Condition
Cardiovascular Disease
Cardiovascular disease develops as fatty plaque slowly builds up in artery walls over decades, fueled by inflammation, oxidative stress and unhealthy blood fats. Among supplements, Panax notoginseng added to usual care eased angina symptoms in trial reviews, and curcumin improved blood sugar, with moderate evidence for each. Most angina trials came from China and varied in quality, and curcumin's effects were small.
Sources: PMID 30166105; PMID 28634988; PMID 27761427
- Supplements studied
- 48
- Medicines and peptides
- 5
- Graded outcomes
- 58
- Trials
- 25
- People studied
- 2,487,816
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Ventricular Arrhythmia Reduction (IV Administration) Multiple human clinical trials from the late 1970s, including double-blind studies, found that intravenous COP (1-3g) reduced ventricular premature beats and showed antiarrhythmic effectiveness in patients with ischemic heart disease. All evidence is limited to IV injection; no data exists for oral administration. | Improves (the measure goes down) | Moderate effect | 8 studies | 100 people | ||
Studies that measured ventricular arrhythmia reduction (iv administration) | ||||||
Resveratrol
- Blood glucose: improves
- C-Reactive Protein (CRP): improves
- Kidney Function: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood glucose Small Improvement | Improves (the measure goes down) | Small effect | 7 studies | 329 people | ||
Studies that measured blood glucose
| ||||||
| C-Reactive Protein (CRP) | Improves (the measure goes down) | 3 studies | 147 people | |||
Studies that measured c-reactive protein (crp)
| ||||||
| Kidney Function | Improves (the measure goes up) | 2 studies | 135 people | |||
Studies that measured kidney function | ||||||
| Liver Enzymes | Changes; see studies | 2 studies | 216 people | |||
Studies that measured liver enzymes | ||||||
| Total cholesterol | Improves (the measure goes down) | 2 studies | 190 people | |||
| Vascular Function | Improves (the measure goes up) | 2 studies | 1,034 people | |||
| Blood Pressure | Improves (the measure goes down) | 1 study | 156 people | |||
| Triglycerides | Improves (the measure goes down) | 1 study | 216 people | |||
| Blood Urea Nitrogen (BUN) | Improves (the measure goes up) | 894 people | ||||
| Body Mass Index (BMI) | Improves (the measure goes down) | 266 people | ||||
| HbA1c | Improves (the measure goes down) | 271 people | ||||
| Insulin | Changes; see studies | 172 people | ||||
| Insulin Resistance | Improves (the measure goes down) | 191 people | ||||
| Intercellular Adhesion Molecule 1 | Changes; see studies | 1,034 people | ||||
| Interleukin 6 | Improves (the measure goes down) | 225 people | ||||
| Plasminogen Inhibitor-1 | Improves (the measure goes up) | 1,034 people | ||||
| Serum Albumin | Improves (the measure goes up) | 516 people | ||||
| TNF-Alpha | Improves (the measure goes down) | 658 people | ||||
| Uric Acid | Improves (the measure goes down) | 353 people | ||||
Panax notoginseng
- Angina Pectoris Symptoms: improves
- Cardiovascular Events: improves
- Platelet Aggregation: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Angina Pectoris Symptoms Multiple meta-analyses of Chinese RCTs (17-18 trials, ~1800 patients) consistently show that Panax notoginseng preparations added to conventional therapy alleviate angina symptoms (RR 1.23 for improvement), reduce angina frequency and duration, and improve ECG findings. However, trial quality is variable and most studies are from China. | Improves (the measure goes down) | Moderate effect | 3 studies | 1,828 people | ||
Studies that measured angina pectoris symptoms
| ||||||
| Cardiovascular Events A systematic review of 18 RCTs (1,828 unstable angina patients) found PNS preparations reduced cardiovascular events (RR 0.35; 95% CI 0.13-0.94) as adjunct to conventional therapy. However, the wide confidence interval and small sample sizes limit confidence in this hard endpoint. | Improves (the measure goes down) | Moderate effect | 2 studies | 1,828 people | ||
| Platelet Aggregation A meta-analysis of 20 RCTs (2,216 patients with coronary heart disease or ischemic stroke) found that Panax notoginseng preparations plus aspirin modulated platelet aggregation compared to aspirin alone, without increasing bleeding risk. In vitro studies show PNS inhibits platelet adhesion to injured endothelium via COX pathway. | Improves (the measure goes down) | Small effect | 1 study | 2,216 people | ||
Salt
- Cardiovascular Disease Risk: worsens
