Your heart is a strong muscle that pumps blood to your body. A normal, healthy adult heart is about the size of your clenched fist. Just like an engine makes a car go, the heart keeps your body running. The heart has two sides, each with a top chamber (atrium) and a bottom chamber (ventricle). The right side pumps blood to the lungs to pick up oxygen. The left side receives blood rich with oxygen from the lungs and pumps it through arteries throughout the body. An electrical system in the heart controls the heart rate (heartbeat or pulse) and coordinates the contraction of the heart's top and bottom chambers.

How Your Heart Changes with Age

People age 65 and older are much more likely than younger people to suffer a heart attack, to have a stroke, or to develop coronary heart disease (commonly called heart disease) and heart failure. Heart disease is also a major cause of disability, limiting the activity and eroding the quality of life of millions of older people.

Aging can cause changes in the heart and blood vessels. For example, as you get older, your heart can't beat as fast during physical activity or times of stress as it did when you were younger. However, the number of heartbeats per minute (heart rate) at rest does not change significantly with normal aging.

Changes that happen with age may increase a person's risk of heart disease. A major cause of heart disease is the buildup of fatty deposits in the walls of arteries over many years. The good news is there are things you can do to delay, lower, or possibly avoid or reverse your risk.

The most common aging change is increased stiffness of the large arteries, called arteriosclerosis (ahr-teer-ee-o-skluh-roh-sis), or hardening of the arteries. This causes high blood pressure, or hypertension, which becomes more common as we age.

High blood pressure and other risk factors, including advancing age, increase the risk of developing atherosclerosis (ath-uh-roh-skluh-roh-sis). Because there are several modifiable risk factors for atherosclerosis, it is not necessarily a normal part of aging. Plaque builds up inside the walls of your arteries and, over time, hardens and narrows your arteries, which limits the flow of oxygen-rich blood to your organs and other parts of your body. Oxygen and blood nutrients are supplied to the heart muscle through the coronary arteries. Heart disease develops when plaque builds up in the coronary arteries, reducing blood flow to your heart muscle. Over time, the heart muscle can become weakened and/or damaged, resulting in heart failure. Heart damage can be caused by heart attacks, long-standing hypertension and diabetes, and chronic heavy alcohol use.

1. The blood vessels in your heart are the most likely to clog. The reasons are blood flows in two directions in many arteries, creating turbulence that can damage artery walls-which makes it easier for plaque to set in. And coronary arteries have lots of branches and bend, which are prime real estate for atherosclerosis. 

2. Nearly half of all heart attacks have no symptoms, according to a 2016 Wake Forest University study. No-symptom attacks were more common in men but deadlier in women. 

3. The best food for your heart? It might be bananas. In a 2020 analysis of studies involving more than 4 million people, banana consumption showed a 24 percent lower risk for coronary heart disease. But all produce helps; people who munched the most fruit and vegetables had 11 percent less cardiovascular disease than those who ate the least. 

4. Spare parts for your heart may come from outer space. In 2020, NASA blasted cardiac stem cells into space for an Emory University research project. The focus was to see if they would become beating heart-muscle cells faster in zero-gravity conditions. The stem cells became heart cells in just three weeks. Researchers hope to use them for heart failure repairs, a therapy that could require up to 150 million cells per treatment. 

5. Grab a racket. A study that tracked 80,306 adults for nine years found that tennis and badminton cut the risk for fatal cardiovascular disease by 59 percent. Swimming and aerobics lowered the odds by 41 and 36 percent, respectively. Distance running was less effective; some research suggests it could have a negative impact.

Zinc can improve cardiovascular health and blood flow. Studies indicate that zinc deficiency is associated with an increased risk of cardiovascular diseases, and zinc supplementation may help reduce this risk. Zinc plays a role in regulating blood pressure by affecting blood vessel relaxation and potentially increasing blood flow. 

Here's a more detailed explanation:

Impact on Blood Pressure:

• Zinc helps regulate blood pressure by influencing the relaxation of blood vessels.

• It does this by reducing calcium levels in the smooth muscle cells of blood vessels, which allows the vessels to relax and widen, thus lowering blood pressure. 

• This relaxation effect can lead to increased blood flow. 

• Zinc's effect on blood pressure is achieved through its coordinated action in sensory nerves, endothelial cells, and smooth muscle cells within the blood vessel walls. 

