Which Supplements Support Good Heart Health

I’m often asked by my students to tell them which supplements are good for promoting and maintaining good heart heath. I’m put together the following list:

Products to Promote Cardiovascular Health

Vitamin C (found in Oranges, Lemons, Acerola Cherries and Strawberries)

• May reduce the risk of cardiovascular disease
  but not proven to reduce the risk of stroke.
• May reduce risk of death from stroke in elderly
  persons.
• May reduce blood pressure.
• Supports the normal metabolism of fats.
• Necessary for the control of blood cholesterol and
  lipids.
• An antioxidant vitamin that prolongs the useful life
  of vitamins A and E and protects the polyunsaturated
  fatty acids and LDL cholesterol from oxidation.
• Necessary for normal red blood cell formation.>
• Necessary for the formation and maintenance of
  collagen, a component of heart tissue.
• Necessary for normal healing.
• May decrease mortality from health-related causes of
  death (e.g., not trauma or accidents).

Food Sources & Amounts

• Citrus fruits and juices, broccoli, cabbage, potatoes,
  cauliflower, peppers, green leafy vegetables, cantaloupe,
  strawberries, tomatoes, rose hips, acerola, camu-camu,
  carambola fruit.
• The current RDA is 60 mg for adult nonsmoking men
  and women.

Vitamin E

• An antioxidant vitamin.
• Supplementation may reduce the risk of coronary heart
  disease.
• Supplementation may reduce the risk of atherosclerosis.
• Supplementation reduces blood pressure when
  combined with other antioxidant vitamins.
• Inhibits cholesterol synthesis.
• Inhibits atherosclerosis in animals and humans.
• May reduce the risk of cardiovascular disease.
• Necessary for normal red blood cell function.
• Necessary for normal muscle function.
• Supports the synthesis of the antioxidants vitamin C,
  and coenzyme Q-10.
• Protects against symptoms caused by a selenium
  deficiency.
• Protects against premature aging.
• May reduce the risk of mortality from health-related
  causes.

Food Sources & Amounts

• Vegetable oils, legumes, some whole grains, nuts, dark
  green leafy vegetables, avocado.
• Palm oil, rice bran, and barley are rich sources of
  tocotrienols.
• The current RDA is 14.90 IU for adult males and 11.92
  IU for adult females.

Folic Acid (Folate, Folacin)

• May help normalize blood levels of homocysteine.
• May help prevent cardiovascular disease.
• May protect against coronary artery disease.
• May improve function of blood vessels in patients with
  high blood homocysteine and/or cholesterol who are at
  increased risk of atherosclerosis.
• Used to treat certain types of anemia.
• Necessary for normal carbohydrate and fat metabolism.

Food Sources & Amount

• Liver, kidney, green leafy vegetables, nuts, citrus fruits,
  legumes, soybeans, whole grains, beets, peas, tomatoes,
  fish, eggs, celery.
• The current RDA is 200 mcg for adult males and 180
  mcg for adult females (400 mcg if pregnant or 280 mcg
  if breastfeeding).

Vitamin B₆

• Lowers blood homocysteine.
• Lowers blood pressure in hypertensive individuals.
• Dietary supplementation may help prevent or treat
  cardiovascular disease.
• Important for normal carbohydrate and fat
  metabolism.
• Necessary for normal protein synthesis.
• May be useful for individuals under stress.

Food Sources & Amount

• Many foods, including fish, meats, kidney, liver, whole
  grain breads and cereals, carrots, cabbage, peas, potatoes,
  milk, eggs, bananas, green beans, fortified cereals.
• The current RDA is 2.0 mg for adult males and 1.6 mg
  for adult females.

Vitamin B₁₂

• May reduce blood levels of homocysteine.
• Important for healthy blood cell formation.
• May support adaptation to stress.

Food Sources & Amount

• Fish, meat, liver, dairy products.
• The current RDA is 2 mcg for adult males and
  females.

Magnesium

• May help prevent and treat cardiovascular disease.
• May lower the risk of developing atherosclerosis.
• May help control high blood pressure.
• May help treat congestive heart failure.
• Necessary for normal nerve and muscle function.
• May increase muscle strength.
• Necessary for normal protein synthesis.

