Answer:

Heart disease remains the leading cause of death for both women and men in the U.S.  Some supplements may help keep your heart healthy, but others may potentially contribute to heart disease.

Heart Healthy Supplements:
There is strong evidence that sterol esters (like the phytosterol beta-sitosterol) and stanol esters, available in supplements and in some "heart healthy" margarines and spreads, can significantly lower LDL cholesterol. (There is also some evidence that taking curcumin may increase the cholesterol-lowering effects of phytosterols.) You can get more information about this, plus our tests and reviews of products in the Cholesterol-Lowering Supplements Review >>

Garlic has been shown to reduce total cholesterol and triglycerides, and may slow the development of atherosclerosis.  One brand of garlic in particular has been shown to lower triglycerides more than others. You can get more information about these, including our tests and reviews of products in the Garlic Supplements Review >>

Red yeast rice can significantly lower cholesterol, but products vary widely in their amounts of natural, active statin compounds.  You can get more information and our tests and comparisons of products in the Red Yeast Rice Supplements Review >>

High-dose niacin has been shown to lower LDL cholesterol. However, it should not be taken with statin-containing supplements (red yeast rice), or with statin drugs, which could increase the risk of serious events like stroke.  You can get more information about niacin, including our tests and reviews of products in the B Vitamin Supplements Review >>

Replacing some saturated fat in the diet with olive oil may help lower risk factors for heart disease, such as high blood pressure and high cholesterol. You can get more information about extra virgin olive oil and see our Top Picks among products in the Extra Virgin Olive Oil Review >>

Oats and oat-based cereals can be a good source of soluble fiber, which can help to lower cholesterol reduce the risk of heart disease. See our Oat Cereals Review for the clinical evidence, including how much you need to consume in order to significantly reduce cholesterol.

There mixed evidence for whether soy can lower cholesterol. Although the FDA currently allows companies to make the claim that "25 grams of soy protein daily, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease," the agency has proposed revoking this health claim due to inconsistent findings (a final decision has not yet been made). In addition, a specific protein peptide isolated from soy, called lunasin, is sometimes promoted to lower cholesterol, but it was not shown to be beneficial in a clinical trial. Also see the Soy article.

Some, but not all studies suggest that pantethine (which is not a B vitamin but is often included as an ingredient in B vitamin supplements) may help to lower LDL cholesterol.

CoQ10 has been shown to significantly reduce the risk of adverse cardiovascular events by 50% in people with moderate to severe heart failure, and may be helpful in reducing some of the side-effects of cholesterol-lowering statin drugs. You can get more information about CoQ10 (and ubiquinol, a related compound), including our tests and reviews of products, in the CoQ10 and Ubiquinol Supplements Review >>

Vitamin D may lower the risk of cardiovascular disease in those with low blood levels of vitamin D but not be of benefit for people who do not have a vitamin D deficiency. You can get more information about vitamin D, including our tests and reviews of products in the Vitamin D Supplements Review >>

Similarly, improving magnesium to adequate levels can slightly reduce blood pressure, and magnesium blood levels in the mid to high normal range have been associated with a lower risk of death from cardiovascular disease, as noted in the Magnesium Supplements Review >>

Berberine may help to reduce blood pressure, triglycerides and total and LDL cholesterol (as well as blood sugar) in people with type 2 diabetes; however, be aware that it may interact with several cholesterol-lowering medications, potentially increasing blood levels (and the risk of side effects) of these drugs.

Cocoa powders and dark chocolate rich in flavanols can improve vascular function and blood pressure, and even raise levels of HDL ("good") cholesterol.  You can get more information about these, as well as our tests and reviews of products in the Cocoa Powders, Extracts, Nibs, Supplements, and Chocolates Review >>

Certain probiotics may modestly lower systolic and diastolic blood pressure, and "bad" LDL cholesterol — although they do not appear to increase "good" HDL cholesterol. There is mixed evidence as to whether probiotics reduce triglyceride levels. More information, plus our tests of popular products, is found in the Probiotic Supplements and Kefirs Review >>

Supplements That May Be Harmful:
Vitamin E supplements, once touted for heart health, have not been found to provide a benefit for people with cardiovascular disease, and could actually be harmful for some heart disease patients, since they could reduce the effectiveness of cholesterol-lowering agents.

There is reason to believe that L-carnitine and lecithin could actually contribute to atherosclerosis in certain people, and it may be wise to avoid long-term supplementation with either one.

