Angiovitis. The use of the drug Angiovit in pregnancy pathologies

Angiovitis. The use of the drug Angiovit in pregnancy pathologies

An important role in the pathogenesis of pregnancy complications is played by disorders of the hemostatic system, caused by a predisposition to thrombosis (thrombophilia) due to genetic or acquired defects in the anticoagulant and fibrinolytic blood system, as well as the coagulation process itself. The central place in the development of thrombophilia in obstetric pathology is occupied by damage to the vascular wall with the subsequent development of endothelial dysfunction. Many markers of endothelial dysfunction are involved in the formation of thrombogenic potential and thromboresistance of blood vessels. The development of thrombophilia largely depends on an imbalance between pro- and anticoagulant factors. The predominance of procoagulant factors leads to increased thrombus formation, adhesion and aggregation of platelets. The risk group for the development of thromboembolic disorders includes women with genetic forms of thrombophilia, patients whose pregnancy is complicated due to the development of gestosis, arterial hypertension, purulent-septic and infectious diseases, diabetes mellitus, etc. [1]. One of the important factors leading to dysfunction of the vascular endothelium and stimulation of thrombus formation is hyperhomocysteinemia, which causes its negative impact on the course of pregnancy. Free penetration of homocysteine ​​acid and homocysteine ​​through the fetoplacental barrier can lead to the development of secondary autoimmune reactions and cause various complications of pregnancy, leading to such severe consequences for the fetus as anencephaly, spinal canal cleft, etc. It has been shown that hyperhomocysteinemia has an adverse effect on the course of pregnancy. gestosis [2, 3]. In the early stages of pregnancy, hyperhomocysteinemia, contributing to the development of fetoplacental circulatory disorders, may be one of the leading causes of miscarriage. The purpose of our study was to determine the content of homocysteine ​​in blood plasma during recurrent miscarriage and the possibility of correcting hyperhomocysteinemia using the drug "Angiovit" (pharmaceutical), which has proven itself in the treatment of hyperhomocysteinemia observed in myocardial infarction, ischemic cerebral stroke and diabetic angiopathy [4] and has found wide application in practice. As a comparison group, pregnant women with manifestations of late gestosis were examined. Along with the determination of homocysteine ​​in the blood, some other markers of hemostasis disorders in pathological pregnancy (D-dimers, protein C, antithrombin III and von Willebrand factor) were studied.

MATERIALS AND METHODS OF RESEARCH

Quantitative analysis of homocysteine ​​was performed in plasma samples (EDTA) by high-performance liquid chromatography (HPLC) with fluorometric detection (Shimadzu RF-535). Chromatographic separation of homocysteine ​​was carried out on a Reprosil 80 ODS-2 column (100×4 mm, 3 µm, Dr Maish GMBH, Germany). Detection was performed at 385 nm (excitation) and 515 nm (emission) [5]. The activity of antithrombin and protein C was determined on an automatic coagulometer ACL-200 (USA) using reagents (ACL-200 Operator's Manual). The activity of von Willebrand factor was determined by the rate of aggregation of a standard suspension of human platelets under the influence of ristomycin in the presence of plasma from the patient being examined. The measurements were carried out on an AR-2110 aggregometer (Solar, Belarus). Platelet-free pooled donor plasma was used to construct a standard curve [6].

To determine D-dimers, which are specific degradation products during fibrinolysis, a latex agglutination test (kits) was used. The principle of the method is based on the fact that in the presence of fibrin degradation products (D-dimers), agglutination of latex particles coated with monoclonal antibodies to them occurs. The concentration of D-dimers is expressed in μg/ml fibrinogen equivalent; the normal value for plasma is less than 0.5 μg/ml. The range of 0.5–3.0 indicates predominantly low concentrations of D-dimers, while the level of 0.5–3.0 indicates the opposite picture, i.e., characterizes the presence of predominantly high concentrations of D-dimers [7].

Angiovit was prescribed 1 tablet 2 times a day for three weeks, regardless of food intake, to all patients with miscarriage and gestosis, whose homocysteine ​​levels exceeded the physiological norms for pregnant women: 6 µmol/l in the first trimester, 4 µmol/l - in the second trimester and 3 µmol/l in the third trimester. For patients whose plasma homocysteine ​​level exceeded 10 µmol/l, the drug was prescribed 2 tablets 2 times a day until the homocysteine ​​level decreased to physiological values ​​corresponding to pregnancy.