Food Sources & Amount

• Soy flour, nuts, whole grains, molasses, green leafy vegetables,
  meats, seafoods, dried fruit, coffee, chocolate.
• The current RDA is 350 mg for adult males and 280 mg
  for adult females.

L-Arginine

• Important in maintaining cardiovascular health.
• May help lower blood pressure.
• Improves dilation of blood vessels and increases blood
  flow.
• Improves heart blood vessel function in patients with
  angina.
• Provides symptomatic benefit in peripheral artery disease.
• Inhibits development of atherosclerosis (in animals).
• May facilitate removal of existing blood vessel cholesterol
  deposits (in animals).
• May help prevent platelet aggregation in people with
  high blood cholesterol.
• Important for normal muscle metabolism and disposal
  of protein metabolic waste.
• Important for transmission of nerve impulses.
• Dietary supply is essential following injury or other
  trauma to improve healing.

Food Sources & Amount

• Meats, wheat germ, cottage cheese, ricotta, nuts, eggs,
  milk, granola.
• Up to 30 g/day have been well-tolerated, with nausea
  and diarrhea reported infrequently.

Garlic

• Dietary supplementation prevents and reduces atherosclerosis
  in animals with high blood cholesterol and in humans.
• Inhibits platelet aggregation (a prelude to blood clot
  formation).
• May prevent oxidative damage to blood vessel lining
  cells.
• May support aortic blood flow in aging individuals.
• May prevent some forms of heart disease and stroke.

Food Sources & Amount

• Root of Allium sativum
• Individuals taking anti-coagulant medications (e.g., warfarin
  or coumadin) should consult their physician before
  consuming large quantities, since it can inhibit blood
  clotting.

Grape Extract

• Grape seeds are a preferential source of oligomeric
  proanthocyanidin (pycnogenol) complexes (OPCs)
  which are naturally occurring antioxidants.
• Grape seed extract (GSE) is a potent antioxidant.
• Dietary supplementation with GSE increased antioxidant
  activity in blood.
• OPCs have anti-inflammatory and immune system
  modulation effects.
• OPCs protect collagen and elastin, proteins found in
  blood vessels and muscle.
• OPCs increase venous tone and reduce the pain and
  swelling associated with varicose veins and other
  vascular diseases.
• Grape seed OPCs lower blood cholesterol and inhibit the
  development of atherosclerosis in animals with high
  blood cholesterol levels.
• OPCs protect heart muscle from oxidative injury
  following heart attack (in animals).

Food Sources & Amount

• Fruit of the common grape (Vitis vinifera)
• OPCs have been given orally in doses as high as 300
  mg/day for up to 6 months in patient studies, with no
  adverse effects noted.

Hawthorn Berry Extract

• May improve coronary artery blood flow.
• Extracts are antioxidants and may protect heart
  muscle from damage caused by heart attack.
• Improves performance of the heart in patients with mild
  congestive heart failure.
• Flavonoid compounds extracted from the hawthorn
  plant increase the performance of animal heart tissue (in
  vitro).
• Extracts cause dilation of arterial blood vessels, which
  may contribute to their cardioprotective effect.
• Lowers blood cholesterol and other lipids and increases
  excretion of bile acids and decreases synthesis of cholesterol
  in the liver.

Food Sources & Amount

• Ripe berries of the hawthorn plant (Crataegus sp)
• A dose of 160 to 900 mg of a standardized Hawthorn
  berry extract containing 2.2% flavonoids or 18.75%
  oligomeric procyanidines, given 2-3X per day has been
  recommended.
• No toxic effects have been reported. However, people
  taking prescription heart medications or CNS depressants
  should consult with their doctor before using
  hawthorn-containing products.

Taurine

• Improves the symptoms of congestive heart failure.
• Protects heart muscle from damage due to calcium
  imbalances.
• Prevents against irregular heartbeat resulting from potassium
  imbalances.
• Increases the strength of heart muscle contractions.
• Lowers blood pressure in animals, and
  patients with high blood pressure.
• Supplementation may reduce blood cholesterol levels.
• Supplementation may reduce the risk of atherosclerosis
  (animal studies).
• May help control blood clot formation.
• May protect the heart from oxidative injury following
  heart attack or angina.
• Individuals with high blood pressure, seizure disorders,
  or heart disease are at risk for deficiencies.