Impact on Atherosclerosis:

• Zinc deficiency is linked to the development of atherosclerosis, a condition where plaque builds up in the arteries. 

• Zinc supplementation may help reduce the risk of atherosclerosis. 

• Zinc can also contribute to a healthy lipid profile, potentially lowering triglycerides and total cholesterol. 

Impact on Blood Clotting:

• Zinc is involved in blood clotting, and imbalances in zinc levels can contribute to the formation of unwanted blood clots.

• Zinc is released from platelets (cells involved in blood clotting), and disruptions in this process can lead to clot formation. 

Zinc's Role in Cardiac Function:

• Zinc is essential for maintaining the normal structure and function of cells, including those in the cardiovascular system. 

• It plays a role in redox signaling pathways, which are crucial in the context of ischemia and myocardial infarction. 

• Zinc supplementation has been shown to improve cardiac function and potentially prevent further damage in cases of myocardial infarction. 

• Zinc deficiency may contribute to heart failure, and supplementation can potentially improve cardiac function in some cases. 

Other Benefits:

• Zinc supplementation may help reduce the risk of developing type 2 diabetes and coronary artery disease.

• Zinc is involved in wound healing and can support cardiac stem cell survival. 

Important Considerations:

• While zinc is essential, excessive zinc intake can be harmful. 

• It's crucial to maintain a balanced diet and consult with a healthcare professional about the appropriate use of zinc supplementation. 

• Further research is ongoing to fully understand the complex relationship between zinc and cardiovascular health fully. 

An International research team uncovers zincs underappreciated metal’s role in lowering blood pressure.

High blood pressure, or hypertension, is the leading modifiable risk factor for cardiovascular diseases and premature death worldwide. And key to treating patients with conditions ranging from chest pain to stroke is understanding the intricacies of how the cells around arteries and other blood vessels work to control blood pressure. While the importance of metals like potassium and calcium in this process are known, a new discovery about a critical and underappreciated role of another metal — zinc — offers a potential new pathway for therapies to treat hypertension.

All the body’s functions depend on arteries channeling oxygen-rich blood — energy — to where it’s needed, and smooth muscle cells within these vessels direct how fast or slow the blood gets to each destination. As smooth muscles contract, they narrow the artery and increase the blood pressure, and as the muscle relaxes, the artery expands and blood pressure falls. If the blood pressure is too low the blood flow will not be enough to sustain a person’s body with oxygen and nutrients. If the blood pressure is too high, the blood vessels risk being damaged or even ruptured.

“Fundamental discoveries going back more than 60 years have established that the levels of the calcium and potassium in the muscle surrounding blood vessels control how they expand and contract,” say lead author Ashenafi Betrie, Ph.D., and senior authors Scott Ayton, Ph.D., and Christine Wright, Ph.D., of the Florey Institute of Neuroscience and Mental Health and The University of Melbourne in Australia.

Specifically, the researchers explain, potassium regulates calcium in the muscle, and calcium is known to be responsible for causing the narrowing of the arteries and veins that elevate blood pressure and restrict blood flow. Other cells that surround the blood vessel, including endothelial cells and sensory nerves, also regulate the calcium and potassium within the muscle of the artery, and are themselves regulated by the levels of these metals contained within them.

In collaboration with researchers at the University of Vermont’s Larner College of Medicine in the United States and TEDA International Cardiovascular Hospital in China, the investigators learned that coordinated action by zinc within sensory nerves, endothelial cells and the muscle of arteries triggers lower calcium levels in the muscle of the blood vessel. This makes the vessel relax, decreasing blood pressure and increasing blood flow. The scientists found that blood vessels in the brain and the heart were more sensitive to zinc than blood vessels in other areas of the body — an observation that warrants further research.

Another surprising fact is that genes that control zinc levels within cells are known to be associated with cardiovascular diseases including hypertension, and hypertension is also a known side effect of zinc deficiency. This new research provides explanations for these previously known associations.

“While there are a range of existing drugs that are available to lower blood pressure, many people develop resistance to them,” says Wright, who added that a number of cardiovascular diseases, including pulmonary hypertension, are poorly treated by currently available therapies. “New zinc-based blood pressure drugs would be a huge outcome for an accidental discovery, reminding us that in research, it isn’t just about looking for something specific, but also about just looking.”

