A Plaque Stabilizing Combo with Unique Properties - Life Extension Blog

Dr. Joel Kahn, MD, FACC

After 11 years of university-based education to complete my cardiology training, my career changed significantly only 3 weeks into practice. It was at that time that I learned, along with the rest of the medical world, that even years of atherosclerotic damage had the potential to reverse along with a reduction in medical events, using lifestyle and supplement based programs 1. Since that time I have combined diagnostic and interventional cardiology with a search for natural and supplement-based tools to promote the stabilization or reversal of atherosclerosis in my heart disease reversal clinic.

About two years ago my routine review of the medical literature for agents with promising or proven effects on atherosclerotic reversal identified a combination agent reported to have this efficacy in humans.2

That report was a registry study of the combination of two natural plant extracts with high antioxidant efficacy, Pycnogenol from the bark of French Maritime pine trees and Gotu Kola (Centella asiatica).

In that study, 50 patients with carotid artery plaques with <50% stenosis and high oxidative stress received the combination therapy and were compared to a control group over 3 months’ time using carotid ultrasound assessments. The combination therapy resulted in reduced plaque height and length as well as the number of plaques compared to the control group. An index of plaque stability increased in the treated group. A measure of plasma free radicals improved in the therapy group only.

My use of the combination of these two plant extracts increased greatly after this science was published and it became a routine component of my clinic’s atherosclerosis reversal program that uses carotid intimal-medial thickness (CIMT) assessments to identify and track plaque status.3 Even more recently, additional published data has confirmed the power of these extracts in atherosclerosis.4


In this study, 391 subjects were followed for 4 years. All had carotid or femoral atherosclerosis of 50%-60% range and were treated with Pycnogenol® alone, the combination including Centella, or a control group. All 3 groups received lifestyle education. The rate of progression of ultrasound arterial score was significantly lower in both of the supplement groups in comparison with a significant difference in favor of the combination (P<0.05). There was a reduction in plaque progression measured by maximum plaque thickness and length in the combination group. Just as striking was that the occurrence of anginal events was less than 3% in the two supplement groups in comparison with 6.25% in controls. The occurrence in myocardial infarctions was significantly lower for the combination therapy. Events requiring hospital admission were seen in 16% of controls in comparison with 9% of subjects using Pycnogenol® and only 3% of patients using the combination of plant therapies. Oxidative stress was reduced by the therapies.


The data for the combination of Pycnogenol® with Centella asiatica is not well known but striking and holds out great promise for slowing the progression of arterial plaques and their progression to clinical stages.

The standard paradigm for cardiovascular care I grew up with was to “manage” atherosclerosis but new models of stabilization and reversal of disease states are emerging and offer hope for people suffering from the number one killer in the Western world. As always, an “ounce of prevention is worth a pound of cure” with ongoing efforts to prevent cardiovascular disease remaining of primary importance. However, millions of people have established atherosclerosis and may benefit from new and safe therapies derived from plants. The reported efficacy of the combination of Pycnogenol and Centella asiatica may be from their powerful role in reducing oxidative stress but other pathways may be active. Pycnogenol has been shown to reduce cholesterol and triglyceride levels and lower inflammation through the NF-kB pathway.5 In further studies also in humans, Pycnogenol has been shown to improve endothelial function compared to a placebo agent.6 Centella asiatica has been studied in experimental cultures and was shown to suppress the adhesion of monocytes to endothelial cell layers.7 I routinely observe reversal of plaque measured by CIMT in patients in my clinic and am hopeful more clinicians will offer this therapy routinely.

Dr. Kahn is a Clinical Professor of Medicine at Wayne State University School of Medicine and founder of the Kahn Center for Cardiac Longevity in suburban Detroit. He is a summa cum laude graduate of the University of Michigan School of Medicine. He is author of The Whole Heart Solution, now a national public TV special, and 3 other #1 best selling books on health. He is owner of GreenSpace Cafe in Ferndale, Michigan. He writes regularly about health on many sites. He can be found at www.drjoelkahn.com.


  1. Ornish D et al. Lancet. 1990 Jul;336(8708):129-33.
  2. Luzzi R et al. Minerva Cardioangiol. 2016 Dec;64(6):603-9.
  3. Bots ML et al. Chin Med J. 2016 Jan;129(2):215-26.
  4. Belcaro G et al. Minerva Cardioangiol. 2017 Feb;65(1):24-31.
  5. Luo H et al. Exp Mol Med. 2015 Oct;23(47):e191.
  6. Enseleit F et al. Eur Heart J. 2012 Jul;33(13):1589-97.
  7. Ivanov et al. J Cardiovasc Pharmacol. 2008 Jul;52(1):55-65.


otto9B9otto said...

Might grape seed extract work similar to pycnogenol? Here is a reference: http://www.enduranceresearch.com/oligomeric-procyanidins-opcs-grape-seed-extract-pycnogenol

Life Extension said...

otto9B9otto - Grapeseed has been shown to help maintain healthy platelet function and other aspects of platelet responses, and protects the central nervous system from reactive oxygen species. Here are the studies: https://www.ncbi.nlm.nih.gov/pubmed/16160595 & https://www.ncbi.nlm.nih.gov/pubmed/?term=IntJ+Dev+Neurosci.+2005+Oct%3B23(6)%3A501-7.

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