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Six Supplements For A Healthy Heart

Treat Your Heart Right With These Natural Supplements!

August 2nd, 2012

Written by Holly Klamer, MS, RD
Edited by , Clinical Nutrition Writer

Heart disease is currently the leading cause of death in the United States. While research has shown eating a diet rich in fruits, vegetables, and other whole foods greatly reduces the risk of heart disease, what is not as well established is what, if any, supplements can also help decrease the risk of heart disease. Some research on supplements done in the last twenty years has shown promising results for decreasing risk of heart disease, but in more recent years further evidence indicates that these individual supplements may not decrease risk and may actually increase risk in some instances.

When speaking of the risk for heart disease, there is a separation between primary and secondary prevention in research studies. Primary prevention refers to preventing an initial episode of cardiovascular disease (CVD), such as a heart attack or stroke, when a person's overall risk for CVD may be relatively low. Secondary prevention refers to preventing a second (or further) CVD event from occurring after one already has. In this situation, the risk for CVD is much higher.

Different supplements affect primary and secondary prevention differently. For example, a drug update by NHS Healthcare Professionals in 2010 suggests that taking aspirin reduces the secondary risk of CVD significantly, outweighing the risks associated with aspirin such as excess bleeding or gastrointestinal problems. However, taking aspirin for primary prevention of CVD has not been shown to be of significant benefit for CVD risk and may not outweigh other risks.

Below is a detailed list of the research on some well-known supplements used for heart health.

Vitamin E Is Most Effective When Used Synergistically

Vitamin E is an antioxidant that helps eliminate free radical damage in the body and can potentially slow the formation of plaque buildup in the arteries. Free radical damage can play a role in the development of CVD, so it seems logical that getting more vitamin E in the diet would help prevent CVD. Some studies have even shown a reduced risk of cardiovascular disease when taking supplemental vitamin E. However, there are also studies which show that vitamin E supplements may actually increase the risk of CVD.

Every study differs slightly from similar ones in terms of length of study, dose of vitamin E, study design, and number of participants, to just to name a few differences. One study in Atherosclerosis in 2009 acknowledged these differences in studies with vitamin E and studied the results of observational and intervention studies for vitamin E supplements. The researchers concluded that a difference in the underlying health conditions of research participants may be a cause for the inconsistent results of vitamin E and heart health.

For instance, if someone has CVD already, a supplement may work differently than it would for someone who does not CVD. In spite of this, after studying the results of around 4,000 participants, they concluded that the underlying health condition of a person with CVD was not significantly influential in the effects of supplemental vitamin E and risk for CVD.

One suggestion why supplemental vitamin E may not decrease the risk of CVD in every study is that dietary antioxidants work together (synergistically) to decrease oxidative stress and free radical damage in the body. Other antioxidants include vitamin C, carotenoids (precursors to vitamin A), phytochemicals like flavonoids, and selenium (a mineral). Taking high doses of vitamin E without other antioxidants may hamper the beneficial role these antioxidants have in the body. Studies are now looking at the effects of mixed antioxidant supplements on the prevention of CVD.

So far, studies have had mixed results in regards to supplemental antioxidants. Eating a wide variety of foods, specifically fruits and vegetables, innately provides a broad array of antioxidants that are beneficial for heart health, so until further research clarifies antioxidant amounts for heart health, the best guideline is to consume a wide variety of antioxidant-rich foods like legumes, fruits, and vegetables.

Coenzyme Q10 Amplifies Other Antioxidants

When antioxidants like vitamin E are taken with ubiquinol, more commonly known as coenzyme Q10 (coQ10), there may be an increased benefit in risk reduction for CVD. CoQ10 is known for its role in mitochondrial energy production, and it also functions as an antioxidant when it is in its reduced form of ubiquinol, helping to regenerate vitamin E as an active antioxidant.

Vitamin E and CoQ10 work together to stop LDL particles from becoming oxidized, which is important because oxidized LDL is much more harmful than unoxidized LDL and can cause more damage to your blood vessels. CoQ10 has been shown in some animal studies to also decrease atherosclerotic plaque buildup in the aorta and to be beneficial for congestive heart failure.