Reference:

“Zinc drives vasorelaxation by acting in sensory nerves, endothelium and smooth muscle” by Ashenafi H. Betrie, James A. Brock, Osama F. Harraz, Ashley I. Bush, Guo-Wei He, Mark T. Nelson, James A. Angus, Christine E. Wright and Scott Ayton, 1 June 2021, Nature Communications.

DOI: 10.1038/s41467-021-23198-6

An arrhythmia is a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slowly, or with an irregular rhythm. When a heart beats too fast, the condition is called tachycardia. When a heart beats too slowly, the condition is called bradycardia.

Arrhythmia is caused by changes in heart tissue and activity or in the electrical signals that control your heartbeat. These changes can be caused by damage from disease, injury, or genetics. Often there are no symptoms, but some people feel an irregular heartbeat. You may feel faint or dizzy or have difficulty breathing.

The most common test used to diagnose an arrhythmia is an electrocardiogram (EKG or ECG). Your doctor will run other tests as needed. She or he may recommend medicines, placement of a device that can correct an irregular heartbeat, or surgery to repair nerves that are overstimulating the heart. If arrhythmia is left untreated, the heart may not be able to pump enough blood to the body. This can damage the heart, the brain, or other organs.

Explore this Health Topic to learn more about arrhythmia, our role in research and clinical trials to improve health, and where to find more information.

Taurine 

Taurine along with magnesium and potassium have been described as “the essential trio” for treating nutritional deficiencies relating to A-Fib. Taurine is a sulfur-containing amino acid and is the most important and abundant amino acid in the heart. It regulates membrane excitability, scavenges free radicals, protects potassium levels inside the heart, and dampens activity in the sympathetic nervous system. Taurine regulates cellular calcium, improves heart muscle contraction, and also prevents the heart from becoming overly irritable, which can lead to heart rhythm problems.

A Word on Atrial Fibrillation

Minimal research has been performed to determine if chocolate is tied to a decreased risk of atrial fibrillation, which takes place when the heart's upper chamber beats irregularly. Just under three million individuals in the United States have atrial fibrillation. Its presence heightens the risk of blood clots and subsequent heart failure, strokes, and other complications.

Indulging in a small amount of chocolate each week may lower the risk for a serious and fairly common irregular heart rhythm. This finding stems from a new study conducted in Denmark. The study's findings were recently published in the journal Heart.

The Results

Those who consumed chocolate between one and three times per month were around 10% less likely to endure atrial fibrillation compared to those who consumed chocolate less than once per month. It is becoming increasingly clear that the moderate intake of chocolate is a component of a healthy diet. However, the study cannot determine that chocolate was completely responsible for preventing atrial fibrillation.

Why Chocolate Improves Human Heart Health

Consuming cocoa and foods containing cocoa might boost heart health due to the considerable number of flavanols. These are compounds that scientists believe have anti-oxidant, blood vessel-relaxing and anti-inflammatory properties. Prior studies have determined the consumption of chocolate is linked to improved measures of heart health and a reduced risk for specific conditions such as heart failure and heart attacks. Dark chocolate is especially helpful as it is chock-full of flavanols.

New Analysis

The above-referenced study involved data collected from more than 55,500 individuals in Denmark. These individuals were between 50 and 64 years of age when the study began. They provided information about their food consumption between 1993 and 1997. The research team then tied the diet data to Denmark's national health registries to determine which individuals were diagnosed with atrial fibrillation. Around 3,346 atrial fibrillation cases occurred across an average of 13.5 years.

Those who ate a single serving (one ounce) of chocolate each week were 17% less likely to endure atrial fibrillation by the study's end compared to those who consumed chocolate less than once per month. Those who consumed between two and six ounces each week were 20% less likely to endure atrial fibrillation. Those who consumed more than one ounce of chocolate per day were 16% less likely to have atrial fibrillation.

It is interesting to note that the largest risk reduction for women was linked to consuming a single serving of chocolate per week. The biggest reduction for men occurred when consuming two to six servings each week.