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cardiovascular Disease Risk Large epidemiological studies and RCTs associate high sodium intake (>5g/day) with increased cardiovascular events and mortality. However, the relationship appears J-shaped, with very low sodium intake (<3g/day) also associated with adverse cardiovascular outcomes, suggesting an optimal range. | Worsens (the measure goes up) | Moderate effect | 3 studies | 50,000 people | ||
Studies that measured cardiovascular disease risk | ||||||
Danshen
- Angina Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Angina Symptoms Multiple Chinese clinical trials of Compound Danshen Dripping Pills report reduced angina frequency and improved ECG findings when used as adjunct therapy. Study quality is generally moderate, and most evidence comes from Chinese-language literature with methodological limitations. | Improves (the measure goes down) | Moderate effect | 2 studies | 1,500 people | ||
Omega-6 Fatty Acids
- Cardiovascular Disease Risk: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cardiovascular Disease Risk Epidemiological studies and RCTs demonstrate that higher dietary linoleic acid intake, when replacing saturated fat, is associated with reduced cardiovascular events. Contrary to the popular narrative, controlled human trials show omega-6 (LA) does not increase systemic inflammatory markers relevant to atherosclerosis. | Improves (the measure goes down) | Moderate effect | 2 studies | |||
Studies that measured cardiovascular disease risk
| ||||||
Flaxseed
- Apolipoprotein A: improves
- C-Reactive Protein (CRP): improves
- Total Antioxidant Capacity (TAC): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Apolipoprotein A Small Decrease | Improves (the measure goes down) | Small effect | 1 study | 629 people | ||
Studies that measured apolipoprotein a | ||||||
| C-Reactive Protein (CRP) | Improves (the measure goes down) | 4 studies | 1,502 people | |||
Studies that measured c-reactive protein (crp)
| ||||||
| Total Antioxidant Capacity (TAC) | Improves (the measure goes up) | 1 study | 429 people | |||
Studies that measured total antioxidant capacity (tac) | ||||||
| Glutathione (GSH) | Improves (the measure goes up) | 429 people | ||||
| Interleukin 6 | Improves (the measure goes down) | 1,502 people | ||||
| TNF-Alpha | Improves (the measure goes down) | 1,502 people | ||||
Strontium
- Venous Thromboembolism Risk: worsens
- Cardiovascular Event Risk: worsens
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Venous Thromboembolism Risk Pooled analysis of strontium ranelate RCTs revealed a ~50% increased risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism), contributing to European Medicines Agency restrictions in 2014. This is a significant safety concern observed across multiple large trials. | Worsens (the measure goes up) | Moderate effect | 1 study | 7,000 people | ||
Studies that measured venous thromboembolism risk | ||||||
| Cardiovascular Event Risk Post-marketing surveillance and pooled RCT analyses of strontium ranelate identified increased risk of myocardial infarction and cardiovascular events, leading to contraindication in patients with cardiovascular disease and restriction by the European Medicines Agency in 2014. | Worsens (the measure goes up) | Moderate effect | 1 study | 7,000 people | ||
Studies that measured cardiovascular event risk | ||||||
Green Coffee Extract
- Blood glucose: improves
- Weight: improves
- Total cholesterol: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood glucose Small Improvement | Improves (the measure goes down) | Small effect | 405 people | |||
| Weight | Improves (the measure goes down) | 2 studies | 532 people | |||
| Total cholesterol | Improves (the measure goes down) | 1 study | 578 people | |||
Studies that measured total cholesterol | ||||||
| Blood Pressure | Improves (the measure goes down) | 421 people | ||||
| Body Mass Index (BMI) | Improves (the measure goes down) | 526 people | ||||
| HbA1c | Improves (the measure goes down) | 122 people | ||||
| Insulin Resistance | Improves (the measure goes down) | 199 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 558 people | ||||
| Triglycerides | Improves (the measure goes down) | 637 people | ||||
| Waist circumference | Improves (the measure goes down) | 177 people | ||||
Black Barberry Extract
- Lipid Profile (TC, LDL, TG): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Lipid Profile (TC, LDL, TG) Significant reductions in total cholesterol, LDL-C, and triglycerides; dose-response with ≥750mg/day for >8 weeks | Improves (the measure goes down) | Moderate effect | 718 people |
