Six heart-healthy supplements people commonly take don’t help lower “bad” cholesterol or improve cardiovascular health, but statins do, according to a study published Sunday.

Some people believe that common dietary supplements – fish oil, garlic, cinnamon, turmeric, plant sterols and red yeast rice – reduce “bad” cholesterol. “Bad” cholesterol, known in the medical community as low-density lipoproteins or LDL, can cause fatty deposits to build up in the arteries. The fatty deposits can restrict the oxygen and blood flow the heart needs to function, and the blockage can lead to heart attack or stroke.

For this study, presented at the American Heart Association Scientific Session 2022 and published at the same time in the Journal of the American College of Cardiology, researchers compared the effect of these special supplements with the effect of a small dose of statin – cholesterol-lowering drug – or placebo, which does nothing.

Researchers made this comparison in a randomized, single-blind clinical trial involving 190 adults with no prior history of cardiovascular disease. The study participants were aged 40 to 75 and different groups received a low-dose statin called rosuvastatin, a placebo, fish oil, cinnamon, garlic, turmeric, plant sterols or red yeast rice for 28 days.

The statin had the greatest effect and significantly reduced LDL compared to the supplement and placebo.

Statistically, the mean LDL reduction after 28 days was about 40%. In addition, the statin had an additional benefit on total cholesterol, which was reduced by an average of 24%, and on blood triglycerides, which were reduced by 19%.

None of the people who took the supplement saw any significant reductions in LDL cholesterol, total cholesterol, or blood triglycerides, and their results were similar to those who took the placebo. Although adverse events were similar in all groups, there was a higher number of complications among those who took plant sterols or red yeast rice.

“We designed this study because many of us have the same experience of trying to recommend evidence-based treatments to patients that reduce cardiovascular risk and having them say, ‘No thanks, I’ll just try this supplement,'” he said. -Author Dr. Carol Watson, Professor of Medicine/Cardiology and Associate Director, UCLA Program in Preventive Cardiology. We want to design a very rigorous, randomized, controlled trial study to confirm and demonstrate in a robust way what we already know.

Dr. Steven Neeson, a cardiologist and researcher at the Cleveland Clinic and co-author of the study, said patients are often unaware that dietary supplements are not tested in clinical trials. He calls these supplements “the snake oil of the 21st century.”

In the United States, the Dietary Supplement and Health Education Act of 1994 severely limited the US Food and Drug Administration’s ability to regulate dietary supplements. Unlike pharmaceutical products, which must be proven safe and effective for their intended use before a company can market them, the FDA does not have to approve dietary supplements before they can be sold. The FDA can step in to regulate them only after they are on the market and proven unsafe.

“Patients believe that studies have been done and that they are statistically effective and that they can save them because they are natural, but natural does not mean safe and does not mean they are effective,” Neeson said.

The study was supported by an unrestricted grant from AstraZeneca, the manufacturer of rosuvastatin. The company had no input into the methodology, data analysis and discussion of the clinical implications, the study said.

The researchers acknowledged some limitations of the study, including the small sample size, and the fact that the 28-year study period may not capture the effects of supplements when used over a longer period of time.

“Supplements are not intended to replace drugs or other treatments,” the dietary supplement industry’s trade association, the Council for Responsible Nutrition, said in a statement Sunday.

“Dietary supplements are not intended to be a quick fix, and their effects cannot be demonstrated in a four-week study period,” the group’s senior vice president of scientific and regulatory affairs, Andrea Wong, said in a statement.

Dr. James Siredu, an interventional cardiologist at University Hospitals Bedford Medical Center and medical director of the University Hospitals Harrington Heart and Vascular Institute, said the work will be helpful.

“They did a good job of gathering data and looking at the results,” said Siredu, who did not work on the study. “Maybe it will resonate with patients. I always ask about supplements. I think this does a good job of providing evidence.”

Dr. Amit Khera, chair of the AHA Scientific Sessions Programming Committee, did not work on the study, but thought it was an important study to include in this year’s presentations.

“I see patients with these exact questions every day. Patients are always asking about supplements instead of or in addition to statistics,” says Kera, M.D., M.D., professor and director of preventive cardiology at UT Southwestern Medical Center. I think it’s important to help inform patients about the lack of certain cholesterol-lowering supplements.

Statins have been around for more than 30 years and have been studied in more than 170,000 people, he said. Consistent studies have shown that the statistical risk is low.

“The good news is, we know that statins work,” Kera said. “That doesn’t mean they are perfect. That doesn’t mean everyone needs it, but we know they work for people at high risk and it’s well-documented. If you’re going to do something different, you have to make sure it works.”

With supplements, he says he often sees misinformation online.

I think people always want something ‘natural’ but you know there are many issues with that terminology and most of all we need to ask them? That’s what this study does,” Khera added. “It’s important to ask, are you taking something that’s proven, and if you’re doing that and it’s not, it’s in lieu of a proven treatment. It’s a serious concern.”

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