Cardiovascular disease (heart disease) is the leading cause of death in the United States. The main way it develops is through a process called atherosclerosis, where deposition of abnormal fatty substances occurs resulting in inflammation of the lining of the arteries (called the endothelial lining), hardening of the arteries (arteriosclerosis), and subsequent blockage of the arteries. This process accounts for one-third of all-cause mortality in people over the age of 35.

The best way to not develop this condition is to practice preventive medicine; i.e. prevent the process from occurring. This entails lifestyle modifications of maintaining a normal weight, losing weight if you’re overweight, exercise, and eating right. A Mediterranean type diet has been shown to be one of the best diets for this.

Conventional medicine also attempts to lower cholesterol levels and statin drugs have been used extensively for this. Figuratively we want to “sweep” your arteries of the bad fatty substances. However, we need cholesterol for many other processes of our body. The brain needs cholesterol to think and maintain its health. Many hormones are made from cholesterol. Every cell in our body needs cholesterol to make the cell wall that keeps the cells intact.

There are many types of fatty substances, called lipids, in your body. We now know that all cholesterol and lipids are bad; in fact the good ones are very good. We just need to know which ones to sweep away and which ones to keep. Think of your lipids as particles floating in your blood, some are big and some small. The large “fluffy” particles are the good guys, since they just float along the arteries and don’t get “stuck” on the walls of the arteries.

Atherosclerosis occurs because the small lipid particles get stuck in “cracks” in you endothelial walls which creates an inflammatory response within those walls. As more lipids accumulate, more inflammation and a widening of the inflamed area, called a plaque, occurs. When the inflammation gets so severe, the plaque ruptures and clogs the whole artery resulting in blockage and a myocardial infarction due to the lack of oxygen to that part of the heart.

Thus, to decrease this process, we need to make sure we have very few of the small particles while leaving the large “fluffy” particles intact. Conventional thought is that the good cholesterol is HDL and the bad is LDL, and it is a good rule of thumb to have higher HDL and low LDL. However, the story doesn’t stop here. It so happens that each of these lipid factions can come in small particles, which are also termed pro-inflammatory and large particles which are anti-inflammatory.

There are several ways to do convert your small particles into larger particles. Unfortunately, statin drugs don’t do this.[1] One compound that has been shown to do this is an extract from a fruit grown only in Calabria, Italy called Bergamot. When on concentrates the active ingredient from this fruit, called polyphenols, it can help reduce your cholesterol partly by changing the particle size to more the fluffy large particles.[2]

If your cholesterol is very high, then you should indeed lower it to manageable levels with low dose statins. Even better is the combination of low dose statins and Bergamot,[3] for you get the lower cholesterol levels while changing the particle size to the bigger less inflammatory size. Studies have indeed shown this benefit using this combination.[4]

Bergamot has also been shown to maintain the health of the lining of your arteries, called the endothelial.[5] If you keep this lining “swept” clean, your blood flows through your arteries better and more efficiently so your tissues get “bathed” in more blood. This would result in delivering more nutrients and oxygen to your tissues so they function better.

Patients with Metabolic Syndrome are also helped with Bergamot. Obesity, high lipids (triglycerides), insulin resistance and hypertension are hallmarks of this condition. Due to the excess fat, fatty substances deposit in the liver and can result in fatty liver disease, which can result in destruction of your liver. In fact, fatty liver is now the primary reason for liver transplants today. Bergamot has been shown to be helpful in decreasing the fatty liver seen in these patients.[6]

It is therefore recommended that Bergamot should be used in the following conditions:[7]

  • All patients over the age of 50 to maintain normal arterial function and flexibility.
  • All patients with metabolic syndrome.
  • All patients on statin therapy in order to achieve the same lipid values at a lower statin dose.
  • All patients who are statin intolerant as an alternative to maintaining healthy LDL and HDL subfractions.
  • All patients at low risk for vascular disease who have lipid abnormalities.

An added benefit of Bergamot polyphenols is they protect the skin from UV light-induced photo-aging by decreasing inflammation in the skin. They also improve telomere length, telomerase activity, and improve cell viability in skin cells.[8] The result is healthier skin, and who wouldn’t want that?

In conclusion, Bergamot may be one of the most important natural substances for the prevention and management of cardiovascular disease that has been available over the past 50 years.


[1] Gliozzi, M, et al. “The effect of bergamot-derived polyphenolic fraction on LDL, small dense particles and non-alcoholic fatty liver disease in patients with metabolic syndrome”, Biological Chemistry, 2014; 129-137.

[2] Ibid

[3] Gliozzi, M, et al. “Bergamot polyphenolic fraction enhances rosuvastatin-induced effect on LDL-cholesterol, LOX-1 expression and protein kinase B phosphorylation in patients with hyperlipidemia” Intern J of Cardiology; 170, 2013;140-145.

[4] Molace, V. et al, “Hypolipemic and hypoglycaemic activity of bergamot polyphenols: From animal models to human studies”, Fitoterapia, 82;2011:309-316.

[5] Ibid

[6] Gliozzi, M, et al. “The effect of bergamot-derived polyphenolic fraction on LDL, small dense particles and non-alcoholic fatty liver disease in patients with metabolic syndrome”, Biological Chemistry, 2014; 129-137.

[7] Walker, et al. “Cardiac Health and Polyphenols”. Polyphenols in Human Health and Disease Vol. 2. Chp 84; 1085-1106.

[8] Bonina, F, et al. “Flavonoids as potential protective agents against photooxidative skin damage”, International Journal of Pharmaceutics, vol. 145, no. 1-2; 87-94; 1996.