Black Garlic Extract
- LDL Cholesterol: improves
- Total Cholesterol: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| LDL Cholesterol Meta-analyses: LDL reduced by 4.41-5.90mg/dL; 10% reduction when taken >2 months | Improves (the measure goes down) | Small effect | 2,300 people | |||
| Total Cholesterol Meta-analysis (PMID: 40580481): TC reduced by 10.21mg/dL with garlic consumption | Improves (the measure goes down) | Moderate effect | 2,300 people |
Omega-3 Fatty Acids
- C-Reactive Protein (CRP): improves
- Interleukin 6: improves
- TNF-Alpha: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) Small Decrease | Improves (the measure goes down) | Small effect | 853 people | |||
| Interleukin 6 | Improves (the measure goes down) | 1 study | 853 people | |||
| TNF-Alpha | Improves (the measure goes down) | 853 people | ||||
| Vascular Function | Improves (the measure goes up) | 853 people |
Citrulline
- Blood Pressure: improves
- Plasma Arginine: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Pressure Small Improvement | Improves (the measure goes down) | Small effect | 7 studies | 40 people | ||
| Plasma Arginine | Improves (the measure goes up) | 1 study | 40 people |
Saffron
- Anxiety Symptoms: improves
- Depression Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Anxiety Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 6 studies | 76 people | ||
| Depression Symptoms | Improves (the measure goes down) | 18 studies | 76 people |
Essential fatty acid (EFA)
- Cardiovascular Risk Markers: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cardiovascular Risk Markers Reviews and mechanistic studies suggest that EFAs may function as endogenous HMG-CoA reductase inhibitors, ACE enzyme inhibitors, and anti-arrhythmic agents. Combined omega-3 and omega-6 supplementation improved blood rheology markers in small human trials, supporting a 'polypill' hypothesis for cardiovascular protection. | Improves (the measure goes down) | Moderate effect | 5 studies |
Phosphorus
- Cardiovascular Disease Risk: worsens
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cardiovascular Disease Risk Multiple observational and mechanistic studies associate high serum phosphorus with increased cardiovascular disease risk and mortality, even within the normal reference range. Elevated phosphate intake, particularly from processed food additives, promotes vascular calcification and endothelial dysfunction through FGF23 and Klotho-related pathways. | Worsens (the measure goes up) | Moderate effect | 5 studies |
Boron
- C-Reactive Protein (CRP): improves
- Total cholesterol: changes; see studies
- Triglycerides: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) Moderate Decrease | Improves (the measure goes down) | Moderate effect | 3 studies | 116 people | ||
| Total cholesterol | Changes; see studies | 1 study | 116 people | |||
| Triglycerides | Changes; see studies | 1 study | 116 people | |||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 116 people | ||||
| Low-density lipoprotein (LDL) | Changes; see studies | 116 people | ||||
| N-terminal Prohormone of Brain Natriuretic Peptide | Improves (the measure goes up) | 116 people |
Grape Seed Extract
- Blood Flow: improves
- C-Reactive Protein (CRP): improves
- High-density lipoprotein (HDL): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Flow Moderate Increase | Improves (the measure goes up) | Moderate effect | 2 studies | 36 people | ||
| C-Reactive Protein (CRP) | Improves (the measure goes down) | 1 study | 32 people | |||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 1 study | 32 people | |||
| Oxidative Stress Biomarkers | Improves (the measure goes down) | 1 study | 32 people | |||
| Triglycerides | Improves (the measure goes down) | 1 study | 32 people | |||
| Total cholesterol | Improves (the measure goes down) | 32 people |
Krill Oil
- C-Reactive Protein (CRP): improves
- Functionality in Elderly or Injured: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) Moderate Decrease | Improves (the measure goes down) | Moderate effect | 2 studies | 90 people | ||
| Functionality in Elderly or Injured | Improves (the measure goes up) | 90 people |
Cocoa Extract
- All-Cause Mortality: improves
- High-density lipoprotein (HDL): improves
- Blood Pressure: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| All-Cause Mortality Small Improvement | Improves (the measure goes down) | Small effect | 1 study | 908,390 people | ||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 13 studies | 986 people | |||