Omega 3 Fatty Acids Are Important To Overall Health

Omega 3 fatty acids are some of the most studied supplements for heart health. Eating fish at least twice per week is associated with a reduced risk of CVD. A 2006 study in the American Journal of Clinical Nutrition concluded that fish and fish oil supplements reduce the risk of heart disease to a greater extent in secondary prevention than primary prevention. However, a review of omega 3s and secondary prevention of heart disease in 2012 in the Archives of Internal Medicine concluded, "To date, there is no conclusive evidence to recommend fish oil supplementation for primary or secondary prevention of CVD."

The researchers still advocated to the general population and people with CVD to eat fish at least two times per week and take omega 3 supplements, and they also suggested that omega 3 supplements cannot take the place of an overall healthy diet. Some of the studies which did not show a benefit from taking omega 3 supplements had low participation numbers and other compounding factors, and more research needs to be done to determine the exact effectiveness of omega 3s in the prevention of heart disease. Despite this, consuming fish twice a week and taking an omega 3 supplement is a good idea for general health, even if its benefits to heart health are still unknown.

Dietary Calcium Is The Most Beneficial

Besides providing bone strength, calcium has other health benefits as well, such as helping to control body weight, determine insulin sensitivity, reduce hypertension, and improve cardiovascular health. All of these benefits are noted from a calcium-rich diet, but according to a 2012 study in Clinics, calcium supplements have not shown to be beneficial in reducing CVD risk, and a few studies have concluded that taking calcium supplements might increase overall risk. The benefits of calcium towards heart health remain from eating a calcium-rich diet, even if they do not from a supplement.

A 2008 study in the British Medical Journal concluded that even though calcium supplements in healthy postmenopausal women were associated with an upward trend in cardiovascular events, the benefits of bone health should be also taken into consideration. A 2012 study in American Journal of Cardiovascular Drugs concluded that many people do not get enough calcium from their diet, and calcium supplements are often suggested as a way to get enough calcium. To this effect, more research needs to be done to further evaluate the impact calcium supplements have on health parameters like heart and bone health.

Vitamin D May Play A Role In Regulating Body Fat

Vitamin D is known to increase our body's ability to absorb calcium, and recent research has also shown that vitamin D works a lot of roles in the body. A 2008 study in Circulation analyzed about 2,000 healthy research participants for vitamin D levels and continued testing for 5 years. Lower blood levels of vitamin D were associated with a higher risk for CVD. Researchers indicated that more research should to be done to assess if increasing low blood levels of vitamin D can reduce the risk of CVD.

Vitamin D blood levels have also been correlated with levels of body fat. Low levels of vitamin D were correlated with high levels of body fat, and vitamin D deficiency was three times more likely in people with high amounts of visceral or subcutaneous fat according to a 2010 study in Diabetes. This link between vitamin D and body fat levels could be associated with CVD. It is not known if healthy people who do not have low levels of vitamin D will benefit further from a vitamin D supplement, but we do know that people who have low vitamin D levels can benefit from a supplement to raise levels to a healthy range (35-55 ng/mL).

Related PEERtrainer Article: Vitamin D And Your Health

Garlic Is One Of The Most Effective Supplements!

Garlic is an herbal remedy for heart health that has been used for centuries, and has been shown to reduce the risk of CVD by inhibiting LDL oxidation, improving blood cholesterol, and reducing hypertension. Many studies have shown a beneficial change in cholesterol and a decrease in blood platelet formation with increased garlic intake. Garlic also helps decrease inflammation, a risk factor which can contribute greatly to CVD.

Related PEERtrainer Article: A Complete Guide To Inflammation

A 2011 study from Lipids in Health and Disease studied a group of people with coronary heart disease for one year divided into groups who either were or were not taking a garlic powder supplement. The study concluded there was a significant decrease in the risk of heart disease for the men taking the garlic supplement compared to men not taking the supplement. Women had similar results, though not quite as strong. The garlic supplement used in this study was a long-lasting one (12-16 hour effects) which preserved the biologically-active ingredients from raw garlic. Other garlic supplements may have a shorter effect in the body and may not contain the active compound that promotes heart health, so make sure you purchase from a reputable company!

