressure

June 28, 2006

Rome, Italy - While gardeners often praise the chokeberry bush, mainly for its ornamental value, cardiologists might soon value the sour-tasting fruit of these plants. Results from a small study presented last week at the International Symposium on Atherosclerosis suggest the addition of a flavonoid-rich extract, derived from aronia berries of the chokeberry bush, can reduce the severity of inflammation independent from statin therapy and might be used clinically in secondary prevention of ischemic heart disease[1].

"From a practical point of view, in patients who are treated with a moderate-dose statin, if that is not enough to reduce markers of inflammation, especially C-reactive protein, new, emerging treatments might be used to treat patients with coronary heart disease after myocardial infarction," said lead investigator Dr Marek Naruszewicz (Pomeranian Medical University, Szczecin, Poland). "We have evidence from different studies, but only in patients without coronary heart disease, showing that the production of free radicals has a direct effect on the progression of atherosclerosis."

With this evidence in mind, Naruszewicz and colleagues sought to determine the effects of combination therapy with a flavonoid-rich extract from chokeberry fruits on reducing cardiovascular risk markers in MI patients. In reducing oxidative stress, investigators hypothesized that the addition of chokeberry flavonoids could reduce the uptake of oxidized LDL cholesterol and the activation of monocyte macrophages, which are responsible for the production of interleukin-6 and downstream CRP production.

Aronia, sometimes called black chokeberry, is a deciduous shrub native to eastern North America and exported to Europe. The juice from aronia berries is often extracted for jelly making, candies, pies, and wine and typically has a very sour taste. Juice extracted from aronia berries contains very high levels of anthocyanins and flavonoids, said Naruszewicz, with levels five times greater than those found in cranberries.

In this randomized, double-blind, placebo-controlled, six-week study, 22 patients treated with simvastatin 40 mg received a commercial preparation (Aronox) rich in chokeberry-flavonoid extract and 22 patients, also treated with statin therapy, received placebo. Approximately 80% of patients in both treatment arms were on aspirin and roughly half were also on ACE-inhibitor therapy.

While there was no observed treatment effect on lipoprotein levels, there was a significant 38% reduction of plasma total F2-isoprostane levels, an indicator of lipid peroxidative stress, in patients treated with the chokeberry-flavonoid extract. There was also a significant 29% reduction in the levels of oxidized LDL levels among those treated with the juice. Treatment with chokeberry extract also resulted in a significant 30% reduction in plasma interleukin-6 levels and a significant 23% reduction in plasma CRP. Levels of adiponectin, which protects endothelial cells from damage, was significantly increased among those treated with chokeberry.

In addition, consumption of the chokeberry extract resulted in an 11-mm-Hg decrease in systolic blood pressure and a 7.2-mm-Hg decrease in diastolic pressure. "This decrease emerged after two weeks and was sustained for the duration of the six-week trial," said Naruszewicz. "Of course, when we stopped treatment, blood pressure went back up again."

While he noted that the study was small and of short duration, Naruszewicz said that the data support future larger trials investigating the effects of chokeberry-flavonoid extract for secondary prevention of coronary heart disease.

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