| Blood Pressure | Improves (the measure goes down) | 10 studies | 918 people | |||
| Blood glucose | Improves (the measure goes down) | 5 studies | 459 people | |||
| Triglycerides | Improves (the measure goes down) | 3 studies | 3,303 people | |||
| Blood Flow | Improves (the measure goes up) | 2 studies | 20 people | |||
| C-Reactive Protein (CRP) | Improves (the measure goes down) | 1 study | 1,317 people | |||
| HbA1c | Improves (the measure goes down) | 1 study | 1,986 people | |||
| Heart Failure Risk | Changes; see studies | 1 study | 114,009 people | |||
| Risk Of Cardiovascular Disease | Improves (the measure goes down) | 1 study | 114,009 people | |||
| Body Mass Index (BMI) | Improves (the measure goes down) | 1,986 people | ||||
| Cardiovascular Disease Mortality | Improves (the measure goes down) | 908,390 people | ||||
| Cell Adhesion Factors | Improves (the measure goes down) | 20 people | ||||
| Glycemic Control | Improves (the measure goes up) | 20 people | ||||
| Insulin | Changes; see studies | 153 people | ||||
| Insulin Resistance | Improves (the measure goes down) | 181 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 986 people | ||||
| Stroke Risk | Changes; see studies | 114,009 people | ||||
| Total cholesterol | Improves (the measure goes down) | 3,303 people | ||||
| Waist circumference | Improves (the measure goes down) | 1,986 people | ||||
| Weight | Improves (the measure goes down) | 1,986 people |
Flavanols
- Cardiovascular Mortality: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cardiovascular Mortality The COSMOS trial (n=21,442), a large RCT, found cocoa flavanol supplementation reduced cardiovascular mortality. EFSA has approved a health claim that 200mg cocoa flavanols daily helps maintain normal blood vessel elasticity, indicating regulatory-level recognition of cardiovascular benefit. | Improves (the measure goes down) | Moderate effect | 1 study | 21,442 people |
Rooibos
- Blood glucose
- High-density lipoprotein (HDL): improves
- C-Reactive Protein (CRP): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood glucose Mixed effect | 40 people | |||||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 1 study | 40 people | |||
| C-Reactive Protein (CRP) | Improves (the measure goes down) | 40 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 40 people | ||||
| Oxidative Stress Biomarkers | Improves (the measure goes down) | 40 people | ||||
| Total cholesterol | Improves (the measure goes down) | 40 people | ||||
| Triglycerides | Improves (the measure goes down) | 40 people |
Berberine
- C-Reactive Protein (CRP): improves
- Total cholesterol: improves
- High-density lipoprotein (HDL): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) Small Decrease | Improves (the measure goes down) | Small effect | 120 people | |||
| Total cholesterol | Improves (the measure goes down) | 3 studies | 689 people | |||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 2 studies | 589 people | |||
| Triglycerides | Improves (the measure goes down) | 1 study | 689 people | |||
| Interleukin 6 | Improves (the measure goes down) | 240 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 689 people | ||||
| TNF-Alpha | Improves (the measure goes down) | 240 people |
L-Carnitine
- Exercise Capacity: improves
- ST-segment depression: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Exercise Capacity Small Improvement | Improves (the measure goes up) | Small effect | 44 people | |||
| ST-segment depression | Improves (the measure goes down) | 1 study | 44 people |
Ginkgo Biloba
- Anti-Oxidant Enzyme Profile
- Atherosclerotic Signs: improves
- Microcirculation: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Anti-Oxidant Enzyme Profile Mixed effect | 8 people | |||||
| Atherosclerotic Signs | Improves (the measure goes up) | 1 study | 8 people | |||
| Microcirculation | Improves (the measure goes up) | 1 study | 32 people | |||
| Nitric Oxide | Improves (the measure goes up) | 1 study | 8 people | |||
| Peripheral Vascular Disease Risk | Changes; see studies | 1 study | 3,069 people | |||
| Apolipoprotein A | Improves (the measure goes up) | 8 people | ||||
| C-Reactive Protein (CRP) | Improves (the measure goes down) | 8 people | ||||
| Heart Attack Risk | Changes; see studies | 3,069 people | ||||
| Interleukin 6 | Improves (the measure goes down) | 8 people | ||||
| LDL Oxidation | Improves (the measure goes down) | 8 people | ||||
| Myeloperoxidase | Improves (the measure goes up) | 8 people | ||||
| Oxidative Stress Biomarkers | Improves (the measure goes down) | 32 people | ||||
| Stroke Risk | Changes; see studies | 3,069 people |
