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    Scientific Comparison of Pine Bark Extracts: Kari's Pine Bark Extract Drink and Pycnogenol® in Support of Cardiovascular Health

     

    Article author:
    Dr. Olli Sovijärvi, MD & Nonfiction Author, Medical Director of Hololife Center
    February 3rd, 2026

    Introduction

    Pine bark extracts represent nature’s most diverse protection against oxidative stress and inflammation. Both the internationally respected Pycnogenol® and the Finnish traditional preparation, Kari's Pine Bark (Havupuu) Extract Drink, share the same scientific core: they utilize potent polyphenols from pine bark and phloem, especially oligomeric proanthocyanidins (OPCs). Although Pycnogenol®, as an extract made from the bark of the maritime pine (Pinus pinaster), is the most globally studied representative of its field, the Finnish Kari’s Pine Bark Extract Drink, prepared for decades in Siikainen (Finland) using a traditional method, offers at least a comparable and in certain respects chemically even broader profile. Both preparations are based on a natural raw material whose physiological mechanisms of action converge especially in promoting cardiovascular health.[1–6]

    This article examines the similarities and complementary strengths of these two top products. By integrating international clinical research data and Finnish university analytics, we obtain a comprehensive picture of how the naturally active compounds of pine support human health – whether in a concentrated extract from coastal regions or a broad-spectrum extract drink from the northern Scots pine (Pinus sylvestris).

    Young pine phloem and bark – why does the raw material matter?

    Between Kari's Pine Bark Extract Drink and Pycnogenol®, there is a subtle but biologically significant difference in the part of the tree used for extraction. Whereas many extracts, such as the maritime pine–based Pycnogenol®, are prepared mainly from thick pine bark, Finnish tradition relies on a special combination of young Scots pine (Pinus sylvestris) bark and phloem.[2,7,8]
    • Phloem – the living tissue of the tree: Phloem is a layer located under the bark of the tree, where the tree’s nutrients and sugars travel. By using an extraction that includes not only dead outer bark but also living phloem, a broader range of the tree’s active metabolic products is obtained in the extract.[9]
    • Young pines vs. old bark: For Kari's Pine Bark Extract Drink, specifically, young pines are selected. The bark of a young tree is thinner, and its chemical profile is more dynamic than the thick, lignified bark of an old tree. This choice partly explains the 22 distinct phenolic compounds in the extract (see later).[2,10,11]
    • Northern growing conditions: In Finnish forests, slowly growing pines develop strong defensive compounds to survive harsh weather. These same compounds, such as resveratrol glucoside and catechin, are transferred into the extract drink in the traditional preparation process.[11]

    Chemical composition and concentrations: OPC compounds and phenolic profile

    The efficacy of pine bark extracts is based on the phenolic compounds they contain, especially oligomeric proanthocyanidins (OPC). These compounds are known as potent antioxidants, anti-inflammatory agents, and blood pressure–lowering substances.
    • Concentrations: According to a 2025 HPLC analysis, Kari's Pine Bark Extract Drink contains significant amounts of OPC compounds (283 mg/dl) and phenolic compounds (380 mg/dl). The Pycnogenol Strong tablet used in the comparison contained 40 mg of OPC compounds.[1]
    • Diversity: A broad range of natural phenolics has been identified in the extract drink, such as resveratrol glucoside, catechin, lignans, and taxifolin. According to analyses, the water-extracted Havupuu Extract Drink contains a more diverse range of these compounds (22 different phenolic molecules) than ethanol-extracted Pycnogenol (10 molecules).[2–4]
    • Special compounds: Taxifolin (dihydroquercetin) is one of the key compounds for which antibacterial, antiviral, and anti-inflammatory effects have been shown.[2,12]

    The effect of preparation methods on efficacy

    The most significant difference between the preparations is the manufacturing process. Pycnogenol® is produced mainly by ethanol extraction, a technically efficient method for isolating OPC compounds. Karin Havupuu Extract Drink, in turn, is produced with traditional hot-water extraction, which preserves a broader range of the tree’s own natural phenolics.

