A variety of dietary supplements that were marketed as supporting heart health were no match for statins — drugs that lower blood lipid (cholesterol and triglyceride) levels — when it came to lowering unhealthy cholesterol levels, according to a new study presented at the American Heart Association’s 2022 Scientific Sessions and described in a news release from the organization.
Statins are some of the most widely prescribed drugs, but they have also generated controversy because of the mix of benefits and risks that they offer. In addition to their cardiovascular benefits, statins have been shown to increase the risk of developing type 2 diabetes and may lead to existing diabetes getting worse. Despite these risks, many scientists believe that for at least some groups of people, the benefits of statins outweighs the risks. Statins have also been shown to potentially reduce the risk for diabetic retinopathy (eye disease) and may reduce the risk of dying from COVID-19 in people with diabetes or heart disease.
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For the latest study, 199 adults ages 40 to 75 were randomly assigned to take either a dietary supplement, a placebo (inactive pill), or a low-dose statin (5 milligrams of rosuvastatin) daily for 28 days. All of the participants had no personal history of cardiovascular disease and had an LDL (low-density lipoprotein, or “bad”) cholesterol level between 70 and 189 mg/dl. An LDL cholesterol level under 100 mg/dl is considered to be healthy, while a level between 100 and 159 mg/dl indicates an elevated cardiovascular risk and a level of 160 mg/dl or higher is considered dangerous. Due to their LDL cholesterol and other lipid levels, participants were estimated to have a 5% to 20% risk of developing atherosclerotic cardiovascular disease (disease due to the buildup of plaque in arteries) within 10 years. Out of the original 199 participants, 190 completed the study and were included in the analysis.
In addition to the statin and placebo groups, there were six dietary supplement groups in the study. Participants who were assigned to those groups took either a fish oil supplement (2,400 milligrams), a cinnamon supplement (2,400 milligrams), a garlic supplement (5,000 micrograms of allicin), a turmeric supplement (4,500 milligrams), a plant sterol supplement (1,600 milligrams), or a red yeast rice supplement (2,400 milligrams).
Supplements not linked to lower cholesterol levels
After 28 days, participants in the statin group had an average LDL cholesterol level 35.2% lower than the average seen in the placebo group. None of the dietary supplements were linked to a significantly lower LDL cholesterol level compared with placebo. Participants who took the statin experienced an average drop in their LDL cholesterol of 37.9% during the study period.
Members of the statin group experienced an average drop in total cholesterol of 24%, which was a larger drop than in any of the other groups. Just as with LDL cholesterol, there was no significant difference between any of the dietary supplements and placebo when it came to total cholesterol levels. The statin group also saw an average drop in triglycerides of 19%, while none of the supplements led to a significantly different triglyceride level than placebo.
Taking the statin was not linked to any overall change in HDL (high-density lipoprotein, or “good”) cholesterol — which is a good thing. Out of all the supplements, only plant sterols were linked to a change in HDL cholesterol compared with placebo — and this supplement lowered HDL cholesterol, which is not considered to be good.
None of the interventions in the study — statins, placebo, or dietary supplements — were linked to changes in blood markers of inflammation. Higher levels of these blood markers could indicate a higher risk for cardiovascular disease.
“This study sends an important public health message that dietary supplements commonly taken for ‘cholesterol health’ or ‘heart health’ are unlikely to offer meaningful impact on cholesterol levels,” said study author Luke J. Laffin, MD, codirector of the Center for Blood Pressure Disorders at the Cleveland Clinic, in the news release. “The results also indicate that a low-dose statin offers important beneficial effects.” But Laffin also noted that future studies should continue to look at how other types of dietary supplements, including different formulations and doses, affect cholesterol and triglyceride levels.
Want to learn more about diabetes and cholesterol? Read “Eight Lifestyle Ways to Lower Your LDL Cholesterol,” “Natural Ways to Lower Your Cholesterol,” “Your Cholesterol Questions Answered,” and “Statin Alternatives: Other Medications That Can Lower Cholesterol.”
