Popping vitamin, mineral, or other dietary supplements might seem like an easy way to boost heart health, but that's usually not the case. A number of large studies over the past several years failed to find that supplements of folic acid and other B vitamins, as well as vitamins C and E, prevent heart attacks or strokes. In one study, in fact, vitamin E was linked to an increased risk of hemorrhagic stroke.
One supplement—red yeast rice—can lower LDL (bad) cholesterol almost as effectively as certain statin drugs. But that's because it can contain a naturally occurring substance essentially identical to the prescription drug lovastatin (Altoprev, Mevacor, and generic). Unfortunately, that means it poses the same risks, too, which can be considerable, especially if you're not being monitored by a doctor.
Moreover, since heart supplements aren't carefully regulated by the Food and Drug Administration, it's often hard to know whether what's on the label is really in the package. Indeed, a study in the Oct. 25, 2010, issue of the Archives of Internal Medicine found "striking" variability in the amount of the active ingredients in 12 red yeast rice supplements. The labels "all said 600 milligrams on the bottle," said Ram Gordon, M.D., a cardiologist at the Chestnut Hill Hospital in Philadelphia and the lead author of the recent study. "The question is, 600 mg of what?" Our medical consultants say people should avoid all red yeast rice supplements.
The evidence for some other heart supplements—such as coenzyme Q-10, garlic and green tea—is often inconsistent or weak. And even those that are more likely to offer benefits can pose some risks, too, especially when taken with certain drugs. Even fish oil, which has good supporting evidence, probably shouldn't be taken with high blood-pressure medication or blood-thinning drugs.
Finally, supplements taken for noncardiac reasons can also interact with certain heart medication. Echinacea, for example, can make statins more potent, possibly increasing the risk of side effects, and St. John's wort can make those drugs less effective. "Many patients on heart drugs don't realize that a number of supplements—no matter what they're taken for—can interfere with how well heart drugs work," Gordon says.
Our advice: Don't take heart supplements without talking with a doctor first, especially if you take heart medication. And supplements should never be used in place of needed medication or as an excuse to skip proven protective measures, such as losing excess weight, exercising more, and eating a heart-healthy diet.
If you do opt for a heart supplement, look for one labeled "USP Verified." That indicates that the manufacturer has voluntarily asked the U.S. Pharmacopeia, a nonprofit, private standards-setting authority, to verify the quality, purity, and potency of its raw ingredients or finished products. For a list of products that have been verified by the USP, go to www.uspverified.org.
Here's our guide to some supplements that are likely to offer some heart-health benefits, according to the Natural Medicines Comprehensive Database, which partners with ConsumerReportsHealth.org to evaluate the safety and effectiveness of supplements. The evidence is especially strong for the first, fish oil. The table below lists some herbs and heart drugs that can sometimes interact in dangerous ways.