    Ethanol extraction and specificity (Pycnogenol®)

    Pycnogenol® is manufactured using ethanol extraction, a highly efficient method for isolating and concentrating OPC (oligomeric proanthocyanidins.[7,8,13]
    • Ethanol as a solvent is selective: it extracts certain flavonoid groups efficiently, but at the same time leaves some of the pine bark’s other natural phenolic compounds unextracted.
    • This leads to a product that is highly standardized with respect to certain active compounds but has a narrower phenolic profile.[1]

    Traditional hot-water extraction (Karin Havupuu Extract Drink)

    Kari's Pine Bark Extract Drink is prepared in Siikainen (Finland) using a traditional method that uses the bark and phloem of young pine.
    • The method is based on hot-water extraction, which imitates a more natural way to release the tree’s nutrients.
    • Hot-water extraction has been shown to preserve a broader range of natural phenolics and OPCs than ethanol extraction.[2]
    • In HPLC analysis (see the table below), a considerably more diverse composition was identified in Havupuu Extract Drink and the Pinena products derived from it.[1]

    Chemical diversity vs. extraction efficiency

    Although ethanol extraction is technically “stronger” for certain components, hot-water extraction produces a more holistic extract.
    In Havupuu Extract Drink, resveratrol glucoside and catechin are particularly emphasized, as they are the two largest individual phenolics in the extract.
    In addition, water extraction preserves important lignan glucosides and taxifolin glucosides, which may not be present in as great abundance in purely ethanol-based concentrates.

    Conclusion: Based on analyses, water-extracted Havupuu Extract Drink contains a more diverse range of natural phenolics than the ethanol-extracted preparations included in the comparison.[1,2]

    Cardiovascular health: Research evidence in comparison

    Cardiovascular health is an area in which the benefits of pine bark extracts are emphasized. The extensive clinical studies conducted with Pycnogenol can be appropriately applied to Karin Havupuu Extract Drink, as their key mechanisms of action and main active compounds, such as oligomeric proanthocyanidins (OPC), are the same in both preparations. Although Karin Havupuu Extract Drink has been found to contain an even broader range of the natural phenolic compounds of nature, it would be very important to see in the future more clinical studies specifically on this Finnish preparation, so that its specific efficacy and possible additional benefits could be demonstrated with full certainty also in the human body.[1–4,13]

    Modern medicine recognizes two interconnected main factors that erode vascular health: oxidative stress and low-grade inflammation. With regard to heart health, the main mechanism of action of both extracts is to reduce oxidative stress and improve the function of the vascular endothelium (the inner lining).[14]

    Inhibition of LDL cholesterol oxidation

    LDL cholesterol circulating in the blood is not in itself dangerous, but when it becomes the target of free radicals and oxidizes, it becomes foreign to the body. This oxidized form can penetrate arterial walls, triggering a chain reaction that leads to arterial hardening (atherosclerosis).[15]
    • Kari's Pine Bark Extract Drink: In studies, the extract drink is a highly effective antioxidant that inhibits the oxidation of LDL particles by up to 95% ex vivo (a test-tube study using living cells).[2]
    • Inhibition of free radicals: In a comparison carried out in 2000, a domestic pine dry extract proved to be 1.5 times more effective as an inhibitor of hydroxyl radicals than a corresponding maritime pine preparation.[4]
    • Pycnogenol®: International reviews and clinical studies confirm that Pycnogenol® protects LDL cholesterol from oxidation and reduces lipid peroxidation of cell membranes. In laboratory experiments, it has been shown to inhibit LDL oxidation in a concentration-dependent manner and to be an effective scavenger of free radicals, such as hydroxyl and superoxide.[6,16]
    • In human trials, Pycnogenol® has reduced oxidative stress and lipid peroxidation. In patients with coronary artery disease, Pycnogenol® lowered plasma 15-F2t-isoprostane, which is a reliable marker of lipid peroxidation and oxidative stress.[17]

