Heart-Smart: The Must-Know Supplements for High Cardiovascular Risk

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If you’ve just had a stent, a heart attack, or news that your cardiovascular risk is sky-high, it’s time to take a close look at your food and lifestyle factors. Your physician will naturally prescribe a statin, but you know it’s time to take action to prevent a major event. Along with everything else, supplements are an important addition to a broader approach to heart health that includes healthy eating, exercise, and following your doctor’s advice. This article dives into how certain nutritional supplements support heart health for those with high cardiovascular risk. Read on as we outline the science on supplements like omega-3 fatty acids, Coenzyme Q10, niacin, fiber, and other effective supplements that can reduce your risk for a cardiovascular event.

What Causes High Cardiovascular Risk?

Heart diseases are a leading cause of mortality, and understanding the factors contributing to high cardiovascular risk is crucial for prevention and management. High cardiovascular risk is often a result of a combination of genetic, lifestyle, and environmental factors. The main causes include hypertension (high blood pressure), elevated cholesterol levels, diabetes, obesity, smoking, a sedentary lifestyle, poor diet, and a family history of heart disease. Of course, age and gender also play roles, with risk increasing as people get older.

There may be no symptoms of high cardiovascular risk in the early stages, which is why cardiovascular diseases are often referred to as ‘silent killers’. But, signs like chest pain, shortness of breath, palpitations, excessive fatigue, and swelling in the legs and feet can be warning signs. Regular check-ups are a key for early detection, especially for those with risk factors.

Nutritional supplements can play a supportive role in managing these risk factors. For instance, omega-3 fatty acids, found in fish oil, are known for their ability to lower triglyceride levels and reduce inflammation, both key contributors to cardiovascular risk. Antioxidants such as Coenzyme Q10 (CoQ10) and vitamin E can help combat oxidative stress, which damages blood vessels. Fiber supplements, like psyllium, are beneficial in lowering LDL (bad) cholesterol. Magnesium plays a role in regulating blood pressure, while B-vitamins, particularly niacin, can improve lipid profiles.

What Food and Lifestyle Factors Are Important For Managing High Cardiovascular Risk?

Getting Help with Lifestyle Changes

Changing your food choices and exercise habits for the long term takes quite a bit of effort. It helps a great deal to work with a registered dietitian nutritionist who can help you prioritize changes and keep you on track. The good news is that if your BMI is over 30, this will be covered at 100% with no deductible under the preventive care provisions of commercial insurance.

If you have a very high cardiovascular risk, consulting with a registered dietitian offers numerous advantages. A dietitian specializes in understanding the complex relationship between food and health, particularly in managing conditions like heart disease. They provide personalized nutritional counseling based on your specific health needs, dietary preferences, and lifestyle.

For people with high cardiovascular risk, a dietitian can help you develop a tailored eating plan that targets key risk factors such as high cholesterol, hypertension, and weight. This plan often includes guidance on consuming heart-healthy foods, controlling portion sizes, understanding food labels, and making the right food changes. Dietitians also offer valuable strategies to incorporate these food adjustments into your daily routine, so that they are both realistic and enjoyable.

More than that, your dietitian can help you address other related concerns like diabetes management, weight loss, and balancing nutrient intake, which are critical in overall cardiovascular health management. Regular sessions with a dietitian not only help in improving food habits but also empower you with the knowledge and skills to make informed food choices, ultimately contributing to a healthier heart and improved quality of life.

The Factors That Make A Difference:

These are the factors that make the biggest difference in cardiovascular risk:

