Don’t bother with heart health supplements, study says

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Don't bother with heart health supplements, study says



CNN

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

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

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

The researchers performed this comparison in a randomized, single-blind clinical trial involving 190 adults with no history of cardiovascular disease. Study participants were 40 to 75 years old, 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, significantly lowering LDL compared to the supplements and placebo.

The average LDL reduction after 28 days with a statin was almost 40%. The statin also had the added benefit of total cholesterol falling by an average of 24% and blood triglycerides falling by 19%.

None of the people taking the supplements saw a significant decrease in LDL cholesterol, total cholesterol, or blood triglycerides, and their results were similar to people taking a placebo. While there were similar adverse events in all groups, there were a numerically higher number of problems in those taking plant sterols or red yeast rice.

“We designed this study because many of us have had the same experience of recommending patients evidence-based therapies that reduce cardiovascular risk and then having them say, ‘No thanks, I’ll just try this dietary supplement,'” he said Study co-author Dr. Karol Watson, Professor of Medicine/Cardiology and Co-Director of UCLA’s Preventive Cardiology Program. “We wanted to design a very rigid, randomized controlled trial to prove what we already knew and show it in a rigorous way.”

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 dietary supplements “snake oil of the 21st century”.

In the United States, the Dietary Supplement and Health Education Act of 1994 severely limited the US Food and Drug Administration’s ability to regulate dietary supplements. Unlike pharmaceutical products, which must be safe and effective for their intended purpose before a company can market them, the FDA does not have to approve dietary supplements before they can be sold. Only after they are on the market and proven unsafe can the FDA step in to regulate them.

“Patients believe that studies have been done and that they are as effective as statins and they can save themselves because they are natural, but natural doesn’t mean safe and it doesn’t mean they’re effective,” Nissen said.

The study was funded through an unrestricted grant from AstraZeneca, which makes rosuvastatin. According to the study, the company had no influence on the methodology, data analysis and discussion of clinical implications.

The researchers acknowledged some limitations, including the small sample size of the study and that the 28-day study period may not capture the effects of dietary supplements with prolonged use.

In a statement Sunday, the Council for Responsible Nutrition, a trade association for the dietary supplement industry, said that “dietary supplements are not intended to replace drugs or other medical treatments.”

“Dietary supplements are not intended as quick fixes and their effects may not be revealed over the course of a study spanning only four weeks,” said Andrea Wong, the group’s senior vice president of scientific and regulatory affairs, in a statement.

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

“They did a good job collecting data and looking at the results,” said Cireddu, who did not collaborate on the study. “It will probably resonate with patients. I am constantly asked about dietary supplements. I think that does a good job of providing evidence.”

dr Amit Khera, chair of the AHA science sessions program committee, did not work on the research but said he thinks it is an important study to include in this year’s presentations.

“I look after patients with exactly these questions every day. Patients are always asking about nutritional supplements instead of or in addition to statins,” said Khera, professor and director of preventive cardiology at UT Southwestern Medical Center. “I think when you have quality evidence and a well-conducted study, it’s really crucial to educate patients about the value, or in this case the lack of value, of some of these cholesterol-lowering supplements.”

Statins have been around for more than 30 years and have been studied in over 170,000 people, he said. Studies consistently show that statins lower the risk.

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

When it comes to dietary supplements, he often sees misinformation on the Internet.

“I think people are always looking for something ‘natural’ but you know there are a lot of problems with this terminology and most importantly we should ask if it works? This study does exactly that,” adds Khera. “It’s important to ask if you’re taking something proven, and if you are and aren’t, that’s in lieu of a proven treatment. It’s a real concern.”

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