    Control of inflammation and blood pressure

    Chronic, low-grade inflammation is one of the most significant factors in vascular deterioration and in the development of elevated blood pressure. Inflammation damages the inner surface of blood vessels, i.e., the endothelium, leading to stiffening of the vessels and predisposing them to plaque formation. [14] The polyphenols contained in Kari's Pine Bark Extract Drink and Pycnogenol can promote natural protection against these harmful processes.
    • Effective inhibition of inflammatory mediators: Studies at the University of Helsinki have shown that Karin Havupuu Extract Drink significantly inhibits the production of inflammation-amplifying prostaglandin PGE2. Already at a 1% concentration, a 54% inhibition was observed, and at a 2% concentration, a 60% inhibition was observed, indicating the extract’s strong ability to suppress the body’s inflammatory responses.[2]
    • Effect at the enzyme level: The extract drink acts directly on enzymes that regulate the inflammatory response. In studies, the extract was observed to inhibit inducible nitric oxide synthase (iNOS) (24% inhibition at 2% concentration), thereby reducing excessive production of harmful nitric oxide (NO) in inflammatory states. In addition, the taxifolin in the extract is a strong anti-inflammatory compound in itself.[2]
    • Vascular elasticity and dilation: Although the direct effects of Havupuu Extract Drink on vasodilation have been studied less, based on scientific grounds, the extensive Pycnogenol research evidence can be applied to it. The key active compounds in both preparations, oligomeric proanthocyanidins (OPCs), stimulate nitric oxide (NO) production in the vascular endothelium, thereby relaxing the vessel walls.[2,23,24]
    • Pycnogenol® and blood pressure: According to a meta-analysis of randomized clinical trials, Pycnogenol® supplementation lowers both systolic and diastolic blood pressure, probably by improving endothelial nitric oxide (NO) production and vascular elasticity. This supports its use as a natural aid in regulating circulation, but requires caution when used with antihypertensive medication.[18]
    • Synergistic effect: Because a significantly broader range of different phenolic molecules has been identified in Karin Havupuu Extract Drink compared to standardized extracts, its mechanism of action may be even more diverse. This “holistic profile” supports vascular health not only by inhibiting inflammation, but also by protecting the endothelium from oxidative stress.[2,7,13]
    • BONUS: Pine bark extract (PBE) – A recent meta-analysis published in 2025 shows that pine bark extract may reduce weight, systolic and diastolic blood pressure, fasting blood glucose, LDL cholesterol, and HbA1c values in randomized controlled trials, which suggests positive effects in managing the cardiometabolic risk profile.[20]
    This multi-effect mechanism, prostaglandin inhibition, combined with the vessel-relaxing effect of OPC compounds. makes pine bark extract a potential natural support for managing blood pressure and overall heart health.

    Feature Karin Havupuu Extract Drink Pycnogenol®
    Tree species & origin Finnish Scots pine (Pinus sylvestris) French maritime pine (Pinus pinaster)
    Plant part used Young bark + living phloem Primarily bark
    Extraction method Traditional hot-water extraction Technical ethanol extraction
    Number of phenolic compounds 22 identified phenolic molecules (broader spectrum) 10–13 phenolic molecules
    Main active compounds Resveratrol glucoside, catechin, taxifolin, lignans, OPCs Primarily OPCs and phenolic acids
    OPC content (dose) ~283 mg/dL (recommended strength) Typically 40 mg per tablet (standard product)
    Antioxidant effect (LDL protection) Very strong: up to 95% inhibition of LDL oxidation Proven LDL protection in multiple clinical studies
    Free radical scavenging ~1.5× stronger vs maritime pine (hydroxyl radical test) Effective, but lower in comparative tests
    Anti-inflammatory effects Reduces prostaglandin (PGE2) production up to 60% Known COX-modulating and anti-inflammatory effects
    Research evidence Strong Finnish university analytics + ex vivo studies Extensive international clinical research base


    Why would Pycnogenol studies also apply to the Finnish extract?