After completing the course of taking Angiovit, a control examination of all patients was carried out, which included, in addition to clinical observation carried out throughout the entire period of treatment, determination of homocysteine ​​and some other markers of endothelial dysfunction in the blood: D-dimers, protein C, antithrombin III and von Willebrand factor.

RESULTS AND ITS DISCUSSION

Clinical observations

As part of the study of the effect of the drug Angiovit on some indicators of the hemostatic system, 92 pregnant women were examined, of which 32 women with signs of threatened miscarriage, 30 women with manifestations of late gestosis and 30 pregnant women without a clinical picture of gestosis and threatened miscarriage.

The average age of patients in the group with threatened miscarriage was 27.8 years; 41% had a first pregnancy, and 59% had a repeat pregnancy. Signs of impending miscarriage were observed in 44% of those examined in the first trimester, and in 19% in the second trimester; the clinical picture of threatening premature birth in the third trimester was observed in 38% of women.

Among patients with gestosis, the average age was 29.3%; The first pregnancy was in 40%, and the second pregnancy was in 60% of patients. 18 pregnant women (60%) had mild late gestosis, 8 (27%) had moderate gestosis, and 4 women (13%) had severe gestosis. In 24 patients (80%), the clinical picture of gestosis developed in the third trimester of pregnancy, and in only 6 women - at the end of the second trimester.

During a control examination of pregnant women taking Angiovit, in the group with threat of miscarriage, pregnancy progressed in 31 patients (97%), and only one woman had a non-developing pregnancy at 12 weeks. Clinical manifestations of the threat of miscarriage completely disappeared in 24 women (75%), in 8 pregnant women (25%) the manifestations of the threat of miscarriage decreased significantly.

In the group with gestosis, during the control examination, pregnancy progressed in all women. At the same time, in 16 patients (53%) there was a decrease in the clinical manifestations of late gestosis, in 14 pregnant women (47%) the severity of gestosis remained at the same level, but there was no increase in the severity of the clinical picture.

Laboratory research

The results obtained showed that the most informative test characterizing endothelial dysfunction in the obstetric pathology under study (recurrent miscarriage, preeclampsia) is the determination of homocysteine ​​(Table 1). We obtained especially clear data regarding miscarriage, in which the level of homocysteine ​​in the blood of patients was 50% higher compared to the control, and after a course of taking Angiovit (1 tablet 2 times a day for 3 weeks) not only reached the control level level, but was almost 2 times lower. With gestosis, the level of homocysteine ​​did not undergo such significant changes as with recurrent miscarriage, but even in this case, after a course of taking Angiovit, a slight decrease in the level of homocysteine ​​in the blood was noted (Table 1).

Table 1 Table 1. Homocysteine ​​content (µmol/l) in blood plasma during pregnancy Note: p1 - compared to control; p2 - compared to the indicators before taking Angiovitis

Along with homocysteine, we identified distinct changes in the content of D-dimers, which are products of fibrin degradation, the level of which increases as a result of activation of fibrinolysis (Table 2). Table 2. Content of D-dimers in blood plasma during pregnancy (%) Note: less than 0.5 μg/ml is normal; 0.5–3.0 mcg/ml - a slight increase in the indicator; 0.5–3.0 μg/ml—elevated D-dimer levels

As can be seen from the data presented in table. 2, the level of D-dimers in the pathology we are studying is either significantly reduced compared to the norm (miscarriage) or they are absent (preeclampsia). After a course of use of Angiovit, the content of D-dimers increases sharply.

It is known that von Willebrand factor is one of the factors leading to an increase in the thrombogenic potential of the endothelium with its subsequent damage. According to our data (Table 3), with recurrent miscarriage and preeclampsia, there is a tendency to increase its content (p > 0.05), and after treatment with Angiovit it normalizes.