Supplements That May Not Help:
Calcium -- Although getting sufficient calcium may decrease your risk of dying from cardiovascular disease, too much may be harmful. A study found that calcium (800 mg) given once daily to post-menopausal women with high cholesterol caused a significant increase in serum cholesterol (up by about 50 mg/dL) and an increase in the thickness of lining of the carotid artery - changes associated with heart disease. Only if you don't get enough calcium should you consider a supplement, and it generally recommended that calcium supplementation not exceed 500 mg per dose, or more than 900 mg per day. You can get more information about these supplements, including our tests and reviews of products, in the Calcium Supplements Review >>

Fish Oil -- Despite the fact that omega-3 fatty acids that have been linked to some heart healthy effects, it seems that the benefits come from consumption of fish, and not supplements.  Only if you don't eat fish might fish oil supplements provide some heart benefit.  Also, because fish oil supplements can have a blood-thinning effect, they should be used with caution in people taking other blood-thinning supplements or medications. You can get more information about these supplements, including our tests and reviews of products, in the Fish/Marine Oil Supplements Review >>

Multivitamins have not been found to reduce (nor increase) the risk of heart attack, stroke or death from cardiovascular disease. You can get more information about these supplements, including our tests and reviews of products, in the Multivitamin and Multimineral Supplements Review >>

Policosanol -- Although there is some evidence from several studies from Cuba suggesting a cholesterol-lowering effect, other studies have failed to find this effect, as noted in our Cholesterol-Lowering Supplements Review>>

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26 Comments

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Linda9811
June 19, 2016

I use flaxseed oil caps rather than fish oil for my omega-3. How does that fit in for "heart healthy"?

ConsumerLab.com
June 20, 2016

Hi Linda - Please see the "What It Does" section of the Flaxseed Oil Review ( https://www.consumerlab.com/reviews/black-currant-borage-evening-primrose-and-flaxseed-oils-sources-of-ala-and-gla-omega-3-and-6-fatty-acids/flaxseed/#whatitdoes) for more about cardiovascular effects. You may also find this CL Answer helpful: Is it better to take fish oil, flaxseed oil -- or both? ( https://www.consumerlab.com/answers/is-it-better-to-take-fish-oil-flaxseed-oil-or-both/fish-or-flax-oil/.

Lazar19089
February 11, 2020

Over years I tried various supplements, but the best results yet I got with
Citrus Bergamot extract- in my annual checkup I saw reduction of total cholesterol from 270 to 225, improved the ratio, and for the first time lowered triglyceride levels.

ConsumerLab.com
February 11, 2020

Hi Lazar - Thank you for sharing your experience. You can find more information about the clinical evidence for bergamot in our Encyclopedia article on High Cholesterol: https://www.consumerlab.com/encyclopedia/.asp?chunkiid=22378.

jeffrey18694
December 4, 2019

About 10 years ago, I successfully lowered my cholesterol with high dose Niacin. For the next 8 years, my numbers were excellent. Two years ago, my cardiologist said that studies had shown that lowering cholesterol with Niacin has no effect on longevity. He told me to stop the Niacin, and go on a statin. Although the statin lowered my cholesterol in comparison to not taking anything, it did not lower it nearly as well as Niacin. I did not see anything about this in your information on Niacin. I would certainly prefer to take Niacin than Lipitor. What is the truth?

ConsumerLab.com
December 4, 2019

High-dose niacin is typically used if statins fail, as discussed in the Niacin section of the B Vitamins Review at https://www.consumerlab.com/reviews/review-best-b-vitamins-and-complexes-energy-b6-b12-biotin-niacin-folic-acid/bvitamins/#niacin. There are risks with high-dose niacin, as discussed, although there are also risks with statins.

robert18687
December 1, 2019

What about citrus bergamot or pycnogenol for lowering cholesterol? There are several studies that support this claim. I just started taking citrus bergamot so I won't know for several months whether it works or not. I took pycnogenol but it caused aphthous stomatitis (one of the side effects) according to published research.

Cappello, A., Dolce, V., Iacopetta, D., Martello, M., Fiorillo, M., Curcio, R., … Dhanyalayam, D. (2016). Bergamot (Citrus bergamia Risso) Flavonoids and Their Potential Benefits in Human Hyperlipidemia and Atherosclerosis: an Overview. Mini-Reviews in Medicinal Chemistry, 16(8), 619–629. doi: 10.2174/1389557515666150709110222

Dean17733
April 9, 2019

I had read that citrus bergamot can lower cholesterol. So I searched and found clinical tests that used the brand Jarrow Citrus Bergamot. I had a total cholesterol of 258. It said to give the supplement a month and get my cholesterol rechecked. So I ordered 2 bottles for $45, which lasts 2 months. I re-took my cholesterol and my cholesterol was 200. I changed nothing else. A drop of 58 points in 30 days equals, I am staying on citrus bergamot.