• Weight Management: Keeping a healthy weight reduces the strain on the heart and lowers the risk of heart disease, hypertension, and diabetes.
• Regular Physical Activity: Engaging in aerobic exercises like walking, cycling, or swimming for at least 150 minutes a week can significantly improve cardiovascular health. Strength training exercises, like weight lifting, help maintain muscle mass and overall fitness, contributing to heart health.
• Healthy Diet:
  • Fruits and Vegetables: Rich in essential nutrients, antioxidants, and fiber, they help lower blood pressure and reduce the risk of heart disease.
  • Whole Grains: Foods like brown rice, whole wheat, and oats are high in fiber, which can help lower cholesterol and improve heart health.
  • Lean Proteins: Opting for lean meats, poultry without skin, fish, beans, and legumes provides essential proteins without excess fats.
  • Healthy Fats: Incorporating sources of unsaturated fats like olive oil, nuts, and avocados helps improve heart health by lowering bad cholesterol levels.
  • Limit Salt and Sugar: Excessive salt intake can lead to high blood pressure, while too much sugar can increase the risk of obesity and diabetes, both of which are risk factors for heart disease.
• Adequate Sleep: Quality sleep is vital for overall health, including heart health. Poor sleep can increase the risk of obesity, high blood pressure, and coronary artery disease.
• Stress Management: Chronic stress can negatively impact heart health, potentially leading to higher blood pressure and other risk factors. Techniques like meditation, yoga, or even regular physical activity can be effective in managing stress.
• Smoking Cessation: Smoking is a major risk factor for heart disease, as it damages blood vessels and increases the risk of atherosclerosis. Quitting smoking can significantly reduce these risks.
• Alcohol Consumption: Alcohol intake can lead to high blood pressure and heart failure. Moderate consumption, defined as up to one drink a day for women and two for men, is key.
• Regular Health Check-Ups: Regular monitoring helps in the early detection and management of risk factors like high cholesterol, hypertension, and diabetes.

What Nutritional Supplements Are Recommended For High Cardiovascular Risk?

• Omega-3 Fatty Acids: Omega-3 fatty acids, particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), found in fish oil, play a significant role in cardiovascular health. They are known to effectively lower triglyceride levels, which are a type of fat in the blood linked to increased risk of heart disease. By reducing triglycerides, omega-3s help decrease the risk of developing heart conditions like atherosclerosis. [PMC10381976] Additionally, these fatty acids possess anti-inflammatory properties, which are beneficial in reducing chronic inflammation – a key factor in the development of cardiovascular diseases. [PMID: 26745681] Regular intake of omega-3s is also associated with other heart health benefits, such as improving the elasticity of blood vessels and potentially reducing blood pressure. [PMID: 29564974]
• Fiber Supplements (e.g., Psyllium): Soluble fiber, such as psyllium, is beneficial in managing cholesterol levels. It works by binding to cholesterol in the digestive system, which is then excreted from the body. This process helps to lower the levels of LDL (low-density lipoprotein) cholesterol. Regular intake of soluble fiber is therefore helpful in reducing the risk of heart disease and improving overall heart health. [PMID: 30239559]
• Magnesium: Magnesium is a mineral that plays several critical roles in cardiovascular health. It is involved in maintaining a normal heart rhythm and is essential for proper muscle contraction, including the heart muscle. Magnesium also helps regulate blood pressure levels by relaxing blood vessels. Adequate magnesium intake can therefore be beneficial in preventing hypertension (high blood pressure), a major risk factor for heart diseases like heart attacks and strokes. “Observational data have shown an association between low serum magnesium concentrations or magnesium intake and increased atherosclerosis, coronary artery disease, arrhythmias, and heart failure.” [PMID: 29793664]
• Garlic Supplements: Garlic supplements have been studied for their potential cardiovascular benefits. Some research suggests that garlic can help modestly lower blood pressure, which is crucial in reducing the strain on the heart and preventing conditions such as hypertension. Garlic may also have a positive effect on cholesterol levels by slightly lowering LDL cholesterol. These benefits are thought to be due to garlic’s antioxidant properties and its ability to help regulate the body’s lipid and blood pressure levels. Researchers concluded, “that garlic supplementation has the potential for cardiovascular protection based on risk factor reduction (hypertension and total cholesterol) and surrogate markers (CRP, PWV, and CAC) of atherosclerosis.” [PMID: 26764327]
• Niacin (Vitamin B3): The AIM-HIGH study performed a secondary analysis on subjects who had both low HDL cholesterol and high triglyceride levels. This analysis revealed a significant 26-36% reduction in the risk of cardiovascular events, but this finding wasn’t widely publicized. Subjects in this study took extended-release (ER) niacin 1500–2000 mg at bedtime. [PMC3862446] Although Niacin increases HDL, lowers triglycerides, and lowers LDL, it has fallen out of favor. For more on this, refer to the article: The “good” HDL cholesterol Under Attack! – Defending Niacin, AKA Vitamin B3. However, high doses of niacin can lead to side effects like skin flushing, itching, liver toxicity, and increased blood sugar levels. Therefore, niacin supplementation for cholesterol control should always be under medical supervision to balance its benefits with potential risks.
• Nattokinase: Benefits are due to its diverse beneficial effects like breaking down blood clots, lowering blood pressure and cholesterol, preventing atherosclerosis and offering neuroprotection, making it a promising candidate for CVD prevention and treatment.[PMC6043915] [PMID: 18971533]
• Multivitamin: Your multivitamin should include Vitamin D and Folate
  • Vitamin D: Vitamin D, widely recognized for its crucial role in bone health, has also been linked to heart health. A deficiency in Vitamin D is associated with an increased risk of cardiovascular diseases such as hypertension, heart attack, and stroke. This connection may be due to Vitamin D’s role in regulating blood pressure, reducing arterial stiffness, and controlling inflammation and glucose metabolism. Some studies indicate that Vitamin D supplementation could benefit heart health, particularly in individuals with low Vitamin D levels. Get your Vitamin D level checked. This is available online through the NutriScape Lab Shop (affiliate link). Vitamin D regulates blood pressure by acting on endothelial cells and smooth muscle cells. Its deficiency has been associated with various CV risk factors and appears to be linked to a higher mortality and incidence of CV disease (CVD). [PMC7770490]
  • Folic Acid (Vitamin B9): Folic acid, a B vitamin, is important for heart health due to its role in reducing homocysteine levels in the blood. High levels of homocysteine are a recognized risk factor for heart diseases, as they can lead to increased arterial stiffness and impaired endothelial function. By helping to convert homocysteine into other harmless substances, folic acid can contribute to a reduced risk of heart attack and stroke. This role is particularly important in those who don’t eat high folate foods like dark green leafy vegetable or have the MTHFR genetic factors that lead to increased homocysteine levels.
  • Coenzyme Q10 (CoQ10): CoQ10 is a substance that’s naturally produced by the body and plays a crucial role in energy production within cells, particularly in the heart, liver, and kidneys. Its supplementation is often recommended for individuals on statin medications, as these drugs can reduce the body’s CoQ10 levels. [PMC6230224] A decrease in CoQ10 can lead to muscle aches and weakness, which are common side effects of statins. Supplementing with CoQ10 may help alleviate these symptoms and support heart function, as CoQ10 is involved in generating energy in heart muscle cells and has antioxidant properties that protect cells from damage.
• Berberine: Berberine may help reduce cholesterol levels and triglycerides, by increasing the expression of LDL receptors in the liver, thus improving cholesterol removal from the blood. It has beneficial effects on other heart disease risk factors, such as obesity and insulin resistance at a dose of 1000-1800 mg/day [PMC9614282]
• Green Tea Extract: Green tea extract, known for its high antioxidant content, is beneficial for heart health. The primary antioxidants in green tea are catechins, including epigallocatechin gallate (EGCG). These compounds help to slightly lower LDL cholesterol levels, which is beneficial in preventing the development of atherosclerosis (plaque buildup in arteries). The antioxidants in green tea extract also protect LDL cholesterol from oxidation, a process that further contributes to atherosclerosis. [PMC7154459] Moreover, green tea extract may have a modest effect on improving blood pressure and overall cardiovascular health. [PMC4909506]