Table No. 3 Table 3. Activity of von Willebrand factor in blood plasma during pregnancy (%) Note: p1 - compared to control; p 2—compared to the values ​​before taking Angiovitis

Other indicators of the functional state of the endothelium that we studied (protein C and antithrombin III) did not undergo noticeable changes in the studied pathology of pregnancy and during treatment with Angiovit.

The results obtained indicate the diagnostic value of determining such markers of endothelial dysfunction as homocysteine ​​and D-dimers in obstetric pathology and the beneficial effect of the drug Angiovit as a therapeutic agent that helps correct these indicators during pregnancy complications - recurrent miscarriage and preeclampsia.

In women of reproductive age, the normal level of homocysteine ​​in the blood plasma is slightly lower than in men, amounting to 8–9 µmol/l [8]. During pregnancy, homocysteine ​​levels decrease by more than 50%, especially low values ​​are observed in the second and third trimesters (4–3 μmol/l). This is due to an increase in the rate of its metabolism, an increase in glomerular filtration and the metabolism of fetal homocysteine.

Our data indicate a significant increase in homocysteine ​​content in the blood plasma of women with recurrent miscarriage, which is confirmed in a number of works by other authors [9–11]. Of particular importance in the increase in homocysteine ​​levels that we discovered during miscarriage is a deficiency of vitamins, primarily folic acid and B vitamins (B6 and B12). It is unlikely that an increase in homocysteine ​​levels can be caused by congenital defects in the enzymes of homocysteine ​​metabolism (cystathionine beta-synthetes and methylenetetrahydrofolate reductase), which leads to persistent and more significant hypercysteinemia (homocysteine ​​content in the blood can range from 15 to 100 µmol/l) and is accompanied by severe clinical symptoms. manifestations. It has been established that such significant hyperhomocysteinemia leads to the appearance of secondary autoimmune reactions and may be one of the important factors in the pathogenesis of severe fetal malformations, such as anencephaly, spinal canal cleft, etc. [3].

In our study, Angiovit turned out to be an effective means of preventing the development of moderate hyperhomocysteinemia, which was most likely due to the balanced ratio of these vitamins in its composition (0.005 g of folic acid, 0.004 g of vitamin B6 and 0.000006 g of vitamin B12). It should be noted that the use of Angiovit led to a decrease in the relatively low (compared to women with miscarriage) level of homocysteine ​​in the blood of pregnant women with preeclampsia.

In addition, the therapeutic effect of Angiovit was accompanied by a decrease in the thrombogenic potential of the vascular wall and the risk of subsequent development of endothelial dysfunction, which can be judged by the decrease in the formation of D-dimers and the activity of von Willebrand factor in the blood of patients with recurrent miscarriage and preeclampsia. This was manifested in a noticeable improvement in the overall clinical picture: a decrease in the severity of clinical manifestations of the threat of miscarriage and preeclampsia in the majority of subjects. In almost all women in the study group who took Angiovit, pregnancy progressed, and in 75% of pregnant women with recurrent miscarriage, the clinical manifestations of threatened miscarriage completely disappeared.

The good tolerability and pronounced effectiveness of Angiovit allow us to recommend it as an effective treatment for recurrent miscarriage and preeclampsia. To assess the effectiveness of using Angiovit for the purpose of preventing pregnancy pathologies, further research on its effect at different stages of gestation (in the 1st, 2nd and 3rd trimester) should be continued.

CONCLUSIONS

1. The effectiveness of Angiovit has been shown in the treatment of recurrent miscarriage and gestosis.

2. Taking Angiovit when there is a threat of miscarriage leads to an improvement in the clinical picture, progression of pregnancy and in most cases (75% of patients) to the complete disappearance of signs of a threat of premature birth.

3. Angiovit was noted to be well tolerated, lack of side effects and the possibility of its use in obstetric practice.

4. Angiovit is a promising drug that helps reduce the risk of hyperhomocysteinemia and the development of thrombolytic conditions in obstetric pathology.

