Live Well Vitamins & Lifestyle Guide

Supplementing Your Heart Health: Omega-3, Plant Sterols, and More

If you have high cholesterol, or if you're at high risk for heart disease and heart attack, you've likely had "the talk" with your doctor. For many people, making lifestyle changes is enough to lower cholesterol. Other people need medications like cholesterol-lowering statin drugs. Dietary supplements can be part of the prescription, too.

Of the $20 billion dollars spent yearly on herbs and supplements, those touted to improve heart health top the list. They range from fish oil and flaxseed oil to artichoke and garlic extracts.

Is there any evidence that these really work? Can they really lower LDL "bad" cholesterol or triglycerides -- or raise HDL "good" cholesterol"? Do they provide an added benefit to drugs? Just as important, which vitamins and supplements should you consider taking for heart health?

The Truth About Vitamins and Supplements for Heart Health

For a top cardiologist's advice on heart-health supplements and vitamins, WebMD turned to Mimi Guarneri, MD, the founder and medical director of the Scripps Center for Integrative Medicine in La Jolla, Calif., and author of the book, The Heart Speaks.

"Supplements can be very beneficial to heart health," Guarneri tells WebMD.

Here are some of the supplements that may benefit your heart:

• Fish oil
• Plant sterols
• Niacin
• Fiber (psyllium)
• Red yeast rice
• Green tea extract
• B-Complex vitamins (B6, B12, folic acid)
• Coenzyme Q10
• Policosanol

A few cautionary notes: Always check with your doctor before using supplements because some can interact with other drugs you take. Some people -- including women who are pregnant or breastfeeding -- should not take supplements other than prenatal vitamins.  Make sure you purchase supplements that have a standardized dosage, approved by the USP (United States Pharmacopoeia), which means they contain 95% to 100% of the active ingredient.

Omega-3 Fatty Acids (Fish Oil, Flaxseed Oil) for Heart Health

Omega-3 fatty acids -- found in fish oil and flaxseed oil -- provide significant reductions in triglyceride levels and increases in good HDL cholesterol. Omega-3 doesn't affect “bad” LDL cholesterol levels.

"Omega-3s have consistently been shown to improve heart health," says Guarneri. "Omega-3s are one of the most important supplements for the heart because of its anti-inflammatory agents. We know that inflammation is a common pathway for many diseases, including heart disease and Alzheimer's disease."

Several studies report that in people with a history of heart attack, regularly eating oily fish (like salmon) or taking fish oil supplements reduces the risk of heart rhythm problems, heart attack, and sudden death. There may also be reductions in angina (chest pain). 

Fish oil supplements can reduce triglycerides by 20% to 50%, says Guarneri. "Fish oil is now available by prescription -- that's how good it is." However, because fish oil comes from real fish, mercury content is an issue. "You have to stick with brands that are tested for mercury,” she notes. Check the labels.