Hesperidin
- Blood glucose
- Low-density lipoprotein (LDL): improves
- Total cholesterol: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood glucose No effect | NoneNo effect | 2 studies | 705 people | |||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 4 studies | 525 people | |||
| Total cholesterol | Improves (the measure goes down) | 2 studies | 525 people | |||
| Blood Pressure | Improves (the measure goes down) | 338 people | ||||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 569 people | ||||
| Insulin | Changes; see studies | 302 people | ||||
| TNF-Alpha | Improves (the measure goes down) | 241 people | ||||
| Triglycerides | Improves (the measure goes down) | 569 people | ||||
| Waist circumference | Improves (the measure goes down) | 116 people | ||||
| Weight | Improves (the measure goes down) | 457 people |
Vitamin E
- All-Cause Mortality
- Prostate Cancer Risk: improves
- Stroke Risk: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| All-Cause Mortality No effect | NoneNo effect | 2 studies | 49,417 people | |||
| Prostate Cancer Risk | Improves (the measure goes down) | 4 studies | 9,541 people | |||
| Stroke Risk | Changes; see studies | 2 studies | 49,417 people | |||
| Cardiovascular Disease Mortality | Improves (the measure goes down) | 1 study | 49,417 people | |||
| Heart Failure Risk | Changes; see studies | 9,541 people | ||||
| Left Ventricular Ejection Fraction | Improves (the measure goes up) | 9,541 people | ||||
| Lung Cancer Risk | Changes; see studies | 49,417 people | ||||
| Major Adverse Cardiac Events | Changes; see studies | 9,541 people |
Coenzyme Q10
- High-density lipoprotein (HDL)
- Low-density lipoprotein (LDL): improves
- Interleukin 6: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| High-density lipoprotein (HDL) No effect | NoneNo effect | 1 study | 52 people | |||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 4 studies | 52 people | |||
| Interleukin 6 | Improves (the measure goes down) | 2 studies | 52 people | |||
| Total cholesterol | Improves (the measure goes down) | 2 studies | 52 people | |||
| Intercellular Adhesion Molecule 1 | Changes; see studies | 52 people | ||||
| Triglycerides | Improves (the measure goes down) | 52 people |
Vitamin D
- All-Cause Mortality
- Risk Of Cardiovascular Disease: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| All-Cause Mortality No effect | NoneNo effect | 1 study | 3,258 people | |||
| Risk Of Cardiovascular Disease | Improves (the measure goes down) | 3 studies | 3,258 people |
Niacin (Vitamin B3)
- Cardiovascular Disease Mortality
- Major Adverse Cardiac Events: changes; see studies
- Stroke Risk: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cardiovascular Disease Mortality No effect | NoneNo effect | 1 study | 35,760 people | |||
| Major Adverse Cardiac Events | Changes; see studies | 4,364 people | ||||
| Stroke Risk | Changes; see studies | 16,705 people |
Vitamin K
- Blood Pressure
- Osteocalcin: improves
- Calcium Score: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Pressure No effect | NoneNo effect | 1 study | 60 people | |||
| Osteocalcin | Improves (the measure goes up) | 1 study | 733 people | |||
| Calcium Score | Improves (the measure goes up) | 733 people | ||||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 60 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 60 people | ||||
| Pulse Wave Velocity | Improves (the measure goes down) | 733 people | ||||
| Total cholesterol | Improves (the measure goes down) | 60 people | ||||
| Triglycerides | Improves (the measure goes down) | 60 people |
Black Currant
- Pulse Wave Velocity
- Arterial Stiffness
- Vascular Function: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Pulse Wave Velocity No effect | NoneNo effect | 1 study | 45 people | |||
| Arterial Stiffness No effect | NoneNo effect | 45 people | ||||
| Vascular Function | Improves (the measure goes up) | 45 people |
Astaxanthin
- Blood glucose
- Total cholesterol: changes; see studies
- Triglycerides: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood glucose No effect | NoneNo effect | 1 study | 193 people | |||
| Total cholesterol | Changes; see studies | 2 studies | 282 people | |||
| Triglycerides | Changes; see studies | 2 studies | 282 people | |||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 1 study | 282 people | |||
| Blood Pressure | Changes; see studies | 178 people | ||||
| Insulin | Changes; see studies | 68 people | ||||
| Low-density lipoprotein (LDL) | Changes; see studies | 282 people |
Fish Oil
- All-Cause Mortality