Caveats

The consumption of chocolate alone is not enough to improve heart health. Chocolate consumption must be combined with physical activity and a healthy diet. It is also important to avoid smoking. It is likely that a double-blind, completely randomized and controlled trial will occur in the future to determine the true efficacy of chocolate consumption to ward off atrial fibrillation. This trial would likely make use of quantified amounts of cocoa.

It is also important to note that the research team could not account for unmeasured variables such as sleep apnea or kidney disease that might affect the risk for atrial fibrillation. Furthermore, the research team did not have data on the type of chocolate the study participants consumed. Nor did the research team have information about the amount of flavanols in the chocolate consumed by study participants. It is also quite likely that dietary intake was altered across the 14 years in which data collection occurred.

If you’ve ever experienced swelling, skin color changes or even throbbing pain in your extremities, you may be experiencing poor blood circulation. Typically felt in your arms, hands, legs and feet, poor blood circulation can be a sign of something more serious going on with your body.

Having poor circulation can lead to complications ranging from varicose veins and blood clots to wounds — or even amputation. While it’s important to seek help from a healthcare provider, there are also things you can do yourself to help improve blood circulation.

For more information on how to do this, we spoke with vascular medicine specialist Deborah Hornacek, MD.

Why circulation is so important

According to Dr. Hornacek, one of the biggest reasons circulation is so important is that it helps maintain quality of life. “The pain you have walking that can be caused by poor circulation can be debilitating and have an impact on your daily life,” states Dr. Hornacek.

She notes that some assessments have found that people with significant or severe peripheral artery disease (PAD), a condition in which buildup in the arteries impacts circulation, rate their quality of life lower than people with heart failure.

Another condition that Dr. Hornacek says affects circulation is chronic venous insufficiency (CVI). This occurs when the valves inside the veins in your legs don’t work as efficiently as they should. In these cases, your blood has difficulty getting back to your heart and pools in these veins as a result.

Many people who have CVI don’t have the obvious varicose veins that indicate a problem, adds Dr. Hornacek.

Some of the most unpleasant symptoms associated with poor circulation include:

• Feelings of pain or weakness in muscles; leg heaviness.

• Prickling, or feeling like “pins and needles,” on your skin.

• Skin that appears pale or even blue or is abnormally red and inflamed.

• Generalized leg swelling or painful swollen veins.

• Numbness.

But Dr. Hornacek says, even if you’re experiencing PAD or CVI, there are things you can do that can be beneficial to getting your blood flowing again.

Tips to improve circulation

Exercise

Exercise can be hugely beneficial for people with poor circulation. Even with limitations from the COVID-19 pandemic (like visiting a gym) or dealing with pain issues (like a bad back or bad knees), it doesn’t take a lot to get things rolling.

“When we make this recommendation, we’re not talking about going out and training for a marathon,” clarifies Dr. Hornacek. “You can start small and still get benefits from the exercise.”

Exercise and conditioning even from low-impact workouts like walking or pool therapy improve the vascular system in your legs. “When your arteries sense exercise, they increase the release of nitric oxide which relaxes blood vessels and improves blood flow,” she adds.  

Supervised exercise therapy (SET) can help many people with PAD lessen leg pain and improve their walking distance. (The Centers for Medicare and Medicaid Services approved coverage of SET effective in 2018 given studies showing positive outcomes.)

Conditioning muscles is also an important element in improving circulation, says Dr. Hornacek: “Our veins are reliant on muscle compression to push blood flow back up the veins, particularly in your legs and calf muscles.” 

And for people who’ve been advised to use compression socks to help treat venous problems, they can wear them while exercising.

Change up your diet

Changes to your diet are also essential in improving your circulation. It’s particularly helpful in combination with exercise as that can help you keep off excess weight.

“Carrying extra weight takes a toll on the legs,” explains Dr. Hornacek. “It increases the resistance against which veins have to carry blood through the body, and the veins already have to work against gravity. It also contributes to more elevated pressures in the veins and more swelling.” 

Cutting back on red meat and full-fat dairy items can help treat or prevent atherosclerosis, which causes PAD. “You can talk with your doctor and individualize those items to meet your needs,” she adds.

But there are a few specific things to also change or try with your diet

Consume less salt

The number one factor when looking to improve circulation is to cut back on salt. High levels of salt in your diet can cause fluid retention, which then increases your blood pressure and swelling.