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Supplement Safety Information

Omega-3 fatty acids, CoQ10, fiber supplements like psyllium, magnesium, garlic supplements, niacin (Vitamin B3), green tea extract, L-arginine, Vitamin D, berberine, astaxanthin, flavonoids (e.g., quercetin, resveratrol), and folic acid (Vitamin B9) are safe options to help manage high cardiovascular risk. Backed by research, they can lower inflammation, blood pressure, and cholesterol levels while promoting overall heart health. These supplements, when part of a healthy lifestyle and under professional guidance, offer friendly support for keeping your heart in top shape.

Medication Interactions:

• Blood-Thinning Medications (e.g., Warfarin, Aspirin): Omega-3 fatty acids, Coenzyme Q10 (CoQ10), garlic supplements, green tea extract, astaxanthin, and flavonoids (e.g., quercetin, resveratrol) may interact with blood-thinning medications, potentially increasing the risk of bleeding.
• Antidepressants or Cholesterol-Lowering Drugs: Fiber supplements (e.g., psyllium) may reduce the absorption of certain medications if taken simultaneously.
• Antibiotics (e.g., Tetracyclines, Fluoroquinolones): Magnesium supplements can interfere with the absorption of certain antibiotics, reducing their effectiveness.
• Cholesterol-Lowering Medications (e.g., Statins): Niacin (Vitamin B3) may interact with statins, potentially increasing the risk of muscle-related side effects.
• Stimulant Medications or Blood Thinners: Green tea extract may interact with stimulant medications or blood thinners, altering their effects or increasing the risk of side effects.
• Blood Pressure Medications: L-arginine may interact with blood pressure medications, causing blood pressure to drop too low.
• Medications Metabolized by the Liver: Berberine may interact with medications that are broken down by the liver, affecting their metabolism and potentially leading to increased side effects.
• Medications for Seizures or Cancer: Folic acid (Vitamin B9) may interact with certain medications used to treat seizures or cancer, affecting their effectiveness.