- Triglycerides: improves
- High-density lipoprotein (HDL): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| All-Cause Mortality No effect | NoneNo effect | 140,983 people | ||||
| Triglycerides | Improves (the measure goes down) | 24 studies | 102 people | |||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 7 studies | 102 people | |||
| C-Reactive Protein (CRP) | Improves (the measure goes down) | 4 studies | 102 people | |||
| Inflammation | Improves (the measure goes down) | 4 studies | 102 people | |||
| Coronary Artery Disease Risk | Changes; see studies | 2 studies | 144,384 people | |||
| LDL Oxidation | Improves (the measure goes down) | 1 study | 102 people | |||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 1 study | 102 people | |||
| Angina | Improves (the measure goes up) | 42,262 people | ||||
| Apolipoprotein B | Improves (the measure goes down) | 102 people | ||||
| Cardiovascular Disease Mortality | Improves (the measure goes down) | 143,514 people | ||||
| Heart Attack Risk | Changes; see studies | 125,611 people | ||||
| Major Adverse Cardiac Events | Changes; see studies | 135,019 people | ||||
| Stroke Risk | Changes; see studies | 65,404 people | ||||
| Total cholesterol | Improves (the measure goes down) | 102 people |
B Vitamins
- CVD Events/Mortality
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| CVD Events/Mortality Meta-analysis: RR 0.98 (0.94-1.03) for CVD; no effect on CHD, MI, or mortality despite homocysteine lowering | NoneNo effect | 47,921 people |
Multivitamin
- CVD Events
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| CVD Events PHS II (n=14,641): No reduction in cardiovascular events over 11 years. Meta-analyses confirm no CVD benefit. | NoneNo effect | 50,000 people |
Whey Protein
- Arterial Stiffness
- Vascular Function: improves
- Nitric Oxide: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Arterial Stiffness No effect | NoneNo effect | 534 people | ||||
| Vascular Function | Improves (the measure goes up) | 1 study | 153 people | |||
| Nitric Oxide | Improves (the measure goes up) | 173 people |
Magnesium
- Arterial Stiffness
- Blood Pressure: improves
- Serum Magnesium: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Arterial Stiffness No effect | NoneNo effect | 86 people | ||||
| Blood Pressure | Improves (the measure goes down) | 10 studies | 164 people | |||
| Serum Magnesium | Improves (the measure goes up) | 6 studies | 60 people | |||
| Sleep Quality | Improves (the measure goes up) | 1 study | 60 people | |||
| Combined Anxiety & Depression | Improves (the measure goes down) | 60 people | ||||
| Vascular Function | Improves (the measure goes up) | 202 people |
Alpha-Linolenic Acid (ALA)
- All-Cause Mortality
- Triglycerides: changes; see studies
- Body Mass Index (BMI): changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| All-Cause Mortality No effect on all-cause mortality | NoneNo effect | 19,327 people | ||||
| Triglycerides | Changes; see studies | 3 studies | 1,776 people | |||
| Body Mass Index (BMI) | Changes; see studies | 1,581 people | ||||
| Cardiovascular Disease Mortality | Changes; see studies | 18,619 people | ||||
| Coronary Artery Disease Risk | Changes; see studies | 19,061 people | ||||
| Heart Arrhythmias | Changes; see studies | 4,912 people | ||||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 1,776 people | ||||
| Low-density lipoprotein (LDL) | Changes; see studies | 2,201 people | ||||
| Major Adverse Cardiac Events | Changes; see studies | 110 people | ||||
| Total cholesterol | Changes; see studies | 2,164 people |
Beta-Carotene
- CVD Mortality: worsens
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| CVD Mortality CARET: 26% increased CVD mortality; meta-analysis shows increased CVD risk in supplementation trials | Worsens (the measure goes up) | Small effect | 40,000 people |
Kaempferol
- Cardiovascular Disease Risk: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cardiovascular Disease Risk Epidemiological studies link higher dietary flavonol intake (including kaempferol from cruciferous vegetables, tea, and fruits) to reduced CVD risk. Preclinical models show endothelial protection and anti-inflammatory effects on vascular tissue. However, no human trials have tested isolated kaempferol supplementation for cardiovascular endpoints, and epidemiological associations cannot be attributed to kaempferol specifically. | Improves (the measure goes down) | Small effect |
Riboflavin (Vitamin B2)
- Blood Pressure: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Pressure | Improves (the measure goes down) | 4 studies | 60 people |
