Adam Streb.

Alexandru Stoian.

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Studies suggest roughly half of U.S. adults take some form of vitamin or supplement to help with their heart health. Dietary supplements are a $55 billion-a-year industry in the U.S., according to CDC research.

But some supplements are researched and studied more often than others, leading to mixed reviews about whether they are as effective as they claim.

St. Lawrence Health Cardiologist Alexandru Stoian, MD; and Rochester General Hospital Cardiology team member Adam Streb, PA-C, explained how some supplements can affect heart health and when it’s best to stick to what your provider prescribes.

What to Try Before Supplements

Before using supplements, experts suggest trying to improve your heart health by starting with changes in your diet and physical activity.

Following guidance from the American Heart Association, experts encourage people to exercise 150 minutes a week, or about 30 minutes 5 days a week. As long as the activity gets your heart rate up to a point where you can say 3-4 words before having to take a breath, that’s a good place to be.

What you eat and drink comes into play with your heart health, too. Do your best to eat more plants in general, eating a variety of vegetables and fruits, along with beans, whole grains, nuts, seeds and lentils. Eating less processed food, fatty meats, and foods with added sugar can go a long way toward keeping your heart in good shape.

Meals that follow the Mediterranean diet, DASH diet, and whole food, plant-based eating are a good rule of thumb.

“I think the data supports this strongly: one of the biggest things someone can do to give themselves an edge in preventing disease in general is healthy eating and exercise,” PA Streb said. “There is not a replacement for it.”

“Even if your cholesterol, blood pressure, and blood sugar look good, maintaining good patterns when it comes to diet and exercise will be your number one solution in helping you have a good quality of life for a longer period of time.”

Dr. Stoian agreed and said he cannot stress enough the importance of a healthy, plant-based diet. Along with the foods listed above, he reminds individuals to that their vegetable intake should include an array of colors, such as red (beets), orange (carrots), and green (lettuce) to name a few. He further noted green tea can be beneficial in fighting off certain cancers.

 Individuals who have undergone heart surgery or have experienced a heart illness, and are prescribed cardiac rehabilitation as part of their recovery, should be certain to follow through with those orders.

“Studies of cardiac rehabilitation patients have proven that proper exercise, sleep, and a balanced diet have a major effect on their recovery and a longer life,” Dr. Stoian said. “There are thousands of patients in northern and central New York who could benefit from this service. Other than stopping smoking, cardiac rehabilitation is the most effective form of making your heart stronger and preventing you from being readmitted to the hospital following a heart procedure or illness. It will also decrease your mortality.”

Common Supplements

There are a number of supplements that adults take with the goal of boosting their heart health. Some have a proven track record backed by scientific study; others are not as well researched.

 Omega-3 fish oil: Often taken as a capsule, omega-3 fish oil benefits patients by helping to lower their cholesterol. However, studies do not support omega-3 fish oil as something that specifically improves heart health when taken as a supplement.

“Cardiac patients who are on blood thinners should avoid fish oil or fatty acid supplements; they could make the patient bleed internally,” Dr. Stoian reported.

He also noted that individuals with a weak heart may be advised by their cardiologist to take iron and B12 supplements, which are both very good at carrying oxygen throughout the body. Vegans can also benefit from taking B12.

Research suggests the best way for people get the benefits of omega 3 fatty acids is through their diet, rather than a supplement. Eating fish rich in omega 3s such as salmon, herring, or mackerel, and eating flax seeds, chia, or walnuts can help your body get the benefits it needs. Eating these foods has a double benefit of being good for your heart and replacing saturated fats that are usually found in red meats.

For heart disease patients with type 2 diabetes, providers will prescribe omega 3 fish oil supplements.

Red yeast rice: Red yeast rice is made by fermenting yeast on rice. The process enriches the rice with a natural active ingredient called monacolin K, similar to lovastatin. Monacolin K can help to slow cholesterol being produced in the body.

People who are hesitant about taking statins often consider red yeast rice as an alternative. However, scientific reviews show the amount of monacolin K varies from supplement to supplement, meaning it is less powerful than prescribed statins. This makes it difficult for providers to recommend as an effective way to manage cholesterol.

Aspirin: Important: Aspirin is a medication, not a supplement. Most heart doctors are familiar with aspirin because it’s required as treatment if you have known heart disease or had a stent placed. It used to be a regularly prescribed medication to help prevent heart conditions, but recent science shows its risks outweigh its benefits for people who aren’t at risk for heart conditions.

Dr. Stoian pointed out, however, that cardiac patients on blood thinners should also stay away from aspirin, as it prevents the blood from clotting, unless it is specifically prescribed.

 CoQ10 (Coenzyme Q10): Coenzyme Q10 is a substance found naturally in the body, mostly in the heart, liver, pancreas, and kidneys.

People who have had muscle aches associated with statins might be able to try these, but they are not widely recommended for heart patients. While there is some evidence that it helps some people when it is specifically prescribed – like heart failure patients – there needs to be more research to support it because existing studies are inconsistent.

 Supplements and statins: With any supplement, it is wise to treat it exactly like you would a medication. It is always good to have a discussion with your primary care provider or cardiologist who might recommend them. Just because something is sold as a supplement doesn’t prevent it from having side effects or interacting with other medications.

 If you are still not seeing results in your heart health after adjusting to a healthy diet and regular physical activity, another approach to consider is adding a statin as prescribed by your primary care provider or cardiologist. Statins are a type of medication that lower cholesterol by reducing cholesterol made by the liver and getting rid of cholesterol that is already in the blood.

 Some people may have had a negative experience with one type of statin might want to ask their provider about trying another type of medicine to reduce their cholesterol, as there are quite a few choices.

Learn more about its Cardiology services by visiting https://www.stlawrencehealthsystem.org/Services/Cardiology.