Supplement Interactions:

• Omega-3 Fatty Acids: Omega-3 fatty acids may interact with blood-thinning medications, such as warfarin or aspirin, increasing the risk of bleeding.
• Coenzyme Q10 (CoQ10): CoQ10 might decrease the effectiveness of blood-thinning medications like warfarin, potentially leading to blood clotting issues.
• Fiber Supplements (e.g., Psyllium): Psyllium may reduce the absorption of certain medications, such as antidepressants or cholesterol-lowering drugs, if taken simultaneously.
• Magnesium: Magnesium supplements can interfere with the absorption of certain antibiotics like tetracyclines or fluoroquinolones, reducing their effectiveness.
• Garlic Supplements: Garlic supplements may enhance the effects of blood-thinning medications, potentially increasing the risk of bleeding.
• Niacin (Vitamin B3): Niacin can interact with cholesterol-lowering medications called statins, potentially increasing the risk of muscle-related side effects.
• Green Tea Extract: Green tea extract may interact with stimulant medications or blood thinners, altering their effects or increasing the risk of side effects.
• L-arginine: L-arginine may interact with blood pressure medications, causing blood pressure to drop too low.
• Vitamin D: Vitamin D may interfere with certain medications used to treat high blood pressure or heart disease, affecting their effectiveness.
• Berberine: Berberine may interact with medications that are broken down by the liver, affecting their metabolism and potentially leading to increased side effects.
• Astaxanthin: Astaxanthin might interact with blood-thinning medications, increasing the risk of bleeding.
• Flavonoids (e.g., Quercetin, Resveratrol): Quercetin and resveratrol may interact with blood-thinning medications, increasing the risk of bleeding.
• Folic Acid (Vitamin B9): Folic acid may interact with certain medications used to treat seizures or cancer, affecting their effectiveness.

Food First!

Although this article discusses supplements in detail, don’t forget that we are absolutely committed to the “Food First” approach to nutrition. When it comes to your health, the totality of your eating habits far surpasses the impact of individual nutrients or any single supplement you consume. Even though this article doesn’t delve into the broader picture of your overall diet, it’s crucial to keep this element at the forefront of our minds. Your food needs to provide all the vitamins, minerals, fiber, and phytochemicals to nourish your body systems down to the cellular level.

Food choices, rather than supplements, are the most critical factors for a healthy gut microbiome. These trillions of tiny inhabitants in your gut affect your brain waves; they orchestrate your immune system. They possess the power to create molecules that can switch genes on or off and are even capable of synthesizing neurotransmitters. Opting for organic foods and steering clear of plastic packaging (including those labeled BPA-free) is a smart move to limit toxin exposure. The sum of all these parts leads to a powerful conclusion: the ultimate key to your health lies in the quality and balance of the food you consume. Supplements are secondary.

To Sum It Up

Incorporating omega-3 fatty acids, CoQ10, fiber supplements (e.g., psyllium), magnesium, garlic supplements, niacin (Vitamin B3), green tea extract, L-arginine, Vitamin D, berberine, astaxanthin, flavonoids (e.g., quercetin, resveratrol), and folic acid (Vitamin B9) offer significant health benefits for managing high cardiovascular risk. These supplements can help address various risk factors like inflammation, high cholesterol, and blood pressure. However, it’s crucial to remember that supplements are not substitutes for a balanced diet and lifestyle. For personalized advice on integrating these supplements into your routine and optimizing your heart health, consulting a Registered Dietitian is recommended. Their expertise ensures you make informed choices to support a healthier heart and overall well-being.

This Article is Not a Substitute for Medical Advice

Dietary supplements are not designed to diagnose, treat, cure, or prevent any disease. The Supplement Sciences website seeks to provide comprehensive access to the most relevant supplement information along with convenient online ordering. We do not provide medical advice and cannot guarantee that every product suggested is completely without risk. Since each person is unique in their health history and medication use, it is important to discuss supplements with your personal physician. Specifically, pregnant women and individuals being treated for cancer or liver or kidney problems must consult their physician about every nutritional supplement they plan to take. People taking medications for the treatment of HIV or with a history of organ transplant must not take supplements without consulting with their physician.