Try the Mediterranean diet

The heart-healthy Mediterranean diet has huge benefits, including lowering the risk of heart attack or stroke. “A diet with low carbs, lean proteins, whole grains, and plenty of vegetables is recommended, as is avoiding saturated fats,” Dr. Hornacek says. 

Keep your legs elevated

Keeping your legs elevated is a good rule for improving blood flow, especially for those with chronic venous insufficiency. Some people are confused by the need to exercise and then elevate their legs, Dr. Hornacek notes, but it’s not as complicated as you might think.

“You should still exercise, but during those times when you’re immobile, find something to prop your legs on,” she explains.

As for how high to elevate your legs, Dr. Hornacek offers this advice: “If you can at least get them higher than hip level, that helps because you create an incline, and gravity works in your favor in helping that blood move. Higher than heart level is ideal but that’s not practical for everyone due to other underlying medical conditions so above hip level is a good compromise.”

Cut out smoking

This is a bit of a no-brainer, but Dr. Hornacek emphasizes the need to cut out smoking. “Nicotine causes tightening of the vessels which restricts blood flow.” It’s also connected to inflammation and long-term damage to the arterial wall.

And as for e-cigarettes, Dr. Hornacek says those should also be avoided. “Even small exposures to nicotine have negative effects. We know that patients who vape still have worse outcomes on exercise performances.”

The bottom line? Whether it’s cigarettes, vaping or e-cigarettes, just cut them out entirely. If you’re not sure how to quit, your healthcare provider can offer guidance.

Wear diabetic or compression socks

This one is a question for your healthcare provider, according to Dr. Hornacek. “Someone might hear that one of these options might help them, but may be confused about how they work.”

Diabetic socks are softer and looser, with the goal of avoiding skin injury, especially for people with neuropathy. Compression socks have an elastic element and gently squeeze your leg to help prevent swelling and venous pooling.

There can be some trial and error when trying to find the best fit for compression socks, notes Dr. Hornacek. Some may find it helpful to work with a specialist experienced in fitting and selecting garments to serve their needs.

Consulting your provider is essential for figuring out which type of sock is right for you.

Take medication

Whether or not these natural efforts are helpful, you should also consult your healthcare provider about medications to aid your circulation. They’ll typically prescribe medications designed to relieve any restrictions on blood flow, including:

• Statins to prevent plaque build-up in your arteries.

• Antiplatelet drugs (such as aspirin or clopidogrel) or blood thinners (such as warfarin, apixaban or rivaroxaban).

• Vasodilator drug called cilostazol, which can help with walking-related pain for people with PAD.

• Medication to lower blood pressure.

• Medication to help control blood sugars if you have diabetes or pre-diabetes.

For some cases, your healthcare provider may also recommend surgery to open blocked arteries, remove blood clots or treat varicose veins.

Let’s talk about diets that are good for a healthy heart. A heart-healthy diet is important for managing blood pressure and reducing your risk of heart attack, stroke and other health risks.

We all know that certain foods are better for your heart than others. Salmon and other fatty fish such as sardines are heart-healthy superstars. They contain omega-3 fatty acids shown in studies to lower the risk of arrhythmia (irregular heartbeat) and atherosclerosis (plaque build-up in the arteries) as well as decrease triglycerides. The American Heart Association recommends to eat fish at least twice a week.

Oatmeal is another common food associated with a healthy heart. Oatmeal is high in soluble fiber which can lower cholesterol. 

Avocados and olive oil are both rich in monounsaturated fats that may lower heart disease risk factors. 

Potatoes and tomatoes are high in heart-healthy potassium and are also a good source of the antioxidant lycopene. 

Blueberries and strawberries are also examples of foods that promote heart health. According to a study in 2013, women aged 25 through 42 who ate more than three servings of blueberries and strawberries a week had a 32% lower risk of heart attack compared with those who ate less. Berries are high-flavonoids foods which boost heart health and decrease blood pressure.

Then there’s green tea – a study found that people who drank four or more cups of green tea daily had a 20% reduced risk of cardiovascular disease and stroke compared with people who "seldom" imbibed the beverage. 

My personal favorites for heart health? Chocolate and red wine! Dark chocolate (not milk chocolate, but chocolate with 60-70% cocoa) contains flavonoids called polyphenols, which may help blood pressure, clotting and inflammation. And even medical professionals now claim that a glass of red (not white) wine a day can keep the doctor away.

