Table 3.
Gradable intermediate outcomes for dietary supplements plus cardiovascular drugs (insufficient grade evidence)a
| Item | Supplement (dose) | Cardiovascular drug | Number of studies, sample size, characteristic (treatment duration) |
|---|---|---|---|
|
All lipids (Low and high density lipoproteins-cholesterol, triglycerides, total cholesterol) |
Coenzyme Q10 (100 to 200 mg/day) |
Statins |
Two studies; 49 hypercholesterolemic patients [57], and 44 patients with statin-induced myopathic pain [39]; (12 weeks) |
| |
Coenzyme Q10 (200 mg/day) |
Fenofibrate |
Participants with type II diabetes and high CHD risk |
| |
Garlic (4 g/day) |
Warfarin |
Single study [59]; 48 participants with prosthetic heart valves, or diagnosed with deep vein thrombosis, valvular heart disease or atrial fibrillation |
| |
Garlic (4 mL/day) |
Statins + aspirin |
Single study [62]; 23 participants with, or at high risk for, coronary artery disease (1 year) |
| |
Garlic (4 g/day) |
Nitrates |
Single study [61]; 60 participants with coronary |
| |
|
|
artery disease (1 year) |
| |
Ginkgo biloba (120 mg/day) |
Aspirin |
Single study [64]; 50 young healthy men (1 week) |
| |
Omega-3 fatty acids (4 g/day) |
Fenofibrate |
Single study [55]; 167 participants with unclear CHD risk (8 weeks) |
| |
Omega-3 fatty acids (3 g/day) |
Calcium channel blockers |
Single study [49], 22 participants with variant angina (16 weeks) |
| |
Omega-3 fatty acids (4 g/day) |
Niacin + aspirin |
Single study [77]; 14 participants with atherogenic dyslipidemia (12 weeks) |
| |
Omega-3 fatty acids (10 g/day) |
Aspirin |
Two studies [80,84]; 30 healthy participants (2 to 3 weeks) |
| |
Vitamin E (0.6/day) |
Gemfibrozil |
Single study [88]; 67 participants with hyperlipidemia (4 weeks) |
| |
Vitamin E (100 mg/day, 100 IU/day) |
Statins |
Pooled results for four studies[89,91-93]; 192 highly selective participants (24 weeks) |
|
Triglycerides |
Omega-3 fatty acids (4 g/day) |
ACE inhibitors |
Two studies [78,79]; 58 participant with renal dysfunction or hypertension (6 to 25 weeks) |
| |
Omega-3 fatty acids (4 to 9 g/day) |
Statins |
Three studies [38,72,82]; 420 highly selected participants with low or unclear CHD risk (4 to 18 weeks) |
| |
Vitamin E (900 mg/day) |
Antiplatelet agents |
Single study [86]; 16 participants with high CHD risk (6 weeks) |
|
Low density lipoprotein-cholesterol |
Omega-3-fish oil (1.8 g/day) |
Calcium channel blockers + aspirin |
Single study [50]; 107 participants with pre-coronary angioplasty (6 weeks) |
|
High density lipoprotein-cholesterol |
Vitamin E (900 mg/day) |
Nifedipine |
Single study [94]; 30 participants with high CHD risk (16 weeks) |
| |
Omega-3 fatty acids (1.8 g/day) |
Calcium channel blockers + aspirin |
Single study [50]; 107 participants with pre-coronary angioplasty (6 weeks) |
| |
Omega-3 fatty acids (3.2 g/day) |
Calcium channel blockers + aspirin + dipyridamole |
Single study [51]; 82 participants with post-coronary angioplasty (12 weeks) |
|
Blood pressure (systolic and diastolic) |
Coenzyme Q10 (200 mg/day) |
Fenofibrate |
Single study[56]; 80 participants with type II diabetes and high CHD risk (12 weeks) |
| |
Garlic (4 g/day) |
Warfarin |
Single study [59]; 48 participants with prosthetic heart valves, or diagnosed with deep vein thrombosis, valvular heart disease or atrial fibrillation |
| |
Ginkgo biloba (120 mg/day) |
Aspirin |
Single study [64]; 50 young healthy male volunteers (1 week) |
| |
Ginkgo biloba (120 mg/day) |
Cilostazol |
Single study [67]; 10 healthy South Asian men (1 day) |
| |
Omega-3 fatty acids (10 g/day) |
Aspirin |
Two studies [80,84]; 30 healthy participants (2 to 3 weeks) |
| |
Omega-3 fatty acids (4 g/day) |
Beta-adrenergic antagonists |
Single study [85]; 25 participants with unclear CHD risk (6 weeks) |
| |
Vitamin E (600 mg/day) |
Furosemide |
Single study [87]; 24 hypertensive participants (4 weeks) |
| |
|
Gemfibrozil |
Single study [88]; 67 participants with hyperlipidemia (4 weeks) |
| |
Vitamin E (900 mg/day) |
Nifedipine |
Single study [94]; 30 participants with high CHD risk (16 weeks) |
|
International normalized ratio |
Echinacea (5 g/day) |
Warfarin |
Single study [97]; 12 healthy volunteers (2 weeks) |
| |
Garlic (4 g/day) |
|
Two studies; 48 participants with high CHD risk [59](12 weeks), and 16 healthy men with known CYP2C9 and VKORC1 genotype [60] (2 weeks) |
| |
Ginger (3.6 g/day) |
|
Single study [63];12 healthy male volunteers (7 days) |
| |
Ginkgo biloba (12 g/day) |
|
|
| |
Panax ginseng (1.5-2 g/day) |
|
Two studies; seven healthy men [70] (1 week), 25 patients with ischemic stroke [68] (2 weeks) |
| Omega-3-fish oil (4 mg/day) | Single study [54]; 11 participants with unclear CHD risk (4 weeks) |
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; CHD: coronary heart disease.