News: Multivitamins Won't Protect Against Heart Attacks and Stroke, Says Study

News: Multivitamins Won't Protect Against Heart Attacks and Stroke, Says Study

Vitamin and mineral supplements may not be as powerful as you think.

Heart disease is the top cause of death in the United States, killing about 610,000 men and women annually—one-quarter of deaths overall. High blood pressure, high cholesterol and smoking are the leading risk factors, and 47 percent of us have at least one of these.

Since these conditions can increase your risk for heart attack, stroke and cardiovascular-related death, many adults turn to vitamins and supplements to reduce their chances of developing them—especially to lower high cholesterol. After all, supplements are quick, they’re easy and—the reasoning goes—if we need certain substances to be healthy, then perhaps more is better.

However, the reality is most people don’t benefit from taking supplements for heart disease prevention. For instance, according to research published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes, multivitamins don't prevent heart attack or stroke. Researchers analyzed 18 studies including more than 2 million participants with an average follow-up of 12 years to draw a conclusion: there are no heart-related benefits to taking a multivitamin. 

And what about other supplements? Read on if you're hoping they'll protect your heart.

Supplements that may have some benefits
You may have heard that fish oil supplements (omega-3 polyunsaturated fatty acid) were good for your heart. Clinical trials in the 1990s suggested they did offer some preventive benefits, explains Geoffrey Zarrella, DO, a cardiologist from Lourdes Health System in Willingboro, New Jersey. “At that time, medical therapy was in a more primitive state and the percentage of patients referred for complete revascularization (restoring blood to the heart via angioplasty versus coronary artery bypass surgery) wasn’t the same as it is today.”

Now, he says, more people undergo revascularization procedures, more people are on statins (drugs that lower cholesterol) and those statins are even more potent than their earlier versions. Therefore, fish oil is not as powerful in terms of absolute cardiovascular risk reduction. In fact, a 2017 scientific advisory statement from the American Heart Association noted there wasn't evidence omega-3 supplements helped the general public—those not at risk for cardiovascular disease—at all.

That's not to say they're useless, however, especially for people with existing conditions, like heart failure. Dr. Zarrella says if you already have heart disease, fish oil supplements may play a small role in preventing a second heart event.

Another potentially helpful heart supplement is psyllium, a soluble fiber that binds up cholesterol in the intestines so you can then pass it in your stool. This, in turn, causes the liver to take more LDL ("bad" cholesterol) out of your blood. So, “taking psyllium will help lower cholesterol levels somewhere between 5 and 8 percent."

Supplements that don’t work or are questionable
Red yeast rice is a traditional Chinese medicine product that helps lower cholesterol by reducing how much of it the liver produces. It's made using a fungus named Monascus pupureus, which produces a chemical called monacolin K. “Red yeast rice is really a low-potency statin,” Zarrella says.

Clinical trials have shown that monacolin K can lower cholesterol and LDL, but at doses much higher than supplements typically provide. In fact, studies by the Food and Drug Administration (FDA) have found that many current red yeast rice products contain little or no monacolin K at all, rendering their lipid-lowering effects null.

Red yeast rice isn't the only questionable heart supplement. Zarrella says the evidence is weak to non-existent for many popular products including garlic, coenzyme Q10, vitamins D and E, folic acid and niacin. He urges us to be skeptical of supplements in general. The FDA does not regulate them, so we don’t know we’re actually getting what the label says we are. Furthermore, some supplements can cause harm, so you should always discuss the potential benefits and risks with your doctor before taking them. Zarrella encourages his patients to bring their supplements with them to visits, so the ingredients can be vetted.

How to lower your risk
More important than taking supplements, Zarrella says, is a general healthy lifestyle. Following the AHA’s Life’s Simple 7, a set of guidelines designed to improve your overall wellbeing—and especially your heart health—can help. They are:

  1. Control your blood pressure
  2. Control your lipids (cholesterol)
  3. Control your blood sugar
  4. Follow a healthy eating pattern
  5. Don’t smoke
  6. Exercise regularly
  7. Maintain a healthy body weight

“Unfortunately, only about 2 to 3 percent of the population meets all of these metrics,” Zarrella says. However, if you can hit all of them, he notes, it goes a long way for protecting yourself against cardiovascular disease—and is the cornerstone for a long and healthy life.

Zarrella says the best trial on nutrition and heart disease, the PREDIMED Trial, found that people who followed a Mediterranean-style diet—heavy on fruits and vegetables and lean protein sources, supplemented with nuts or extra virgin olive oil—had fewer major cardiac events.

Bottom line: skip the supplements and prevent heart disease by eating a nutritious diet, maintaining a healthy weight, getting regular physical activity and not smoking.

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