    It is scientifically justified to mirror the clinical results of the globally known Pycnogenol® in Kari's Pine Bark Extract Drink. Although it is a pine species collected from different geographical areas, their biological core and the mechanisms of health effects are comparable for the following reasons:[6–8]

    1. Biological similarity of the active compounds

    The physiological activity of both Pycnogenol® and Karin Havupuu Extract Drink is based on the same main chemical groups: oligomeric proanthocyanidins (OPC) and other phenolic compounds.
    • OPC compounds: Both preparations contain significant amounts of these flavanols, which account for the preparations’ antioxidant and vessel-protective properties.
    • Identical active compounds: The same key molecules have been identified in Karin Havupuu Extract Drink, including catechin, taxifolin (dihydroquercetin), and proanthocyanidins, which are also active compounds in maritime pine bark extract.

    2. Concentration comparison and efficacy

    HPLC analyses (high-performance liquid chromatography) show that the Finnish extract is at least at the international standard level in concentrations:
    • OPC strength: With dosing as directed, Kari's Pine Bark Extract Drink (100–200 ml/day) provides a higher amount of OPC compounds than the Pycnogenol Strong used in the comparison.
    • Broader range: Whereas ethanol-extracted Pycnogenol® is highly standardized and contains about 10–13 different phenolic molecules, 22 different phenolic molecules have been identified from water-extracted from Kari's Pine Bark Extract Drink. This diversity may indicate an even broader synergistic effect in the body.
    • Antioxidant efficacy: In laboratory tests, the Finnish extract was up to 1.5 times more effective than the maritime pine preparation at inhibiting hydroxyl radicals.

    3. Purity, quality, and safety

    Both preparations examined represent the top of pine bark extracts, and high quality, purity, and safety of use have been emphasized in their manufacturing processes. The products have passed strict quality requirements, which makes them reliable options for daily use:

    • Cytotoxicity and cellular-level safety:
      • Kari's Pine Bark Extract Drink: In tests at the University of Helsinki Faculty of Pharmacy, the extract drink (freeze-dried) was found to be completely safe and non-cytotoxic for Caco-2 intestinal cells. This shows that the product does not damage the intestinal surface epithelium even at concentrations that have a physiological effect.[2]
      • Pycnogenol®: The preparation has extensive, long-term research supporting its safety. It has been classified as generally safe (GRAS), and numerous clinical studies (over 90 studies and 6,000 participants) show that it is very well tolerated and safe in regular use.[13]
    • Standardization and concentrations:
      • According to 2025 HPLC analyses, both preparations contain the amount of active OPC compounds stated by the manufacturers. The products are consistent in quality and meet the technical quality requirements set for them, ensuring the promised efficacy to consumers with every dose.[1]

    Contraindications and possible drug interactions

    Although the safety profile of Kari's Pine Bark Extract Drink and Pinena® preparations is excellent and they are non-cytotoxic, caution is warranted with certain medications. The most important factor observed in studies is a change in the rate of intestinal drug absorption.

    Effect on drug absorption

    In studies at the University of Helsinki Faculty of Pharmacy, it was observed that dried Pine Bark Extract Drink clearly inhibited the absorption of metoprolol, a beta-blocker, at a concentration of 1 mg/ml. This suggests that the phenolic compounds contained in the extract may affect the transport rate of certain medicinal substances through the intestinal epithelial cell layer. Although the effect has been observed in cell models, this warrants attention to the timing between medication and the extract's consumption.[2]