First experience of using the drug Angiovit in the complex treatment of the acute stage of COVID-19 infection

A new coronavirus was isolated and identified in 2021 in Wuhan, China.
On March 11, 2021, WHO declared this disease a pandemic [1]. The disease was found to be caused by a new single-stranded RNA virus (ss-RNA, 29903 bp) belonging to the group of coronaviruses (CoV). The new coronavirus was designated SARS-CoV2 – severe acute respiratory syndrome coronavirus 2 [2], and the disease it causes was named COVID-19 – coronavirus disease 2019. According to WHO, at the beginning of June 2021, there were already more than 7 million confirmed cases of the disease in the world, including more than 400 thousand deaths. To penetrate cells, the SARS-CoV2 virus, like SARS-CoV, expresses a receptor for angiotensin-converting enzyme (ACE) 2. In humans, ACE2 is expressed by most organs and tissues, the most vulnerable to the new coronavirus infection are the lungs and lower respiratory tract, heart, kidneys, intestines, as well as smooth muscle cells of the vascular wall (mainly the microvasculature) and the central nervous system [3]. Biochemical markers of active infection and poor prognosis of infection are increased levels of CRP, D-dimer (DD), and homocysteine. A follow-up study of patients with COVID-19 has been published to assess the prognostic significance of various computed tomography (CT) indices characterizing lung damage. The mean age of the 273 COVID-19 patients admitted with progression of CT changes was higher than that of patients without such progression (p=0.006). Leukocytes, platelets, neutrophils, and acid glycoprotein levels were decreased in patients with imaging progression (all P < 0.05), and monocytes were increased ( P = 0.025). The content of homocysteine ​​and CRP was statistically significantly higher in patients with disease progression (p<0.05). Logistic models showed that in the 1st week after COVID-19 infection, age, homocysteine ​​level and the period from the onset of infection to hospital admission were independent factors for predicting the progression of changes in the lungs according to CT data [4, 5].

There is no medicine or vaccine against coronavirus in humans or animals yet. Inhibition of the 3CL hydrolase enzyme provides a promising therapeutic principle for the development of treatments for CoViD-19. 3clpro (Mpro) is known to be involved in counteracting the host innate immune response. An experimental study using Autodock molecular docking demonstrated the inhibitory effect of some natural compounds against the main enzyme of the virus, 3CL hydrolase. Three candidate agents have been identified that inhibit the main coronavirus protease: hispidin, lepidin E and folic acid [6]. Folic acid is a natural factor that reduces the severity of homocysteinemia.

A domestic drug containing an adequate dose of folic acid is Angiovit (manufactured by Altaivitamins JSC). Angiovit is a complex drug that contains B vitamins and folic acid (pyridoxine hydrochloride 4 mg, folic acid 5 mg, cyanocobalamin 6 mcg). The drug is able to activate the key enzymes of methionine transsulfuration and remethylation in the body - methylenetetrahydrofolate reductase and cystathione-B-synthetase, resulting in an acceleration of methionine metabolism and a decrease in the concentration of homocysteine ​​in the blood. Hyperhomocysteinemia is an important risk factor for the development of atherosclerosis and arterial thrombosis, as well as myocardial infarction, ischemic stroke, and diabetic angiopathy. The occurrence of hyperhomocysteinemia is promoted by a deficiency in the body of folic acid and vitamins B6 and B12 [7].

Target

This pilot study is to evaluate the effect of Angiovit as part of complex therapy for the acute stage of COVID-19 infection, manifested by pneumonia or acute respiratory viral infection (ARVI) with fever.

Patients and methods.

The study included 50 patients with the acute stage of COVID-19 infection. In all patients, the diagnosis of coronavirus infection was confirmed using polymerase chain reaction. Angiovitis was received by 25 patients with moderate severity of infection (13 women; 52%), average age - 39.4 years, who were admitted on average on the 3rd day of the disease. Using the method of randomization, 25 patients of the comparison group were selected, who did not differ in gender, age and characteristics of the clinical manifestation of COVID-19 infection, but were admitted a little later - on the 3.3 day of illness.

In table Table 1 shows the demographic indicators of patients in the main group and the comparison group. Indicators of basic CT changes on a 5-point scale of severity (from 0 to 4 points) and the degree of respiratory failure (RF) on a 4-point scale of severity (from 0 to 3 points) did not differ significantly in the two groups. The distribution of the dominant syndrome (pneumonia or acute respiratory viral infection) also turned out to be almost equal in the groups, but in general all severity indicators were slightly higher in the comparison group than in the main group. Patients in the main group received Angiovit at a dose of 3 tablets per day for at least 10 days in addition to standard therapy, including enoxaparin; none of the 50 patients were prescribed glucocorticoids.