Calcium
- Blood Pressure: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Pressure | Changes; see studies | 3 studies | 3,039 people |
Vitamin C
- Inflammation: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Inflammation | Improves (the measure goes down) | 2 studies | 24 people |
Panax Ginseng (Korean Ginseng)
- Blood Flow: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Flow | Improves (the measure goes up) | 2 studies | 50 people |
N-Acetylcysteine
- Urinary NOx: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Urinary NOx | Improves (the measure goes up) | 1 study | 8 people |
Elderberry
- Risk Of Cardiovascular Disease: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Risk Of Cardiovascular Disease | Improves (the measure goes down) | 1 study | 57 people |
Prescription medicines and peptides studied, for context
Liraglutide (Victoza/Saxenda)
- Major Adverse Cardiovascular Events (MACE): improves
- Cardiovascular Mortality: improves
- All-Cause Mortality: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Major Adverse Cardiovascular Events (MACE) LEADER trial (9,340 patients) showed 13% reduction in MACE with liraglutide vs placebo (HR 0.87, P=0.01) in high-risk T2DM patients. | Improves (the measure goes down) | Moderate effect | 17 studies | |||
| Cardiovascular Mortality LEADER trial showed significant reduction in cardiovascular death with liraglutide vs placebo in patients with T2DM and high CV risk. | Improves (the measure goes down) | Moderate effect | 14 studies | |||
| All-Cause Mortality LEADER trial demonstrated reduced all-cause mortality with liraglutide compared to placebo over median 3.8 years follow-up. | Improves (the measure goes down) | Moderate effect | 9 studies |
Dulaglutide (Trulicity)
- Major Adverse Cardiovascular Events (MACE): improves
- Systolic Blood Pressure: improves
- Non-fatal Stroke: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Major Adverse Cardiovascular Events (MACE) REWIND trial (9,901 patients) showed 12% reduction in MACE (HR 0.88, P=0.026) over median 5.4 years, the longest GLP-1 RA CV outcomes trial. | Improves (the measure goes down) | Moderate effect | 11 studies | |||
| Systolic Blood Pressure REWIND showed 1.7 mmHg reduction in systolic blood pressure sustained over median 5.4 years follow-up. | Improves (the measure goes down) | Small effect | 6 studies | |||
| Non-fatal Stroke REWIND showed significant reduction in non-fatal stroke as component of MACE primary endpoint. | Improves (the measure goes down) | Moderate effect | 4 studies |
Semaglutide (Ozempic/Wegovy)
- Major Adverse Cardiovascular Events (MACE): improves
- Cardiovascular Death: improves
- Heart Failure Outcomes: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Major Adverse Cardiovascular Events (MACE) SELECT trial (17,604 patients) showed 20% reduction in MACE with semaglutide vs placebo (HR 0.80, P<0.001) in patients with obesity without diabetes. | Improves (the measure goes down) | Moderate effect | 11 studies | |||
| Cardiovascular Death SELECT trial showed 24% reduction in cardiovascular death in heart failure subgroup (HR 0.76). Benefits observed in both HFrEF and HFpEF patients. | Improves (the measure goes down) | Moderate effect | 9 studies | |||
| Heart Failure Outcomes SELECT heart failure prespecified analysis showed 21% reduction in composite heart failure endpoint (HR 0.79). Benefits seen in both preserved and reduced ejection fraction. | Improves (the measure goes down) | Moderate effect | 9 studies |
Exenatide (Byetta/Bydureon)
- All-Cause Mortality: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| All-Cause Mortality EXSCEL showed nominal 14% reduction in all-cause mortality (P=0.016), though this was not the primary endpoint. | Improves (the measure goes down) | Moderate effect | 22 studies |
Tirzepatide (Mounjaro/Zepbound)
- Cardiovascular Outcomes (MACE): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cardiovascular Outcomes (MACE) SURPASS-CVOT showed tirzepatide non-inferior to dulaglutide for MACE in patients with T2DM and established cardiovascular disease. | Improves (the measure goes down) | Moderate effect | 5 studies |
Key findings
- Blood glucoseImproves (the measure goes down)
- Ventricular Arrhythmia Reduction (IV Administration)Improves (the measure goes down)
- Angina Pectoris SymptomsImproves (the measure goes down)
Safety notes in the studies
- However, the relationship appears J-shaped, with very low sodium intake (<3g/day) also associated with adverse cardiovascular outcomes, suggesting an optimal range.
