The potential of natural hydroxytyrosol (HT) for cardiovascular management can come from different mechanisms

Apart from the reduction of LDL cholesterol oxidation, already discussed in a previous article, there are some other mechanisms that may explain the anti-atherogenic action of olive phenolic compounds. Two additional mechanisms involved in the vascular damage, platelet aggregation (and improvement of blood flow) and proliferation of smooth muscle cells, are also antagonized by olive phenolic compounds.

The endothelium is currently recognized as a dynamic organ with important autocrine and paracrine functions, which allow it to maintain vascular homeostasis through multiple and complex interactions between endothelial cells and the vessel lumen. The main homeostatic functions of the endothelium involve: a) the regulation of vascular tone through a balanced production of vasodilator and vasoconstrictor factors; b) maintaining the fluidity and coagulation of the blood by producing factors that regulate platelet activity, the coagulation cascade and the fibrinolytic system; and c) the production of cytokines and adhesion molecules that regulate vascular inflammatory function (Badimon L, et al.; Disfunción endotelial. Rev Esp Cardiol. 2006)

Endothelial function is a key factor in preserving vascular health, which also serves as a clinical marker for predicting the development and/or result of undesirable disorders.

The endothelial dysfunction is currently considered one of the first manifestations of vascular disease, mainly based on the concept of an imbalance in the bioavailability of active substances of endothelial origin, predisposing to inflammation, vasoconstriction, and increased vascular permeability, facilitating platelet aggregation, thrombosis and arteriosclerosis, representing a key early step in the development of atherosclerosis, participating in the progression of plaque and the appearance of atherosclerotic complications. In 2014, Carolina Emilia Storniolo et al. (Redox Biol.) suggested a protective effect of olive oil polyphenols on endothelial dysfunction induced by hyperglycemia and free fatty acids.

Other study (“Protective effect of hydroxytyrosol and its predominant plasmatic human metabolites against endothelial dysfunction in human aortic endothelial cells; Molecular Nutrition & Food Research; 2015; Ursula Catalán et al.) showed that the inhibition of the endothelial dysfunction could be partly due to the HT and its metabolites. Results indicated that in the case of adhesion molecules (VCAM-1, ICAM-1, E-selectin and P-selectin) the attenuation effect of the metabolite mixtures could be due to a large extent to the residual HT.

Erika Terzuoli et al. (“Targeting endothelial-to-mesenchymal transition: the protective role of hydroxytyrosol sulfate metabolite” European Journal of Nutrition; 2018) indicated that their results provided biological evidences of the protective effects of the HT metabolite on endothelium against an inflammatory stimulus, suggesting that consumption of an appropriate diet with EVOO could be useful to prevent endothelial dysfunction.

Oral supplementation with hydroxytyrosol in middle-aged healthy adults exerted anti-atherosclerotic effects by improving endothelial function (Quirós-Fernández, R. et al. “Supplementation with Hydroxytyrosol and Punicalagin Improves Early Atherosclerosis Markers Involved in the Asymptomatic Phase of Atherosclerosis in the Adult Population: A Randomized, Placebo-Controlled, Crossover Trial”. Nutrients 2019).

Overall, evidence shows that virgin olive oil phenols may improve endothelial function in large, medium and small size vessels, indicating the involvement of various mechanisms, including a higher NO bioavailability, upregulation of antioxidant pathways and a decrease in pro-oxidant substances production (“The Fluid Aspect of the Mediterranean Diet in the Prevention and Management of Cardiovascular Disease and Diabetes: The Role of Polyphenol Content in Moderate Consumption of Wine and Olive Oil” Paola Ditano-Vázquez et al.; Nutrients 2019).

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