    Also, Pycnogenol® contains a high amount of polyphenols and proanthocyanidins, which, in theory, can affect drug binding and transport in the intestine. However, in clinical studies, the preparation has been well tolerated, and significant pharmacokinetic interactions have not been reported at typical doses. Monographs still recommend caution, especially with blood thinners and antihypertensive medications, because polyphenols can affect platelet function and vascular regulation. In practice, the recommendation is the same as for Pine Bark extract: a 1–3 hour dosing interval between the medication and the extract.[6,13]

    Possible interactions

    Antihypertensive medication

    Because OPC compounds in pine bark naturally have blood pressure–lowering and vessel-relaxing properties, they may enhance the effect of antihypertensive medications. It is recommended to discuss co-use with a physician to avoid excessive lowering of blood pressure.[18]

    Blood thinners

    Pine bark extracts have been reported to affect platelet aggregation (function), which may increase the risk of bleeding when used together with anticoagulants or platelet inhibitors (e.g., warfarin or acetylsalicylic acid).[6]

    When should the products not be used?

    As a general precaution, the use of Havupuu extract preparations is not recommended in the following situations without consultation with a physician:
    • Before surgical operations: Due to a possible increase in bleeding risk, use should be discontinued at least two weeks before a planned surgery.[6]
    • Pregnancy and breastfeeding: There is not enough clinical research data on the product’s effects on the fetus or breast milk to fully recommend use during these stages.[13]
    • Hypersensitivity: If a person has a known allergy or hypersensitivity to pine components or resin.
    As a practical rule of thumb, those taking regular medication are advised to wait at least 2–3 hours between taking their medication and consuming pine extract to ensure optimal absorption of the medicinal substance.[19]

    Pine Bark Extract drink + Sauna: A Clear and Practical Protocol

    The purpose of this protocol is to combine sauna heat stimulation, which improves circulation and vascular elasticity, with the antioxidant and anti-inflammatory effects of pine extract, thereby reducing LDL oxidation, improving endothelial function, and supporting cardiovascular health to the greatest possible extent.

    Before sauna (30 min):

    • Drink 100 ml Karin Havupuu Extract Drink
    • Drink additionally 3–5 dl water
    • Avoid a heavy meal at least 4 hours before sauna bathing

    Sauna protocol:

    • Temperature 80–85 °C (adjust humidity by throwing steam)
    • 25–30 min total time
    • 2–3 cycles:
      • 8–10 min heat
      • 1–3 min cooling (cold shower/ice bath)
      • 1 dl Kari's Pine Bark Extract Drink (on the second break)

    After sauna:

    • 5–10 min light movement or rest
    • 3–5 dl water + 1 dl Karvi Havupuu Extract Drink
    • Light salt/electrolyte if needed

    Frequency:

    • 3–5 times per week
    • Long-term regularity produces the greatest benefits.

    Benefits of the protocol for the cardiovascular system

    Sauna bathing: [21,22]

    • increases circulation
    • dilates blood vessels
    • improves endothelial function
    • lowers blood pressure
    • is associated with lower cardiac mortality in long-term follow-up

    Havupuu extract (phenolics + OPC): [2,10]

    • inhibits LDL oxidation
    • reduces lipid peroxidation
    • suppresses inflammatory mediators
    • supports nitric oxide signaling in blood vessels

    Combination:

    Sauna improves tissue distribution – the extract reduces oxidative load. Potential benefits:
    → better arterial elasticity
    → lower ox-LDL (oxidized LDL)
    → lower inflammation
    → better overall cardiovascular response

    Summary

    The use of pine bark extracts to support health is supported by clearly described, repeatedly observed biological mechanisms in studies. These include especially regulation of the cells’ redox state, support of vascular endothelial function, and a strong antioxidant and inflammation-reducing response. The effect is not only general protection, but it involves subtle biochemical signaling that directs inflammatory pathways and protects the body’s critical structures, such as LDL particles, from oxidation.