In addition to these foods that are deemed heart-healthy, certain diet plans are also considered very good for heart-health. The following six are highly regarded and were included in a recent U.S. News & World Report in which a panel of health professionals identified the best diets for heart health.

Lycopene

Lycopene is an antioxidant in the carotenoid family.

Antioxidants protect your body from damage caused by compounds known as free radicals.

When free radical levels outnumber antioxidant levels, they can create oxidative stress in your body. This stress is linked to certain chronic diseases, such as cancer, diabetes, heart disease and Alzheimer’s (Source).

Lycopene may also help lower your risk of developing or prematurely dying from heart disease (Source).

That’s in part because it may reduce heart disease risk factors. More specifically, it may reduce free-radical damage, total and “bad” LDL cholesterol levels and increase “good” HDL cholesterol (Trusted Source)

High blood levels of lycopene may also add years to the lives of people with metabolic syndrome — a combination of health conditions that can lead to heart disease.

Over a 10-year period, researchers noted that individuals with metabolic disease who had the highest blood lycopene levels had up to a 39% lower risk of dying prematurely (Source).

In another 10-year study, diets rich in this nutrient were linked to a 17–26% lower risk of heart disease. A recent review further associates high blood levels of lycopene with a 31% lower risk of stroke (Source)

Lycopene’s protective effects appear particularly beneficial to those with low blood antioxidant levels or high levels of oxidative stress. This includes older adults and people who smoke or have diabetes or heart disease (Trusted Source).

Research shows that lycopene’s antioxidant properties can help keep free radical levels in balance, protecting your body against some of these conditions (Source).

In addition, test-tube and animal studies show that lycopene may protect your body against damage caused by pesticides, herbicides, monosodium glutamate (MSG) and certain types of fungi 

Lycopene is considered an effective singlet oxygen quencher in the carotenoids group (Kong et al., 2010; Viuda-Martos et al., 2014). It is a much more potent antioxidant than alpha-tocopherol (10 × more potent) or beta-carotene (twice as potent) (Kim et al., 2010; Kong et al., 2010). Lycopene modulates also the production of antioxidant enzymes, such as superoxide dismutase and catalase (Böhm, 2012; Pereira et al., 2017). Lycopene can also scavenge peroxynitrite, resulting oxidized lycopene products (Pisoschi and Pop, 2015).

Oxidative stress causes endothelial dysfunction due to uncoupling of the nitric oxide synthase and oxidative injury of the endothelial cells (Mozos and Luca, 2017). Both are associated with inflammation. By reducing oxidative stress and reactive oxygen species, lycopene increases the bioavailability of nitric oxide (NO), improves endothelium-dependent vasodilation and reduces protein, lipids, DNA, and mitochondrial damage (Hollman et al., 2011; Naz et al., 2014; Nakamura et al., 2017; Abdel-Daim et al., 2018).

Endothelial NO enables vasodilation, inhibits platelet functions, and adhesion and transmigration of white blood cells, and reduces smooth muscle cell proliferation (Opatrilova et al., 2017). Watermelon supplementation, due to L-citrulline content, increases plasma L-arginine, enabling NO production (Figueroa et al., 2017), because NO is synthesized from L-arginine by NO synthase in virtually all cell types (Jobgen et al., 2006). Lycopene supplementation improved endothelial mediated vasodilation in cardiovascular disease patients, but not in healthy controls (Gajendragadkar et al., 2014), suggesting the importance of lycopene in secondary cardiovascular prevention (Costa-Rodrigues et al., 2018).

In summary, lycopene scavenges both reactive oxygen and nitrogen species, increases the production of antioxidant enzymes and protects the endothelial cells from oxidative damage.

