Nutritional supplements should never be used as a replacement for prescription antihyperlipidemic agents.
Because cardiovascular disease (CVD) continues to be the leading cause of death among men and women in the United States, many consumers elect to take a proactive approach in augmenting and protecting their cardiovascular health.
A host of nutritional supplements are marketed for protecting against CVD and promoting overall cardiovascular health. Before taking any of these supplements, patients, especially those taking medications for chronic medical conditions, should check with their primary health care provider to ascertain the appropriateness of using these products and to avoid contraindications or drug interactions.
Patients should be advised that these supplements should never be used as a replacement for prescription antihyperlipidemic agents. Patients with hyperlipidemia or with risk factors for CVD should be encouraged to consult their primary health care provider for a thorough medical evaluation and treatment. Patients should also be reminded that a healthy diet and lifestyle, including exercise and lifestyle modifications (eg, low-fat, low-cholesterol, low-sugar, high-fiber diet; smoking cessation; limited use of alcohol), are the best defenses against CVD. Pharmacists should stress that there is no substitution for a healthy diet and lifestyle and that patients should always discuss the use of nutritional supplements with their physician.
The most common ingredients marketed for promotion of cardiovascular health include omega-3 fatty acids, plant sterols, coenzyme Q10 (CoQ10), and garlic.
These nutritional supplement products include single-entity or combination products and are often incorporated in multivitamin supplements formulated for cardiovascular health, such as Centrum Specialist Heart (Pfizer). While many of these supplements are available in capsule form, some new products include Nature Made Fish Oil in fruit-flavored gummy form. Other new supplements include Nature Made CholestOff Complete and CholestOff Plus as well as Cholestra Flavored Chews (Quest Consumer).
Omega-3 and -6 Fatty Acids
Many dietary supplements that are specifically formulated for cardiovascular health contain omega-3 fatty acids alone or in conjunction with omega-6 fatty acids. Omega-6 and omega-3 fatty acids (found in fattier fish such as tuna, mackerel, and salmon) are referred to as poly-unsaturated fatty acids (PUFAs). Some studies suggest that these supplements may provide health benefits when consumed in the recommended amounts, especially when used to replace saturated fats or trans fats in the diet.1 Omega-6 and -3 PUFAs play a crucial role in heart and brain function and in normal growth and development.1 PUFAs are classified as essential fats that the body needs but can’t produce, so they must be obtained through dietary means or supplements (Online Table).1
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