    The systemic effects via circulation and metabolism differ from those of individual, narrow dietary supplements. When the body is exposed to the broad phenolic spectrum of Finnish Scots pine and its phloem, the response is not limited to local oxidative protection. Still, it can be mediated at the whole-body level through regulation of blood pressure and balancing of the immune system. For this reason, traditional water extraction and the broad profile it produces have been studied especially in situations where the goal is systemic support of vascular health and recovery. Studies have reported significant changes, among other things, in the control of inflammatory mediators and in the tissues’ ability to resist oxidative stress.

    From a practical standpoint, the efficacy of pine bark extract does not depend only on a single active compound, but on the breadth of the phenolic profile, the extraction method, and the regularity of use. Traditional Finnish hot-water extraction preserves the tree’s own chemical diversity, up to 22 different phenolic molecules, whereas concentrated ethanol extracts offer a narrower profile. The response follows a dose–response relationship in which use according to instructions, moderate and repeated use, is a key principle for achieving an optimal physiological effect.

    The overall safety profile is excellent when quality requirements are met. The preparations are cytotoxically safe and pure, and most users experience no adverse effects. The most important precautions relate to the possible slowing of the absorption of certain medications, such as metoprolol, which requires clinical attention when used. When these factors are controlled, the domestic Karin Havupuu Extract Drink provides a consistent, predictable, and physiologically justified method for optimizing cardiovascular health, regulating inflammatory status, and promoting cellular-level well-being.

    Scientific references:

    1. Fingredient Ltd. (2025). Mäntyuutevalmisteiden Polyfenolien vertailu, osa 2. FT Jari Siivari.

    2. Helsingin yliopisto. (2003). Analyysitodistus: Havupuu uutejuoman fenoliset yhdisteet, antioksidanttiteho ja tulehduksen esto. Elintarvikekemian ja farmasian laitokset. 

    3. Vienola, M., & Pihlaja, K. (2001). Phenolic compounds in the pine bark extract and their functional properties. Department of Chemistry, University of Turku.

    4. Siivari, J. / CRS BioTech. (2000). Tutkimuslausunto: Havupuu kuivauutteen antioksidatiivisuus. 

    5. Robertson, N. U., Schoonees, A., Brand, A., & Visser, J. (2020). Pine bark (Pinus spp.) extract for treating chronic disorders. Cochrane Database of Systematic Reviews, (9).

    6. Rohdewald, P. (2002). A review of the French maritime pine bark extract (Pycnogenol), a herbal medication with a diverse clinical pharmacology. International Journal of Clinical Pharmacology and Therapeutics, 40(4), 158–168.

    7. Bayer, S., Högger, P., & Vetrano, E. (2024). The pharmacokinetics of French maritime pine bark extract (Pycnogenol) and its metabolites in humans: A comprehensive review. Frontiers in Nutrition, 11, 1389422.

    8. Ferreira-Santos, P., Genisheva, Z., Botelho, C., Santos, J., Ramos, C., Teixeira, J. A., & Rocha, C. M. R. (2020). Unravelling the biological potential of Pinus pinaster bark extracts. Antioxidants, 9(4), 334.

    9. De Schepper, V., De Swaef, T., Bauweraerts, I., & Steppe, K. (2013). Phloem transport: a review of mechanisms and controls. Journal of experimental botany, 64(16), 4839-4850.

    10. Karonen, M., Hämäläinen, M., Nieminen, R., Klika, K. D., Loponen, J., Ovcharenko, V. V., ... & Pihlaja, K. (2004). Phenolic extractives from the bark of Pinus sylvestris L. and their effects on inflammatory mediators nitric oxide and prostaglandin E2. Journal of Agricultural and Food Chemistry, 52(25), 7532-7540.

    11. Verkasalo, E., Möttönen, V., Roitto, M., Vepsäläinen, J., Kumar, A., Ilvesniemi, H., ... & Sikanen, L. (2021). Extractives of stemwood and sawmill residues of scots pine (Pinus sylvestris L.) for biorefining in four climatic regions in Finland—Phenolic and resin acid compounds. Forests, 12(2), 192.

