In my 27 years of practicing cardiology, I’ve noticed an increasing frequency in receiving questions about vitamins and supplements. Patients, friends, and even new acquaintances want to know what I think about certain vitamins and supplements. Even more common are situations in which patients come to my office taking handfuls of daily supplements, believing that they are beneficial to the heart.
It is not clear why so many people trust in the benefits (and safety) of supplements, but I do believe that physicians have played a role by promoting certain vitamins and also by not knowing the most current scientific information.
Since I started in practice, I can recall recommending the use of folic acid, then vitamin E, and most recently fish oil supplements, believing that these promoted heart health. These recommendations were based mostly on studies of specific groups or from those that looked at patients’ dietary histories. In fact, when these and other vitamins and supplements have been put to the test in large clinical trials, or through meta-analyses, they have not been shown to reduce cardiovascular event rates. Some vitamins such as beta-carotene and vitamin E in high doses have been to shown to be harmful.
A recent study from The Journal of the American Medical Association, looked at 15,000 men over the age of 50, half receiving a multivitamin (Centrum Silver), and the other half a placebo. After approximately 11 years, there was no significant difference in the rates of heart attack, stroke, or death from cardiovascular disease (there was an 8% lower risk of cancer in the vitamin group).
And although populations that eat more fish tend to have less heart disease, ameta-analysis of studies comparing fish oil supplements to placebo did not show different cardiovascular event or death rates. Additionally:
- Red yeast rice supplements have been shown to lower cholesterol, but long-term safety and improved patient outcome data are lacking.
- Coenzyme Q10 can reduce muscle aches caused by statins (cholesterol-lowering drugs), but some people take it to help heart failure.
Clinical trials have not shown benefit for heart failure patients taking CoQ10.
People taking vitamins and supplements believing that they are beneficial for the heart may ignore their doctors’ recommendations regarding healthy lifestyleand scientifically proven therapies. This is a major concern, as is the potential for drug interactions with certain supplements.
What should one do to optimize heart health?
1. Exercise. Regular exercise promotes weight loss, blood pressure, and lipid lowering, and results in a reduction of cardiovascular events and overall mortality.
2. Make healthy food choices by consuming fewer processed or fast foods. Eat more fresh vegetables, fruits, high fiber foods, and foods rich in omega-3 fatty acids (including fish, nuts, beans, and vegetables).
3. Don’t smoke. Smoking increases your risk of blood clots, increased blood pressure, coronary spasms and overall damage to the heart.
4. If you have cardiac risk factors or heart disease, follow the advice of your physician.
Specific recommendations concerning supplements and vitamins will change over time. Future evidence may clearly indicate that certain supplements reduce cardiac risk and there are other clinical situations in which vitamins are beneficial. For now, however, promoting general heart health does not include the use of vitamins or unproven supplements.
Guest Blog By:
Cliff Ehrlich, M.D., FACC
Clinical cardiologist in private practice at Cardiology Consultants of Philadelphia, Lansdale Division Active Medical Staff at Abington Health – Lansdale Hospital serving as Director of Diagnostic Cardiology.