- Pooled analysis of strontium ranelate RCTs revealed a ~50% increased risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism), contributing to European Medicines Agency restrictions in 2014.
- Post-marketing surveillance and pooled RCT analyses of strontium ranelate identified increased risk of myocardial infarction and cardiovascular events, leading to contraindication in patients with cardiovascular disease and restriction by the European Medicines Agency in 2014.
The Cardiovascular Disease Prevention & Support protocol
2 primary supplements · 4 supporting supplements
- Omega-3 Fatty Acids (EPA/DHA)2–4 g EPA/DHA daily (higher doses for elevated triglycerides)
- Coenzyme Q10100–300 mg daily (ubiquinol form preferred)
Shop the evidence-backed picks
Support alongside medical care. These supplements are not a treatment for Cardiovascular Disease. If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.
The collection holds the supplements we grade A or B for its theme, in third-party tested products where the catalog has them. It opens in our Fullscript store. You can look through it without signing in; Fullscript asks for a free account to order.
Or shop one supplement
The supplements graded A or B for Cardiovascular Disease. Each opens third-party tested products for that supplement.
- Grade B
- Grade B
- Grade B
- Grade B
- Grade B
- Grade B
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Studies cited
20 studies from PubMed
- Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis
- The effect of dietary approaches to stop hypertension (DASH) on serum inflammatory markers: A systematic review and meta-analysis of randomized trials.
- Dietary Patterns and Blood Pressure in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Vegan dietary pattern for the primary and secondary prevention of cardiovascular diseases
- The effect of plant-based dietary patterns on blood pressure: a systematic review and meta-analysis of controlled intervention trials
- Inhibiting progression of coronary calcification using Aged Garlic Extract in patients receiving statin therapy: a preliminary study
- Metabolic effects of aspartame in adulthood: A systematic review and meta-analysis of randomized clinical trials
- The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals
- Mediterranean dietary pattern, inflammation and endothelial function: a systematic review and meta-analysis of intervention trials
- Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors.
- Mediterranean-type diets and inflammatory markers in patients with coronary heart disease: a systematic review and meta-analysis.
- Mediterranean diet, cardiovascular disease and mortality in diabetes: A systematic review and meta-analysis of prospective cohort studies and randomized clinical trials.
- Comparison of seven popular structured dietary programmes and risk of mortality and major cardiovascular events in patients at increased cardiovascular risk: systematic review and network meta-analysis.
- Effects of a Mediterranean diet on blood pressure: a systematic review and meta-analysis of randomized controlled trials and observational studies.
- Mediterranean diet and blood pressure reduction in adults with and without hypertension: A systematic review and meta-analysis of randomized controlled trials.
- Mediterranean Diet Increases Endothelial Function in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
- Effects of daily extra virgin olive oil consumption on biomarkers of inflammation and oxidative stress: a systematic review and meta-analysis.
- Effects of high-intensity interval training on physical morphology, cardiopulmonary function, and metabolic indicators in older adults: a systematic review and meta-analysis.
- Effects of Eicosapentaenoic Acid vs Eicosapentaenoic/Docosahexaenoic Acids on Cardiovascular Mortality: Meta-Analysis of Clinical Trials.
- Association Between Intake of Non-Sugar Sweeteners and Health Outcomes: Systematic Review and Meta-Analyses of Randomised and Non-Randomised Controlled Trials and Observational Studies