The connection between NAD+ and Heart HealthRevitalyzeMD

February is Heart Health Month!

The connection between NAD+ and Heart Health

Nicotinamide adenine dinucleotide (NAD+) exists in every cell and plays a role in hundreds of enzymes. NAD+ is involved in a variety of important cellular processes, including energy production, metabolism, and DNA repair. NAD+ is a ubiquitous cofactor may also support a healthy cardiovascular system based on emerging studies connecting healthy levels of NAD+, sirtuins, and heart health.

February is heart health month

NAD+, Sirtuins, and Heart Health

An important family of NAD+ - consuming enzymes is sirtuins (SIRTs), also known as silent information regulators. There are seven SIRTs. Sirtuins play various roles in:

  • Energy metabolism
  • Cell survival
  • Inflammation
  • Circadian rhythm
  • DNA transcription
  • DNA repair

Increasing the activity of SIRTs may increase longevity and support healthy aging and cardiovascular function. SIRT1 and SIRT3 seem to be key SIRTs with cardiovascular health.


In animal studies, increased SIRT1 function has been associated with:

  • Decrease in atherosclerosis
  • Endothelial inflammation
  • Obesity
  • Serum lipid levels
  • Hypertension

A decrease in SIRT1 activity has the opposite effect.

Human cell studies found an inverse correlation between age and SIRT1 protein expression. Furthermore, there is a correlation between lower levels of SIRT1 and atherosclerosis plaques, and there is reduced function in vascular smooth muscle cells.


SIRT3 is associated with inhibited mitochondrial function and pulmonary arterial hypertension. According to one study on human ventricular tissue, the age-associated changes in SIRT1 and SIRT3 connected with cardiovascular inflammation and mitochondrial dysfunction may be more likely in women than men.


These animal and mechanistic studies have some substantiation in clinical practice. In a study on patients who were admitted for cardiac catheterization, SIRT1 levels in the monocytes were higher in those considered to be healthy subjects compared to those with stable coronary artery disease and those with acute coronary syndromes.

Increasing SIRT1

Increasing SIRT1 activity by boosting NAD+ may support normal cardiac function. One mouse study found that short-term administration of nicotinamide mononucleotide (NMN), an NAD+ precursor, increased NAD+ levels in the heart and that increase protected the heart from ischemia/reperfusion injury.

NAD+ and Redox Balance

NAD+ also plays a role in redox balance in the cell. As part of the oxidation process of energy metabolism, NAD+ accepts a hydride group to become NADH, which then becomes re-oxidized during oxidative phosphorylation. The ratio of NAD+ to NADH can impact the redox balance. When this imbalance leads to excess oxidative stress, it may contribute to mitochondrial dysfunction in the heart, increasing the risk of heart failure and endothelial dysfunction in vascular aging. Improving the ratio has been shown in a mouse study to benefit heart failure.

The emerging research into the connection between NAD+, sirtuins, and heart health indicates promising areas of support for normal cardiovascular function. One such way may be to support NAD+ levels. NAD+ levels can be supported with substrates, including NAD+ precursors, such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). NAD+ can also be supplemented directly:

  • NAD+ IV infusions
  • NAD+ nasal sprays
  • NAD+ skin patches

Please call / text (865) 293-5828 to set up an appointment today. At our Med Spa, RevitalyzeMD NAD+ IV drips are available! These are amazing treatments to provide your body with NAD+ optimization. NAD+ / NR / Resveratrol products to use at home are also available at RMD.

Heart health is highlighted in February but important all the time to our patients and to the staff at RMD.

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