Food Sources & Amount

• Red meats, fish, beets, human milk.
• No significant adverse health effects reported in patients
  given daily oral doses of 3-6 g given for 3-6 weeks.

Trimethylglycine

• Lowers blood levels of homocysteine.
• May help prevent heart attack, stroke, and thromboembolism.
• May protect liver from diets high in fat and cholesterol
  (animal studies).

Food Sources & Amount

• Plant foods, particularly beets.
• Considered safe when 6-9 g was given daily for up to 16
  years.

Alpha-Lipoic Acid

• May improve heart function in diabetics.
• May protect heart muscle from oxidative stress following
  angina or heart attacks.
• Provides effective antioxidant support.
• A treatment for individuals in whom the liver is affected
  by oxidative stress.
• May protect brain cells following stroke.
• May help individuals adapt to and have fewer adverse
  health effects from stress.

Food Sources & Amount

• Yeast, liver.
• No significant adverse effects when given orally at a
  daily dose of 800 mg for 4 months.

N-Acetyl-L-Cysteine

• May help prevent damage caused by blood oxidants following
  ischemic (restricted blood flow) injury (in animals).
• May inhibit muscle fatigue.

Food Sources & Amount

• Duck, wheat germ, yogurt, pork, turkey, chicken.
• Well tolerated by patients at oral doses of 4-6 g/day for
  30 months.
• Should be used with caution by individuals with asthma.

Coenzyme Q-10 (Ubiquinol form is most effective)

• Patients with coenzyme Q-10 deficiency and heart disease may show symptomatic improvement following supplementation.
• May help treat congestive heart failure when used in conjunction with conventional medications.
• May protect against symptoms following heart attack.
• May protect against symptoms following heart surgery.
• May protect the heart, kidney, lung and spleen against
  oxidative damage.
• May be useful for cardiomyopathy (heart muscle disease).
• Lowers blood pressure in hypertensive individuals.
• Lowers blood lipoprotein(a) and glucose and increases
  HDL cholesterol.
• Patients with congestive heart failure are at risk for deficiencies.
• Individuals taking statin drugs to treat high blood cholesterol
  are at risk for deficiencies.

Food Sources & Amount

• Heart, sardines, peanuts, spinach.
• Beneficial dosage is typically about 120 mg/day.

Cardiovascular Benefit Summary*

Cardiovascular benefit	Ingredients
Supports the normal metabolism of fats	Vitamin C, vitamin B6
Supports the normal metabolism of carbohydrates	Vitamin B6
Antioxidant	Vitamin C, vitamin E, garlic, grapeseed extract, pycnogenolcomplexes, hawthorn berry extract, alpha-lipoic acid, n-acetyl-l-cysteine, coenzyme Q-10
Protects LDL cholesterol from oxidation	Vitamin C
Helps control blood cholesterol levels	Vitamin C, coenzyme Q-10
May lower blood cholesterol levels	Grape seed pycnogenol complexes,levels hawthorn berry extract, taurine
Helps control blood lipid levels	Vitamin C, coenzyme Q-10
Normalizes blood homocysteine levels	Folic acid
Lowers blood homocysteine	Vitamin B6, vitamin B12, trimethyl- glycine
May reduce blood pressure	Vitamin C, vitamin E, vitamin B6,vitamin B12, arginine, coenzymeQ-10
Improves performance of the heart	Hawthorn berry extract, alpha-lipoic
May improve blood vessel function	Folic acid, arginine, garlic, pyc- nogenol complexes, hawthorn berryextract
Supports normal blood flow	Garlic
Improves coronary artery blood flow	Hawthorn berry extract
Supports normal heartbeat	Taurine
Protects heart muscle	Taurine
May reduce blood clotting	Arginine, garlic, taurine
May reduce the risk of cardio- vascular disease	Vitamin C, vitamin E, folic acid,vitamin B6, vitamin B12, garlic,trimethylglycine, arginine, grape seed pycnogenol complexes, taurine
May help treat heart disease	Vitamin B12, arginine, taurine, hawthorn berry extract, coenzyme Q-10

*Adapted from: Ramberg, J and Gardiner, T. Dietary Supplements that Support
Cardiovascular Health: A Review of
Potential Benefits. GlycoScience Vol. 3: (1): 1-15.