Table 1.
Gradable clinical outcomes for dietary supplements plus cardiovascular drugsa
| Item | Supplement (dose) | Cardiovascular drug | Number of studies, sample size, characteristic (treatment duration) | Outcome (combination versus control) |
|---|---|---|---|---|
|
Clinical outcome efficacy |
|
|
|
|
|
All-cause mortality |
Coenzyme Q10 (100 mg/day) |
ACE inhibitors (80% of participants were also taking digoxin, furosemide, hydralazine and/or nitrates) |
Single study [53]; 30 mostly male patients with left ventricular dysfunction (3 months) |
Death: none versus one |
| |
Ginkgo biloba (40 mg four times a day) |
Antiplatelet agents |
Single study [47]; 62 South Asian patients with previous ischemic stroke (1 month) |
No deaths |
| |
Omega-3 fatty acids (4 g/day) |
Aspirin |
Single study [46]; 291 patients admitted for coronary artery bypass grafting (1 year) |
Death: five versus four |
| |
|
Statins |
Single study [37]; 50 healthy nonsmoking adults (2 weeks) |
No deaths |
| |
|
Warfarin |
Single study [46]; 319 patients admitted for coronary artery bypass grafting (1 year) |
Deaths: three versus two |
| |
|
Fenofibrate |
Single study [55]; 167 participants with hyperglycemia (2 months) |
No deaths |
|
Quality of life |
Coenzyme Q10 (100 mg/day) |
ACE inhibitors |
Single study [53]; 30 mostly male patients with left ventricular dysfunction (3 months) |
Minnesota ‘Living with Heart Failure’ questionnaire (mean sum of all scores post-treatment 26.7 ± 17.9 versus 26.5 ± 18.7 |
|
Myocardial infarction |
Omega-3 fatty acids (1.8 g eicosapentaenoic acid + 1.2 g docosahexaenoic acid) |
Aspirin + calcium channel antagonists |
Single study [50]; 58 patients who had undergone successful coronary angioplasty (6 months) |
Acute MI: 4 versus 2 |
| |
|
|
|
RR 1.70 (95% CI 0.32, 8.84) |
|
Arrhythmia |
Omega-3 fatty acids (4 g/day) |
Statins |
Single study [41]; 256 patients with persistent hypertriglyceridemia despite statin therapy (2 months) |
Arrhythmia: one versus none |
|
Stroke |
Vitamin E (0.4 g/day) |
Aspirin |
Single study [48]; 100 patients with previous reversible or irreversible ischemic neurologic deficit (2 years) |
Fatal or non-fatal stroke: three versus six |
| Ischemic stroke, hemorrhagic stroke and transient ischemic attack | Vitamin E (600 IU/day) | Aspirin | Single study [40]; 19,934 healthy women (10 years) | Composite outcome of nonfatal MI, nonfatal stroke and vascular death, RR 0.95 (95% CI 0.79, 1.13) |
aInconclusive results: studies had an imprecise statistically non-significant pooled estimate (the 95% CIs were wide enough to be compatible with either clinical benefit, true no difference or harm). ACE: angiotensin-converting enzyme; CI: confidence interval; MI: myocardial infarction; RR: relative risk.