How can arterial calcification be reversed?

From the Guidelines

Reversing arterial calcification is challenging, but potentially possible through limiting calcium intake from phosphate binders to under 1,500 mg/day and possibly lower, as well as using non-calcium-based phosphate binders like sevelamer, which has been shown to attenuate the progression of arterial calcifications compared to calcium-based phosphate binders 1. To address arterial calcification, it's essential to consider the following approaches:

• Limiting calcium intake from phosphate binders to under 1,500 mg/day, as excessive calcium intake may worsen vascular and other extraskeletal calcification 1
• Using non-calcium-based phosphate binders like sevelamer, which has been shown to attenuate the progression of arterial calcifications compared to calcium-based phosphate binders 1
• Maintaining a balanced diet with restricted phosphorus intake, as dietary phosphate restriction is an important component in the management of uremic bone and vascular disease 1
• Considering lifestyle modifications, such as regular exercise, a Mediterranean or DASH diet, smoking cessation, and blood pressure control, which can help address underlying mechanisms of calcification, including inflammation, oxidative stress, and mineral imbalances
• Medications like statins may help stabilize plaques, while emerging therapies such as EDTA chelation therapy might remove calcium deposits, though this remains controversial It's crucial to note that arterial calcification reversal is a slow process requiring consistent, long-term adherence to these interventions, and should be undertaken with medical supervision, especially if you have existing cardiovascular disease. Key factors to consider when managing arterial calcification include:
• The total calcium intake from diet, calcium-containing phosphate binders, and dialysate should ideally be equal to the recommended daily adequate intake (AI) for adults (1,000 to 1,500 mg/day) 1
• The use of sevelamer has been shown to decrease LDL cholesterol levels and attenuate the progression of arterial calcifications compared to calcium-based phosphate binders 1
• Hypercalcemia and excessive calcium load should be avoided, as they can worsen vascular and other extraskeletal calcification 1

From the Research

Reversing Calcium Buildup in Arteries

• Arterial calcification is a complex process that has been linked to various cardiovascular diseases, including atherosclerosis, chronic kidney disease, and diabetes 2.
• Current research suggests that there is no clinically accepted therapy that can prevent the progression of arterial calcification, and some treatments, such as statins, may even worsen its progression 3, 4.
• However, some studies have found that certain compounds, such as eicosapentaenoic acid (EPA), may have a suppressive effect on arterial calcification by reducing inflammatory responses, oxidative stress, and Wnt signaling 3.
• Visualization of coronary artery calcification and lifestyle recommendations may also have a favorable influence on plasma total cholesterol concentration, adherence to statin therapy, and risk behavior 5.
• The pathogenesis of arterial calcification is still not fully understood, but it is thought to be a multifactorial process that involves immune responses to endothelial injury, such as shear stress or oxidative stress 2.
• Some researchers propose that instead of attempting to treat arterial calcification, we should focus on preventing or treating all causes of endothelial injury 2.
• Statins, which are commonly used to lower cholesterol levels, may actually stimulate atherosclerosis and heart failure by depleting coenzyme Q10 and impairing muscle function in the heart and blood vessels 4.

Potential Therapeutic Approaches

• EPA supplementation may be a potential therapeutic approach for reducing arterial calcification, although more research is needed to confirm its effectiveness in clinical settings 3.
• Lifestyle modifications, such as a healthy diet and regular exercise, may also help to reduce the risk of arterial calcification and cardiovascular disease 5.
• Further research is needed to fully understand the mechanisms of arterial calcification and to develop effective therapeutic strategies for preventing and treating this condition 2, 4.