Table 2.
Gradable intermediate outcomes for dietary supplements plus cardiovascular drugs (low grade evidence)
| Outcome measures | Dietary supplement | Cardiovascular drug(s) | Conclusion effect estimate | Applicability |
|---|---|---|---|---|
|
Lipid profile |
Co-Q10 (200 mg/day) |
Fenofibrate |
No difference for HDL-C (one study): MD,1.55 mg/dL (95% CI −6.78, 3.68) |
Mean age: |
| |
|
|
|
53 years |
| |
|
|
|
Mixed gender |
| |
|
|
|
High CHD risk |
| |
|
|
|
12 weeks treatment |
|
Lipid profile |
Garlic (4 g/day) |
Nitrates |
In favor of combination |
Unknown age, gender |
| |
|
|
HDL-C (one study): MD, 8.40 mg/dL (95% CI 1.91, 14.89) |
High CHD risk |
| |
|
|
|
12 weeks treatment |
|
Lipid profile |
Omega-3-fish oil (3.6 g/day omega-3 to 9.2 g/day fish oil) |
Statins |
In favor of combination |
Mean age: 45 to 63 years |
| |
|
|
TG (two studies pooled): MD, -74.95 mg/dL (95% CI −95.80, -54.10)a |
Mixed CHD risk |
| |
|
|
No difference between combination and CV drug alone |
Mixed gender |
| |
|
|
HDL-C (six studies pooled): MD, 2.26 mg/dL (95% CI −1.8, 6.3) |
Up to 25 weeks treatment |
| |
|
|
LDL-C (five studies pooled): MD, 1.3 mg/dL (95% CI −3.6, 6.2) |
|
| |
|
|
Achieving LDL-C targets: RR 0.93 (95% CI 0.84, 1.03) |
|
| |
|
|
Achieving HDL-C targets (one study): and 1.00 (95% CI 0.90, 1.10) |
|
|
Lipid profile |
Omega-3-fish oil (1.8 g/day)+ |
Calcium channel blockers + aspirin |
In favor of combination |
Mean age: 57 y; |
| |
|
|
TG (two studies not pooled): MD −81.00 mg/dL (95% CI −125.30, -36.70) and MD −54.00 mg/dL (95% CI −94.1, -13.90) |
85% men |
| |
|
|
|
High CHD risk |
| |
|
|
|
Up to 6 weeks treatment |
|
Lipid profile |
Omega-3-fish oil (3.2 g/day) |
Calcium channel blockers + aspirin, or dipyridamole |
In favor of CV drug alone |
Mean age: 56 y; |
| |
|
|
LDL-C (one study): MD 21.00 mg/dL (95% CI 3.30, 38.70) |
100% men |
| |
|
|
In favor of combination |
High CHD risk |
| |
|
|
TG (one study): MD −81.0 mg/dL (95% CI -125.30, -36.70) |
|
| |
|
|
|
Up to 12 weeks treatment |
|
Lipid profile |
Vitamin E (900 mg/day) |
Nifedipine |
In favor of combination |
Elderly; mixed gender |
| |
|
|
LDL-C (one study): MD −39.83 mg/dL (95% CI −71.29, -8.37) |
High CHD risk |
| |
|
|
|
12 weeks treatment |
| |
|
|
In favor of combination |
|
| |
|
|
TG (one study): MD, -23.91 mg/dL (95% CI -35.89, -11.93) |
|
|
Blood pressure |
Omega-3-fish oil (2 g/day)+ |
Statins |
In favor of combination |
Mean age: 44 to 53 y; mixed gender |
| |
|
|
Systolic blood pressure (one study): MD, -8.50 mmHg (95% CI -16.3, -0.66) |
Mixed CHD risk |
| |
|
|
|
5 weeks treatment |
| |
|
|
Systolic blood pressure (one study): median change from baseline −5.0 versus + 0.3 mmHg |
|
| |
|
|
No difference between combination and CV drug alone |
|
| |
|
|
Diastolic blood pressure (one study): MD, 0.20 mmHg (95% CI -4.76, 5.16) |
|
| |
Omega-3-fish oil (4 g/day fish oil)+ |
Statins |
Diastolic blood pressure (one study): Median reductions from baseline -3.30 versus −1.80 to |
Mean age: 58 y; Mixed gender |
| |
|
|
|
Unclear CHD risk |
| 6 weeks treatment |
aBoth studies recruited participant with higher baseline levels of triglyceride (>200 mg/dL). CHD: coronary heart disease; CI: confidence interval; CV: cardiovascular; HDL-C: high density lipoprotein-cholesterol; LDL-cholesterol: low density lipoprotein-C; MD: mean difference (post-treatment values); RR: relative risk; TG: triglycerides.