The study of laboratory parameters (CRP, DD, international normalized ratio - INR, activated partial thromboplastin time - APTT) and a clinical blood test, which included the determination of formed elements, hemoglobin, hematocrit, leukocyte subpopulations, were carried out on a biochemical analyzer Sapphire-500, an immunochemical analyzer Immulite- 2000, CA-660 coagulometer, MEK-7300 hematology analyzer. The level of homocysteine ​​in the blood was determined by enzyme immunoassay in 10 patients (5 from each group), selected by simple randomization.

Statistical processing of the results was carried out using SPSS and Microsoft Excel software. Statistical comparison of the study results was carried out using the nonparametric Mann–Whitney test (Mann–Whitney U test), which is used to assess differences between two small samples in terms of the level of a quantitatively measured trait.

results

. The dynamics of clinical parameters during treatment are presented in Table. 2. Patients received Angiovit in addition to basic therapy, according to the Temporary Guidelines of the Russian Ministry of Health for the prevention, diagnosis and treatment of new coronavirus infection (COVID-19), version 6 [8]. When taking Angiovit, a significant decrease in the duration of the febrile period was noted (4.12 days compared to 5.88 days without Angiovit); patients spent significantly fewer days in the hospital - the duration of hospitalization was 13.0 and 16.8 days, respectively.

During treatment, laboratory parameters stabilized and approached reference values ​​(Table 3). In both groups, a decrease in the level of CRP and DD in the blood, an increase in the content of leukocytes and lymphocytes was noted. In patients receiving Angiovit, a more significant decrease in the level of CRP and DD was observed, and DD levels were monitored 3 times, and its decrease occurred already on the 5th day of treatment.

The figure shows the dynamics of the DD level during and without Angiovitis therapy. In the group receiving Angiovit, a statistically significant decrease in the level of DD was observed already on the 5th day of treatment, and in the comparison group - only on the 10th day. No statistically significant dynamics of other indicators were obtained in this sample. Only in the main group, with the addition of Angiovit, a significant decrease in homocysteine ​​levels was recorded on the 10th day.

Discussion

. One of the important factors in the development of endothelial dysfunction (ED) in various conditions is considered to be an increase in the blood plasma content of homocysteine, a sulfur-containing acid that is a product of methionine metabolism. Homocysteine ​​is metabolized in two main ways: transsulfuration to cysteine ​​and remethylation to methionine. The key enzymes for these metabolic pathways are cystathionine-β-synthetase and methylenetetrahydrofolate reductase, respectively. The metabolism of homocysteine ​​is largely determined by the content of folic acid, vitamin B12, vitamin B6 (which is a coenzyme in the homocysteine ​​demethylation reaction), which act as remethylation cofactors [9].

Currently, the presence of several main mechanisms of the negative effect of homocysteine ​​in ED has been shown [10]. Homocysteine, unlike other aminothiols (cysteine, glutathione, N-acetylcysteine), causes oxidative stress through various mechanisms (direct and indirect), the role of which has not yet been sufficiently studied. This, in turn, leads to the development of ED and the formation of a prothrombogenic state. In cells, a small part of homocysteine ​​is converted into the thiolactone form, which easily penetrates membranes and has high biological activity. Thus, it has been shown that homocysteine ​​thiolactone inhibits Na+/K+-ATPase [11] and lysyl oxidase [12], but the role of these mechanisms in the development of ED is still unclear. With an increase in the intracellular concentration of homocysteine, the decomposition reaction of its precursor, S-Adenosylhomocysteine ​​(SAH), is inhibited. Excess SAH inhibits transmethylation reactions of proteins, DNA and other substrates, leading to multiple changes in gene expression. Hypomethylation, in turn, inhibits the expression of cystathione-γ-lyase, an enzyme in the transsulfuration pathway that is involved in the removal of excess homocysteine ​​and the synthesis of the vasodilator H2S [13, 14]. Hypomethylation is now believed to play a key role in homocysteine-mediated ED. In addition, homocysteine ​​stimulates the proliferation of smooth muscle cells in the vascular wall [15, 16].

