Dietary supplements are not better than statins for heart disease


As I wrote previously, statins are important in preventing cardiovascular disease and mortality, but people continue to push dietary supplements as a better alternative to statins. Well, a new study blows that claim out of the water — statins are better for your cardiovascular health than dietary supplements.

I keep writing about supplements, and rarely do I find powerful, robust, and repeated evidence that supplements have any positive effect on one’s health. Occasionally, some research might show a small clinical benefit, but mostly, taking supplements means you have very expensive urine since most of it is removed by your kidneys.

As most of you who read this blog know that I love reviewing these articles, so you have the bullet points for the results. Of course, the article is linked, so you can get into the weeds if you want. Here we go.

several cloves of garlic against gray background
Garlic. Photo by Karolina Grabowska on Pexels.com

Dietary supplements vs statins study

In a study published in the Journal of the American College of Cardiology, Luke J Laffin, MD, Co-Director, Center for Blood Pressure Disorders at the Cleveland Clinic, and colleagues reviewed data from 190 individuals included in a randomized, single-blind clinical trial that compared the efficacy of a low-dose statin, rosuvastatin, with placebo and six common supplements in impacting lipid and inflammatory biomarkers. The six supplements were fish oil, cinnamon, garlic, turmeric, plant sterols, and red yeast rice.

The primary endpoint for the study was the percent change in LDL cholesterol from baseline for rosuvastatin 5 mg daily compared with placebo and each supplement after 28 days.

Here are the key results:

  • People taking rosuvastatin (5 mg per day for 4 weeks) had an average 37.9% reduction in LDL cholesterol, the only group to do better than the placebo arm. I could just stop with this data point.
  • The low-dose statin group had a 24.4% reduction in total cholesterol from baseline compared with the placebo and all supplements.
  • There was no significant change in HDL cholesterol with rosuvastatin.
  • The garlic supplement increased LDL cholesterol by 7.8% over the placebo arm. Garlic is one of the trendy supplements for heart health and it increased one of the markers for cardiovascular disease.
  • None of the other dietary supplements demonstrated a significant decrease in LDL cholesterol compared with the placebo.
  • The supplements did not lower LDL cholesterol, inflammatory markers, total cholesterol, or triglycerides any more than the placebo.
  • Adverse event rates were similar across study groups; there were no reports of musculoskeletal or neurological adverse events in the statin arm.

I’ve discussed this before. There is plenty of evidence that fish oil does not improve CV outcomes, but it may increase the risk for atrial fibrillation. I think fish oil (and related omega-3 supplements) are useless for most clinical outcomes, but here we are, discussing it once again.

selective focus photography of assorted color stars
Photo by Jess Bailey Designs on Pexels.com

The Skeptical Raptor Rating™

Let me discuss a couple of issues I have with the study. First, it’s small. I know it’s difficult for researchers to do a massive clinical trial with 3000 participants, but I really prefer it. Second, the study endpoint was at 28 days. It would be nice to have a study that compared statins to dietary supplements at one year or later. Third, the study did not provide us with actual clinical outcomes, such as cardiovascular events or death, just a proxy in LDL and HDL cholesterols.

That being said, these numbers were statistically significant. And it showed that statins worked in reducing LDL cholesterol (which is linked to heart disease) whereas the supplements were either equal to or worse than the placebo. I mean garlic is worse than taking nothing in controlling your LDL cholesterol.

So, I give this 4 out of 5 stars. It is a credible study, though I hope that a longer-term and larger study is coming our way.

Citations

Laffin LJ, Bruemmer D, Garcia M, Brennan DM, McErlean E, Jacoby DS, Michos ED, Ridker PM, Wang TY, Watson KE, Hutchinson HG, Nissen SE. Comparative Effects of Low-Dose Rosuvastatin, Placebo and Dietary Supplements on Lipids and Inflammatory Biomarkers. J Am Coll Cardiol. 2022 Oct 19:S0735-1097(22)07125-X. doi: 10.1016/j.jacc.2022.10.013. Epub ahead of print. PMID: 36351465.

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