ConsumerLab.com
April 11, 2019

Hi Dean - Thank you for sharing your experience with this. You can find information about the clinical evidence for bergamot in the Encycopedia article about Cholesterol: https://www.consumerlab.com/encyclopedia/.asp?chunkiid=22378.

robert18688
December 1, 2019

What was your daily dosage?

Glenn18689
December 1, 2019

My husband and I both took Citrus Bergamot for over a year with blood tests taken a year apart. There was absolutely no change in cholesterol numbers for either one of us. Needless to say, we discontinued this supplement.

Stephen18764
December 25, 2019

What brand did you take?

Shirley169
September 22, 2014

Regarding the statement that fish oil can have a blood-thinning effect, I think this should be researched because I have read that they do not thin the blood. Fish oil 'conditions' the blood so that the platelets are slippery and do not stick together. For many people taking blood thinners, with monitoring, their medication can safely be reduced.
Another benefit of good fish oil is it does not have mercury.

Doron168
September 21, 2014

One of the most beneficial dietary supplement for cardiovascular health was left out of your list. Among its many benefits such as anti-inflammation and blood clotting, RESVERATROL provides blood thinning properties, and softens the arteries walls. Both benefits may prevent heart-attacks and strokes.

ConsumerLab.com
October 20, 2014

Hi Doron - The Resveratrol Review does mention potential cardiovascular effects of resveratrol while pointing out that, to date, clinical studies have not established a clear benefit in this regard - and even some concerns. You can read more about this in the What It Does section ( https://www.consumerlab.com/reviews/resveratrol-review/resveratrol-red-wine/#whatitdoes) and Concerns and Cautions section ( https://www.consumerlab.com/reviews/resveratrol-review/resveratrol-red-wine/#cautions) of the report.

Matt16622
March 24, 2018

I've done multiple lipids tests with fish oil and krill oil. The most extreme was 5 grams of Kirkland fish oil a day for three months. I've tried various other strict regimens of fish and krill oil, but not in that high of dose. The 5G fish oil test actually left me with higher triglycerides, up ~10%-20%, but not conclusively. In the end, none provided any noticeable benefit to my LDL, HDL, and especially my triglycerides (I have hypertriglyceridemia). It's good to see that acknowledged in your post here.

Gabriel16438
February 8, 2018

I was very surprised to read the following in the above article:

"There is strong evidence that sterol esters (like the phytosterol beta-sitosterol) and stanol esters, available in supplements and in some "heart healthy" margarines and spreads, can significantly lower LDL cholesterol."

Really???!!!. Do you recommend margarine and spread as something healthy and especially good for reducing risk of heart disease? What about the trans fats that margarine and spreads are so famous about? I feel like I am in the '60 again when butter was evil and margarine was godsend!

ConsumerLab.com
February 8, 2018

Hi Gabriel - The "margarines" referred to are not the old "stick margarines" with trans fats, but those made with polyunsaturated fats and no trans fats.

richard16435
February 7, 2018

Pantethine can help lower cholesterol.
and
small bad particles should be evaluated with cholesterol.

ConsumerLab.com
February 13, 2018

Thank you for your comment Richard. We've added information about pantethine to the answer above.

Jeanne11640
February 1, 2017

What about Acetyl L-Carnitine? Does it have the same potential problems re atherosclerosis??

ConsumerLab.com
February 1, 2017

Hi Jeanne - Please see the "Concerns and Cautions" section of the Acetyl-l-carnitine ( https://www.consumerlab.com/reviews/acetyl-l-carnitine-supplements-review/acetyl-l-carnitine/#cautions).

Kenneth11081
July 17, 2016

What about vitamin K2?
There are many observational studies showing that K2 directs calcium away from arteries and into bones.
What do you think?

ConsumerLab.com
July 18, 2016

Hi Kenneth - Please see the "What It Does" section of the vitamin K review for more about vitamin K and coronary artery calcification: https://www.consumerlab.com/reviews/vitamin-k-supplements-review/vitamin-k/#heartdisease

Greg102
August 12, 2014

Recent Cacoa (as pure as possible eg. 85% cacao) studies show improved circulation and imply improved cardio vascular function. Should be considered for further review to include here.

ConsumerLab.com
August 12, 2014

Great point, Greg. Per your suggestion, we added a link to the Cocoa Review above, which covers that research -- as well as our product tests.

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