Anti-inflammatory effect

Inflammation is related to atherosclerosis, arterial stiffness, and major cardiovascular events. The anti-inflammatory role of lycopene was demonstrated by several studies (Hung et al., 2008; Kim et al., 2010; Xu et al., 2012; He et al., 2016). Hung et al. revealed that lycopene can inhibit TNF-alpha induced NF-kappa B activation, expression of intracellular adhesion molecule-1 (ICAM-1), and interaction between monocytes and endothelial cells, which might explain the cardiovascular benefits of lycopene (Hung et al., 2008). In a different study with Korean women, lycopene levels were found to correlate with cytokines, but no correlation with acute phase reactants was found, probably due to lycopene's inhibitory effect on the formation of oxidized LDL (Kim et al., 2010). Xu et al. found an inverse association of lycopene with vascular cell adhesion protein 1 (VCAM-1), which enable adhesion of monocytes to the endothelial cells, but could not verify any association between serum lycopene concentration and atherosclerosis in their study as suggested by earlier studies (Xu et al., 2012). In the same context, Gianetti et al. reported no significant correlations between plasma lycopene and soluble adhesion molecules (Gianetti et al., 2002). Lycopene obtained from red guava exerts several anti-inflammatory effects besides modulation of inflammatory mediators, such as inhibition of leukocyte mobilization, stabilization of mast cells, and inhibition of genes which expression is involved in inflammation (Vasconcelos et al., 2017).

Lycopene can also reduce the secretion of metalloproteinases by macrophages and inhibit T lymphocyte activation (Thies et al., 2017). Recently, lycopene was found as an effective antiglycation agent, able to reduce the synthesis of advanced glycation end-products (AGE), downregulating the expression of their receptors (RAGE), which further contributes to vessel protection (Tabrez et al., 2015; Thies et al., 2017).

Tomato products reduced oxidative stress related to postprandial lipemia and the associated inflammatory reaction in a study including normal weight participants (Burton-Freeman et al., 2012). He et al. reported the benefits of lycopene in preventing transplant vasculopathy, demonstrating that intimal hyperplasia and smooth muscle cell proliferation were reduced by the administration of lycopene and the infiltration of inflammatory cells in allograft vessels was reduced in an animal model (He et al., 2016). Lycopene can ameliorate allograft atherosclerosis via downregulating Rho-associated kinases and regulating the expression of key factors through NO/cGMP pathways (He et al., 2016). On the other hand, the benefits of the tomato-rich diet were not directly related to the anti-inflammatory effect according to a randomized study including 103 apparently healthy volunteers, after 300 g tomatoes daily for 1 month or placebo (Blum et al., 2007).

Watermelon was shown to reduce levels of inflammation by downregulation of the proinflammatory mediator cyclooxygenase 2 (COX-2), impairing prostaglandin E2 and I2 production, which reduces the progression of cardiovascular disorders (Sellers et al., 2010; Hong et al., 2015). Watermelon powder supplementation exerts an anti-inflammatory effect similar to COX-2 inhibitors or conventional non-steroidal anti-inflammatory drugs (Hong et al., 2015).

High mobility group box 1 (HMGB1), a non-histone DNA binding protein, produced by necrotic and immune cells, exposed to pro-inflammatory signals, has an important pro-inflammatory effect by attracting and activating inflammatory cells and mediators and binding to RAGE and toll-like receptors, related to fatal outcomes (Lee et al., 2012). Lee et al. demonstrated that lycopene inhibits adhesion molecules expression, which impair HMGB1—induced monocyte adhesion and transmigration (Lee et al., 2012). Lycopene has been also shown to inhibit lipopolysaccharide-induced HMGB1 release and HMGB1-mediated secretion of TNF-alpha and secretory phospholipase A2 (Lee et al., 2012).

Oxysterols, the result of cholesterol auto-oxidation, accumulate in the subendothelial arterial layer, exerting oxidative and pro-inflammatory roles and favoring the atherosclerotic process (Palozza et al., 2011). Lycopene impairs oxysterol-induced pro-inflammatory cytokines production in human macrophages and oxysterol-induced ROS production, limiting the formation of atherosclerotic plaque (Palozza et al., 2011).

Lycopene exerts a cardioprotective effect against atrazine induced cardiac injury due to its anti-inflammatory effect, by blocking the NF-kappa B pathway and NO production (Li et al., 2017).

Considering the mentioned anti-inflammatory mechanisms (Figure ​

(Figure3),

3), including decrease of adhesion molecules, pro-inflammatory cytokines, inhibition of leukocyte migration and genes involved in inflammation, impaired monocyte-endothelium interaction, T lymphocytes activation and synthesis of AGE and RAGE and downregulation of cyclooxygenase 2, lycopene can be useful in the therapy for vascular inflammatory disorders.