Millions of Americans are prescribed statins to cut back the danger of coronary heart illness, however many want to take dietary supplements like fish oil, garlic and flaxseed.

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Peter Dazeley/Getty Images

Millions of Americans are prescribed statins to cut back the danger of coronary heart illness, however many want to take dietary supplements like fish oil, garlic and flaxseed.

Peter Dazeley/Getty Images

If you have been prescribed medication to decrease your threat of a coronary heart assault or stroke, would you’re taking it?

Millions of Americans are prescribed statins similar to Lipitor, Crestor or generic formulations to decrease their ldl cholesterol. But a lot of individuals are hesitant to begin the remedy.

Some individuals fret over potential uncomfortable side effects similar to leg cramps, which can be – or might not be – linked to the drug. As an alternate, dietary dietary supplements, typically marketed to advertise coronary heart well being, together with fish oil and different omega-3 supplements (Omega-3’s are important fatty acids present in fish and flaxseed), are growing in popularity.

So, which is handiest? Researchers on the Cleveland Clinic got down to reply this query by evaluating statins to dietary supplements in a scientific trial. They tracked the outcomes of 190 adults, ages 40 to 75. Some individuals got a 5 mg every day dose of rosuvastatin, a statin that’s offered beneath the model title Crestor for 28 days. Others got dietary supplements, together with fish oil, cinnamon, garlic, turmeric, plant sterols or purple yeast rice for a similar interval.

The maker of Crestor, Astra Zeneca sponsored the examine, however the researchers labored independently to design the examine and run the statistical evaluation.

“What we found was that rosuvastatin lowered LDL cholesterol by almost 38% and that was vastly superior to placebo and any of the six supplements studied in the trial,” examine creator Luke Laffin, M.D. of the Cleveland Clinic’s Heart, Vascular & Thoracic Institute informed NPR. He says this degree of discount is sufficient to decrease the danger of coronary heart assaults and strokes. The findings are revealed within the Journal of the American College of Cardiology.

“Oftentimes these supplements are marketed as ‘natural ways’ to lower your cholesterol,” says Laffin. But he says not one of the dietary dietary supplements demonstrated any vital lower in LDL ldl cholesterol in contrast with a placebo. LDL ldl cholesterol is taken into account the ‘dangerous ldl cholesterol’ as a result of it will probably contribute to plaque build-up within the artery partitions – which might slender the arteries, and set the stage for coronary heart assaults and strokes.

“Clearly, statins do what they’re intended to do,” the examine’s senior creator Steve Nissen, M.D., a heart specialist and Chief Academic Officer of the Heart, Vascular & Thoracic Institute at Cleveland Clinic informed NPR. By comparability, he says this analysis exhibits that dietary supplements are usually not efficient. “They do not promote heart health. They do not improve levels of the bad cholesterol.” Nissen says dietary supplements will be costly in comparison with statin drugs. Depending on insurance coverage, Nissen says individuals might pay lower than $5.00 a month out-of-pocket for rosuvastatin.

“Statins are the most effective heart attack and stroke prevention drugs that we have really ever seen,” says Michael Honigberg, MD, a heart specialist and researcher at Massachusetts General Hospital who shouldn’t be affiliated with the brand new examine. He says the brand new findings add to an already massive physique of proof exhibiting statins decrease LDL ldl cholesterol, and he is not shocked to see that the dietary supplements weren’t as efficient.

However, he says, not everybody with a household historical past of coronary heart illness or barely elevated ldl cholesterol ought to be on a statin. The American College of Cardiology and American Heart Association developed some prescription guidelines. Typically, if an individual’s LDL ldl cholesterol (dangerous ldl cholesterol) is 190 or increased, they’re typically suggested to begin a statin. Health care professionals use a risk calculator to estimate an individual’s threat of getting a coronary heart assault or stroke over the subsequent 10 years. If the danger is excessive sufficient, based mostly on elements together with age, blood strain and smoking standing, then a statin could also be really helpful.

Honingberg says for individuals who have barely elevated ldl cholesterol, however are usually not at excessive sufficient threat to be prescribed a statin, he recommends that they deal with weight loss program and train, fairly than shopping for dietary supplements. “I tell my patients to save their money and instead spend that money on eating heart healthy, high quality food.” He factors to research that present heart-healthy diets, together with Mediterranean diets which emphasize wholesome fat, a lot of fruits, greens and entire grains and the DASH diet, considerably cut back the danger of coronary heart illness. “I think a formulation that we perhaps don’t use enough is that food is medicine and is probably a more effective medicine than supplements,” says Honingberg.

The National Center for Complementary and Integrative Health, a part of the National Institutes of Health, has additionally concluded, based mostly on prior analysis, that omega-3 supplements do not reduce the risk of heart disease, however consuming fish – which incorporates omega-3 fatty acids – is linked to a lowered threat. This means that omega-3 fatty acids are most useful as a part of a nutritious diet. And it is price noting that the NIH overview concludes that omega-3 dietary supplements might assist relieve signs of rheumatoid arthritis. Omega 3’s are additionally added to child formulation to advertise mind improvement. The NIH overview additionally concludes that omega-3 dietary supplements can decrease triglycerides, a sort of fats discovered within the blood. But Dr. Honingberg says this can be really helpful for a “small subset of patients” with very excessive triglyceride ranges.

As for individuals whose threat of coronary heart illness is excessive sufficient to warrant a statin prescription, Dr. Honingberg says he spends a good period of time speaking via issues with sufferers.

“We talk about the excellent safety profile and the very, very low risk of side effects,” he says. He describes the danger of significant uncomfortable side effects as “vanishingly small.”

Sometimes sufferers cease taking a statin as a result of they imagine it is inflicting a sure facet impact. But Honingberg factors to a double-blind research study that confirmed when sufferers got a placebo rather than a statin, sufferers reported feeling many of the similar uncomfortable side effects. “So the punch line of the trial is people blame statins for side effects the statins aren’t really causing,” he says.