Considering that dysregulation of the angiotensin system plays an important role in the pathogenesis of vascular complications of COVID-19 infection [17], reducing homocysteine ​​levels may have a beneficial effect, since there is evidence indicating a close relationship between homocysteine ​​and angiotensin II activity. First, the possibility of direct activation of angiotensin receptors (AT1R) by homocysteine ​​and the important role of this mechanism in vascular remodeling were demonstrated in a mouse model of hyperhomocysteinemia [18]. Later, direct activation (ortho- and allosteric) of AT1R upon binding to homocysteine ​​was confirmed by molecular dynamics and in vitro

[19].
Secondly, in an experimental model of hyperhomocysteinemia in rats, it was found that the use of folic acid reduced both the level of homocysteine ​​and its hypertensive effect. This model also revealed that homocysteine ​​caused overexpression of ACE1 as well as AT1R and that these effects were also reversed by folic acid [20]. Conclusion
. Our first pilot study showed that Angiovit with folic acid contained in it as part of complex therapy statistically significantly reduces the level of hyperhomocysteinemia during the acute period of COVID-19 disease and helps normalize clinical and laboratory parameters, in particular, accelerating the normalization of DD levels. Further studies on a larger number of patients are needed to determine the place of this drug in the treatment and prevention of COVID-19.

Conflict of Interest Statement

The study had no sponsorship. There is no conflict of interest. The authors bear full responsibility for submitting the final version of the manuscript for publication. All authors took part in developing the concept of the article and writing the manuscript. The final version of the manuscript was approved by all authors.

The investigation has not been sponsored. There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors.

The article was first published: Neurology, neuropsychiatry, psychosomatics. 2020;12(3):82–86

https://nnp.ima-press.net/nnp/article/view/1363/1054

Question answer

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To which group of drugs can ANGIOVIT be classified?

®
?
The drug ANGIOVIT

® was created as a special vitamin complex for the correction of hyperhomocysteinemia; further intensive clinical studies confirmed its angioprotective properties.
ANGIOVIT
® promotes structural and functional normalization of the endothelium of blood vessels.

Are there analogues of the drug
ANGIOVIT
®
?
ANGIOVITIS

® has no complete analogues in composition either among domestic or foreign drugs.
The vitamins that make up ANGIOVIT
® are present in many vitamin complexes recommended for the treatment of diseases of the central and peripheral nervous system, but they have different dosages of active ingredients.
to achieve the same concentration of active ingredients as in ANGIOVITE
® only by using injectable forms of B vitamins. But these procedures are not always convenient and are very painful for patients.

How should ANGIOVIT be used?

®
?
Before using the drug ANGIOVIT

® it is advisable to consult a doctor or read the instructions. The usual regimen for taking the drug for therapeutic purposes involves a 2-month course. Take 1 tablet orally daily, regardless of food or time of day. After six months, the course can be repeated. As prescribed by a doctor, the single dose and course of taking the drug can be increased.

Are there any restrictions on the use of the drug ANGIOVIT?

®
?
Over more than 10 years of experience in using the drug, no cases of overdose have been recorded. But nevertheless, there are a number of contraindications: allergic reactions to the components of the drug, childhood, breastfeeding, sucrase/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption.

Why does the drug
ANGIOVIT
®
exactly this dose of folic acid?
Is there a risk of overdose? The amount of folic acid in
ANGIOVIT
® exceeds the usual dosages of this vitamin contained in other multivitamin complexes, since
ANGIOVIT
®
was created as a medicinal product
.
Its therapeutic effect is achieved precisely by the proposed dose of folic acid and vitamins B6 and B12. Long-term experience in the clinical use of the drug ANGIOVIT
®, including in pregnant women, has proven that side effects associated with a possible overdose of the drug are very unlikely. According to the literature (K. Oster, 1988), daily intake of folic acid at a dose of 80 mg for 8 years did not lead to the development of any undesirable consequences.

Why does consuming meat and dairy products lead to the development of hyperhomocysteinemia?