    12. Filippovich, S. Y., Isakova, E. P., Bachurina, G. P., & Deryabina, Y. I. (2025). Modern Developing Directions in the Dihydroquercetin Study. Molecules, 30(21), 4187.

    13. Oliff, H. S., & Blumenthal, M. (2019). Pycnogenol® (French maritime pine bark extract): Proprietary botanical ingredient—Scientific and clinical monograph (2019 update). American Botanical Council.

    14. Higashi, Y., Noma, K., Yoshizumi, M., & Kihara, Y. (2022). Roles of oxidative stress and inflammation in vascular endothelial dysfunction-related disease. Antioxidants, 11(10), 1958.

    15. Poznyak, A. V., Nikiforov, N. G., Markin, A. M., Kashirskikh, D. A., Myasoedova, V. A., Gerasimova, E. V., Orekhov, A. N., & Orekhov, A. N. (2021). Overview of OxLDL and its impact on cardiovascular health: Focus on atherosclerosis. Frontiers in Pharmacology, 11, 613780.

    16. Packer, L., Rimbach, G., & Virgili, F. (1999). Antioxidant activity and biologic properties of a procyanidin-rich extract from pine (Pinus maritima) bark, pycnogenol. Free radical biology and medicine, 27(5-6), 704-724.

    17. Enseleit, F., Sudano, I., Periat, D., Winnik, S., Wolfrum, M., Flammer, A. J., ... & Noll, G. (2012). Effects of Pycnogenol on endothelial function in patients with stable coronary artery disease: a double-blind, randomized, placebo-controlled, cross-over study. European heart journal, 33(13), 1589-1597.

    18. Pourmasoumi, M., Hadi, A., Mohammadi, H., & Rouhani, M. H. (2020). Effect of pycnogenol supplementation on blood pressure: A systematic review and meta‐analysis of clinical trials. Phytotherapy Research, 34(1), 67-76.

    19. Laitinen, L. A., Tammela, P. X. I. S., Galkin, A., Vuorela, H. J., Marvola, M. L., & Vuorela, P. M. (2004). Effects of extracts of commonly consumed food supplements and food fractions on the permeability of drugs across Caco-2 cell monolayers. Pharmaceutical research, 21(10), 1904-1916.

    20. Mohammadi, S., Fulop, T., Khalil, A., Ebrahimi, S., Hasani, M., Ziaei, S., ... & Heshmati, J. (2025). Does supplementation with pine bark extract improve cardiometabolic risk factors? A systematic review and meta-analysis. BMC Complementary Medicine and Therapies, 25(1), 71.

    21. Hamaya, R., Joyama, Y., Miyata, T., Fuse, S. I., Yamane, N., Maruyama, N., ... & Sesso, H. D. (2025). Non-acute effects of passive heating interventions on cardiometabolic risk and vascular health: systematic review and meta-analysis of randomized controlled trials. American Journal of Preventive Cardiology, 101082.

    22. Kunutsor, S. K., Jae, S. Y., Kurl, S., & Laukkanen, J. A. (2024). Sauna bathing and mortality risk: unraveling the interaction with systolic blood pressure in a cohort of Finnish men. Scandinavian Cardiovascular Journal, 58(1), 2302159.

    23. Fitzpatrick, D. F., Bing, B., & Rohdewald, P. (1998). Endothelium-dependent vascular effects of Pycnogenol. Journal of Cardiovascular Pharmacology, 32(4), 509-515.

    24. Hu, S., Belcaro, G., Cornelli, U., Luzzi, R., Cesarone, M., Dugall, M., ... & Trignani, M. (2014). Effects of Pycnogenol® on endothelial dysfunction in borderline hypertensive, hyperlipidemic, and hyperglycemic individuals: the borderline study. International angiology: a journal of the International Union of Angiology, 34(1), 43-52.

     

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