Supplements and heart health

Will taking supplements improve my heart health?

16 August 2023

When you see ads promising more energy, better focus, improved heart health and the like, it’s tempting to think that supplements will put you on the fast track to good health.

To separate fact from fiction, we took a deep dive into the world of supplements to see what role, if any, these products can play in improving heart health.

What supplements are commonly promoted as being beneficial for heart health?

Some of the most common heart health supplements include:

• fish oil (Omega-3)
• coenzyme Q10 (CoQ10)
• vitamin D
• red yeast rice
• plant sterols
• magnesium
• folate
• fibre

What does the research say?

There is currently little evidence of a link between supplement use and reduced cardiovascular disease risk.

A 2018 meta analyses into common supplements and cardiovascular risk found that popular supplements including multivitamins, calcium, vitamin D and vitamin C showed no consistent benefit in preventing cardiovascular disease, heart attack and stroke.

Vitamin D supplementation was associated with a small reduction in major cardiovascular events in a 2023 study of approximately 21 000 participants aged 60-84. The authors noted that further research is needed, particularly in relation to supplementation in people who take medication for existing cardiovascular diseases.

A 2023 study of 190 participants ranging from 40 to 75 years with an increased 10-year risk of developing atherosclerotic cardiovascular disease found that within these individuals, low dose statin use lowered LDL ‘bad’ cholesterol significantly more than placebo and six common dietary supplements, including fish oil, cinnamon, garlic, turmeric, plant sterols and red yeast rice.

Vitamin B6, vitamin A, multivitamins, antioxidants, and iron supplements were found in a 2019 systematic review to not significantly reduce the risk of cardiovascular disease. However, omega-3 and folate supplements were associated with a reduction in cardiovascular outcomes. The review also found that combined calcium and vitamin D supplements might increase the risk of stroke.

When are supplements beneficial?

Supplements are beneficial when they are used to address existing deficiencies. This may include common deficiencies like iron and vitamin D. Deficiencies can be identified via a blood test.

Omega-3 intake has been linked to benefits such as lower triglyceride levels, higher ‘good’ cholesterol, reduced risk of blood clots and slightly lower blood pressure. Omega-3s can be found in fish and some plant foods, but for those who don’t consume enough of these foods, omega-3 supplements may be a viable alternative.

Plant sterols have been found to lower total and LDL-cholesterol levels, though not to the same degree as statins. Therefore, plant sterol-fortified foods may be beneficial as one part of an overall strategy to manage high cholesterol levels.

Fibre has many benefits for heart health. As the average Australian consumes less than the recommended daily fibre intake, an appropriate fibre supplement may be beneficial for those who struggle to get enough fibre through food, or for those who have specific digestive needs e.g. people with IBS and other digestive disorders.

Is there any harm in taking supplements?

Due to the fact supplements can be purchased over the counter and are often marketed as a ‘natural alternative’ to medication, people may not be aware of the potential side effects associated with their use.

While for some the only downside to supplements is wasting money on something you’re already getting through food, on the other end of the scale supplement use may lead to consuming vitamins in toxic amounts. This is of particular note with fat-soluble vitamins, like vitamins A, D, E and K, which accumulate in the body, as opposed to water-soluble vitamins that are excreted through urine when they reach excess amounts.

Some supplements can also interact with medications, in particular heart medications such as blood thinners, therefore it is important to discuss supplement use with your GP or cardiologist.

What is the final verdict on supplements for heart health?

A healthy diet is one of the best defenses against heart disease. Unless there is an identified deficiency that needs to be addressed, most supplements are at best a waste of money and at worst can cause issues with toxicity and drug interactions.

For those who aren’t getting the vitamins they need through food, supplementation may appropriate, but should be discussed with your GP or cardiologist.