Hyperhomocysteinemia develops in the body with a lack of folic acid, vitamins B6 and B12, which take part in the metabolism of the amino acid methionine, which is rich in meat and dairy products. Homocysteine ​​is an intermediate substance in the metabolism of methionine, which, in the absence of the above vitamins, is not converted into final metabolic products, but accumulates in cells, destroying them.

Why does vegetarianism contribute to hyperhomocysteinemia?

Excluding protein foods from the diet leads to a deficiency of vitamin B12, which, like folic acid, is necessary for methionine metabolism.

Why does hyperhomocysteinemia develop when drinking large amounts of coffee and tea?

Caffeine contained in tea and coffee destroys folic acid.

Is it possible with ANGIOVIT?

®
lower blood cholesterol?
The drug
ANGIOVIT
® does not reduce blood cholesterol levels. But its action eliminates the factor that damages the vascular endothelium, and thereby prevents the deposition of cholesterol on the vascular walls.

ANGIOVIT (tablets)

changes happen whether we want it or not.
And as a result of these changes, the blood cells, instead of moving through the vessels in orderly rows, begin to “sway” from side to side, and when colliding with each other, they connect and stick together. In order for red blood cells to move smoothly through the vessels, folic acid is needed. Folic acid has a lot of work in our body. This normalizes blood pressure and affects the skin and mood. She turns out to be smart, without whom we could be much worse off.

Now B vitamins. If you remember, they are also prescribed during pregnancy, and then we conveniently forget about them.

The lack of these vitamins also affects our blood vessels, and therefore the entire cardiovascular system as a whole. With a lack of B vitamins, those same glued red blood cells are pressed against the walls of blood vessels, as if magnetized to them, gradually forming blood clots. Blood clots sooner or later block all blood flow and disaster ensues ((

Meanwhile, B6, in addition to being involved in metabolism, can reduce cholesterol in the blood. And it is after 40 years that the fight against this same cholesterol begins in our body. If the liver cannot cope with its removal, and how can it cope with such an environment and the quality of food, then you have high cholesterol in the blood. You will then have to reduce it with a cholesterol-lowering drug. But prevention is better than drugs. Vitamin B6 also has many good properties. However, on TV we often hear advertisements for the drug Magne B6 - they say, treat your nerves. Yes, they have a beneficial effect on the nervous system, but they also help the heart and blood vessels!!!

Next is vitamin B12. Cyanocobalamin is its other name. It also maintains normal blood pressure and helps produce red blood cells, including in the bone marrow. It also increases the ability of tissues to regenerate.

In a word, these vitamins are very good for most people. But they are specifically prescribed to pregnant women so that the formation of the fetus occurs successfully. But none of the therapists ever said this name out loud.

I found out about these vitamins by accident when I was looking for information on the Internet.

I would like to add that I was lucky to find them right away at the pharmacy. But first, I decided that I would buy folic acid and B vitamins separately. I thought it would be cheaper. But when the pharmacist did the math, she gave me more than 500 rubles. This is the case if I bought it separately - I repeat.

Angiovit is a ready-made complex. And it costs an order of magnitude cheaper than 500 rubles. I bought it for a little over 200.

The course of admission is 20 - 30 days. There are 60 tablets in a package. That is, one package is enough for 2 people. And this makes its packaging more profitable. Even if you take it alone, the package = 2 courses, or even three (if 20 tablets per course).

Elena Malysheva talked about these same vitamins in her program. I know that many people treat its broadcast with irony. But nevertheless, it was her story with a visual demonstration in the spirit of Elena Malysheva that gave me an idea of ​​how and what works for us. And I share this information with you.

I’m sharing this for a reason. I first heard the word angiography in the hospital, in the vascular surgery department. This angiography procedure was performed on my husband before the operation to find out if there were any blood clots in the vessels that were blocking the blood flow.

I’ll add that my husband, by and large, had not complained about his health before. I lowered my blood pressure with pills, and that was all. But it turned out that in a vessel in his neck he had a huge (albeit cholesterol) plaque, which almost led to sad consequences.

I recommend these vitamins. They have almost no contraindications except for increased sensitivity. They are inexpensive. They taste sweetish. And even if you don’t think you need it yet, give it to your parents! And be healthy YOU and YOUR LOVED ONES!!