The six supplements people typically take for heart health don’t help lower “bad” cholesterol or improve cardiovascular health, but statins do, according to a study published Sunday.
Some people think that common dietary supplements—fish oil, garlic, cinnamon, turmeric, plant sterols, and red yeast rice—lower their “bad” cholesterol. “Bad” cholesterol, known in medical circles as low-density lipoprotein or LDL, causes the buildup of fatty deposits in arteries. Fat deposits can block the flow of oxygen and blood that the heart needs to work, and blockages can lead to a heart attack or stroke.
In the study, presented at the American Heart Association’s 2022 Scientific Sessions and concurrently published in the Journal of the American College of Cardiology, researchers compared the effects of these particular supplements with the effects of low-dose statins, a type of cholesterol. comparison. Lowering the drug – or a placebo, it won’t help.
The researchers made this comparison in a randomized, single-blind clinical trial involving 190 adults with no prior history of cardiovascular disease. Study participants, aged 40 to 75, received a low-dose statin called rosuvastatin, a placebo, fish oil, cinnamon, garlic, turmeric, plant sterols, or red yeast rice in different groups. Lasts 28 days.
Statins had the greatest effect and significantly lowered LDL compared with supplements and placebo.
Average LDL reductions were nearly 40% after 28 days of statin use. Statins also had additional benefits on total cholesterol (down 24 percent on average) and blood triglycerides (down 19 percent).
None of the people taking the supplements had any significant reductions in LDL cholesterol, total cholesterol or blood triglycerides, and their results were similar to those taking the placebo. While there were similar adverse events in all groups, those taking plant sterols or red yeast rice had a higher number of problems.
“We designed this study because many of us have had the same experience of trying to recommend evidence-based therapies to reduce cardiovascular risk to patients and then having them say ‘no thanks, I’ll try this supplement agent,’” said the research firm — author Dr. Karol Watson, professor of medicine/cardiology and co-director of the Preventive Cardiology Program at UCLA. “We wanted to design a very rigorous, randomized, controlled pilot study to prove what we already knew and show it in a rigorous way.”
PhD. Patients are often unaware that dietary supplements are not being tested in clinical trials, said Steven Nissen, a cardiologist and researcher at the Cleveland Clinic and co-author of the study. He calls these supplements “21st century snake oils.”
In the United States, the Dietary Supplements and Health Education Act of 1994 severely limited the FDA’s ability to regulate supplements. Unlike pharmaceutical products, which must be proven safe and effective for their intended use before companies can market them, the FDA does not need to approve dietary supplements before they can be marketed. The FDA can step in to regulate them only after they’re on the market and proven to be unsafe.
“Patients believe that the research is done, that they are as effective as statins, and that they can be rescued because they are natural, but natural doesn’t mean they’re safe, and it doesn’t mean they’re effective,” Nissen said.
The study was funded by an unrestricted grant from AstraZeneca, which manufactures rosuvastatin. Based on the study, the company provided no input on the methods, data analysis, and discussions of clinical significance.
The researchers acknowledged some limitations, including that the study’s small sample size and its 28 study periods may not have captured the effects of long-term supplement use.
“Supplements are not intended to replace drugs or other medical treatments,” the Committee on Responsible Nutrition, the dietary supplement industry trade association, said in a statement Sunday.
“Dietary supplements are not designed to be a quick fix, and their effects may not last over the course of a study that lasts only four weeks,” Andrea Huang, the group’s senior vice president of scientific and regulatory affairs, said in a statement. manifest.”
PhD. James Cireddu, an invasive cardiologist and medical director of the Harrington Heart and Vascular Institute at University Hospitals Bedford Medical Center, said the work would be helpful.
“They did a great job of collecting data and observations,” said Cireddu, who was not involved in the study. “It might resonate with patients. I get asked all the time about supplements. I think it does a good job of providing evidence.”
PhD. Amit Khera, chair of the AHA Scientific Sessions Program Committee, was not involved in the study, but said he believed it was an important study that could be included in this year’s presentation.
“I care for patients with these exact questions every day. Patients are always asking about supplements to replace or complement statins,” said Khera, professor and director of preventive cardiology at UT Southwestern Medical Center. “I think if you have high-quality evidence and well-established research, it’s very important to help patients understand the value, or lack thereof, of some of these cholesterol-lowering supplements in this case.”
Statins have been around for more than 30 years and have been studied in more than 170,000 people, he said. Consistently, studies have shown that statins reduce risk.
“The good news, we know that statins work,” Khera said. “That doesn’t mean they’re perfect. It doesn’t mean everyone needs one, but for those at higher risk, we know they work and are well-proven. If you’re going to do something different thing, you have to make sure it works.”
As for supplements, he said he often sees misinformation online.
“I think people are always looking for ‘natural’ things, but you know there are a lot of problems with that term, the most important thing we should be asking if they work? That’s what this study did,” Khera added. “It’s important to ask if you’re taking a proven drug, and if you’re doing it and that’s not the case, is that an alternative to a proven treatment. That’s a real concern.”