Don’t worry about dietary supplements for heart health, says study


Six heart health supplements people commonly take don’t help lower “bad” cholesterol or improve cardiovascular health, according to a study published Sunday, but statins do.

Some believe that common dietary supplements – fish oil, garlic, cinnamon, turmeric, plant sterols and red yeast rice – will lower “bad” cholesterol. “Bad” cholesterol, known in the medical community as low-density lipoprotein or LDL, can cause fatty deposits to form in the arteries. Fatty deposits can block the flow of oxygen and blood that the heart needs to function, and the blockage can lead to a heart attack or stroke.

For this study, presented at the American Heart Association’s Scientific Sessions 2022 and simultaneously published in the Journal of the American College of Cardiology, researchers compared the effect of these particular supplements to the effect of a low dose of a statin -cholesterol. lowering the medication or a placebo, which does nothing.

Researchers conducted this comparison in a randomized, single-blind clinical trial involving 190 adults with no history of cardiovascular disease. The study participants were between the ages of 40 and 75, and different groups received a low-dose statin called rosuvastatin, a placebo, fish oil, cinnamon, garlic, turmeric, plant sterols, or red yeast rice for 28 days.

The statin had the greatest effect and significantly lowered LDL compared to supplements and placebo.

The average reduction in LDL after 28 days with the statin was almost 40%. Statins also had an additional benefit in total cholesterol, which fell by an average of 24%, and in blood triglycerides, which fell by 19%.

People who took the supplements did not see a significant decrease in LDL cholesterol, total cholesterol, or blood triglycerides, and their results were similar to people who took a placebo. Although there were similar adverse events in all groups, there was a higher number of problems among those taking plant sterols or red yeast rice.

“We designed this study because many of us have had the same experience of trying to recommend evidence-based therapies that reduce cardiovascular risk to patients and then ‘no thanks, I’ll try this supplement,'” said the researcher. -by Dr. Karol Watson, professor of medicine/cardiology and co-director of UCLA’s preventive cardiology program. “We wanted to design a very rigorous, randomized, controlled study to prove what we already knew and show it rigorously.”

Dr. Steven Nissen, a cardiologist and researcher at the Cleveland Clinic and co-author of the study, said patients are often unaware that dietary supplements are not tested in clinical trials. He calls these supplements “the snake oil of the 21st century.”

In the United States, the Dietary Supplement and Health Education Act of 1994 significantly limited the US Food and Drug Administration’s ability to regulate supplements. Unlike pharmaceutical products that must be proven safe and effective before a company can market them, the FDA does not have to approve dietary supplements before they can be sold. Once they are on the market and proven to be unsafe, they can be regulated by the FDA.

“Patients think they’ve been tested and they’re as effective as statins and they can keep them because they’re natural, but natural doesn’t mean safe and doesn’t mean they’re effective,” Nissen said.

The study was funded by an unrestricted grant from AstraZeneca, which makes rosuvastatin. The company had no input into the methodology, data analysis, and discussion of the clinical implications, according to the study.

Dr. James Cireddu, an invasive cardiologist and director of the University Hospitals Harrington Heart & Vascular Institute at University Hospitals Bedford Medical Center, said the work will be helpful.

“They did a nice job collecting the data and analyzing the results,” said Cireddu, who did not work on the study. “It will probably resonate with patients. I get asked about supplements all the time. I think this does a nice job of providing evidence.’

Dr. Amit Khera, chair of the AHA Scientific Sessions programming committee, did not work on the research, but said he believed the research was important to include in this year’s presentations.

“I take care of patients every day with these specific questions. “Patients are always asking about statin replacements or supplements,” said Khera, who is professor and director of preventive cardiology at UT Southwestern Medical Center. helping inform the value or, in this case, the lack of value.”

Statins have been around for more than 30 years and have been studied in more than 170,000 people, he said. In particular, studies show that statins reduce the risk.

“The good news is, we know that statins work,” Khera said. “That doesn’t mean they’re perfect. That doesn’t mean everyone needs it, but for those at higher risk we know they work and that’s well proven. If you’re going to do something different, you have to make sure it works.”

With supplements, he said he often sees misinformation online.

“I think people are always looking for something ‘natural’, but you know there are a lot of problems with that terminology and most importantly we should ask do they work? That’s what this research does,” added Khera. “It’s important to ask, are you taking something that’s proven, and if you’re doing that and not, instead of a proven treatment. It’s a real concern.”