In Conclusion...

Discrepancies in the conclusions of research often arise from differences in study design, length of study, and number of study participants, and in most cases more research needs to be done to further understand the effect of supplements in regards to heart health. The heart health benefits of nutrients found in food and captured in pill form often do not translate to the same results for reducing the risk of CVD. For example, the effects of a high-calcium diet (very beneficial) do not mean you will get the same effects from taking calcium in pill form.

One theory as to the why is that perhaps other nutrients in whole foods work synergistically for health benefit. When a nutrient is taken in pill form, other nutrients from the whole food are not added alongside it and therefore some health benefit might be missed.

For instance, a 2012 study in The Journal of Nutrition concluded that women who ate more than ten tomato-based foods per week compared to those who only had one per week had significant improvements in certain cardiovascular biomarkers. A 2011 study in Clinical Nutrition studied the benefits of dark chocolate and heart health and concluded that consumption of chocolate was inversely related to heart disease. Tomatoes and chocolate are both high in antioxidants, but there may be a benefit to eating the whole food instead of isolating only one antioxidant as a supplement.

Supplements cannot be substituted for a healthy lifestyle, diet, and exercise in the prevention of CVD. Even though supplements for heart health have had conflicting results, physical activity and a healthy diet continue to offer the best reduction of risk for CVD.

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1. Regional Drug Therapeutics Center (2010). Aspirin for primary prevention of cardiovascular disease. Volume 65, July 2010.

2. Dietrich M, et al (2009). Vitamin E supplement use and the incidence of cardiovascular disease and all-cause mortality in the Framingham Heart Study: Does the underlying health status play a role? Atherosclerosis; volume 205(2); 549-553.


4. Littarru GP, Lambrechts P (2011). Coenzyme Q10: Multiple benefits in one ingredient. Oleagineux Corps Gras, Lipides; volume 18(2);76-82.

5. Wang C, et al (2006). N-3 fatty acids from fish or fish oil supplements, but not α-linolenic acid, benefit cardiovascular disease outcomes in primary-and secondary-prevention studies: A systematic review. American Journal of Clinical Nutrition, volume 86(1);5-17.

6. Hu FB, Manson JE (2012). Omega-3 fatty acids and secondary prevention of cardiovascular disease- Is it just a fish tale? Comment on "Efficacy of omega 3 fatty acid supplements in the secondary prevention of cardiovascular disease". Arch Internal Med, volume 172(9);694-696.

7. Goncalves Torres MRS, Sanjuliani AF (2012). Does calcium intake affect cardiovascular risk factors and/or events? Clinics (San Paulo), volume 67(7);839-844.

8. Bolland MJ, et al (2008). Vascular events in healthy older women receiving calcium supplementation: randomized controlled trial. BMJ, volume 336.

9. Neuhouser ML, et al (2009). Multivitamin use and risk of cancer and cardiovascular disease in the women's health initiative cohorts. Arch Internal Med, volume 169(3);294-304.

10. Wang L, Manson JE, Sesso HD (2012). Calcium intake and risk of cardiovascular disease: a review of prospective studies and randomized clinical trials. Am J Cardiovasc Drugs, volume 12(2);105-116.

11. Sesso HD, Wang L, Ridker PM, Buring JE (2012). Tomato-based food products are related to clinically modest improvements in selected coronary biomarkers in women. The Journal of Nutrition, volume 142(2);326-333.



14. Sobenin IA, et al (2010). The effects of time-released garlic powder tablets on multifunctional cardiovascular risk in patients with coronary artery disease. Lipids in Health and Disease, volume 9.

15. Wang TJ, et al (2008). Vitamin D deficiency and risk for cardiovascular disease. Circulation, volume 117;503-511.

16. Cheng S, et al (2010). Adiposity, cardiometabolic risk, and vitamin D status: The Framingham Heart Study. Diabetes, volume 59(1);242-248.

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