Coronary Artery Disease
Coronary artery disease (CAD) is the most common form of heart disease. Blood vessels that bring blood to the heart muscle are narrowed. It can slow or stop blood flow to the heart. Blood vessels are narrowed by a process called atherosclerosis. Fat, cholesterol, and calcium stick to blood vessel walls and form a plaque. The plaque can damage the blood vessels walls. This can lead to blood clots. The clots and plaque both make the blood vessel more narrow. It also makes it easier for more plaque to develop. Blocked blood flow in these blood vessels can lead to a heart attack.
Treatment can help to slow or stop buildup of plaque, open narrow arteries, and decrease the risk of clotting. One step is to manage factors that lead to CAD. This includes:
- Decreasing blood pressure and cholesterol
- Managing diabetes
- Losing weight if overweight
- Quitting smoking
Information on these issues can be found in separate articles. The following include supplements that were specifically studied for impact on CAD.
Dietary factors that may reduce the risk of CAD:
- ChocolateA9, A10
- Garlic preparations may reduce blood pressure.A1-A3, A5, A8
- Green Tea or Black TeaA7
- Moderate coffee consumption (three to four cups a day)A4, A6
Therapy that may affect CAD include:
Possibly Not Effective
These supplements may not be effective:
- Beta-carotene Omega-3 fatty acids B1, B4, B8 Note: Eating foods rich in these nutrients has been linked with a reduction in the risk of CAD. Supplements may not be as effective.
- Omega-6 fatty acids (linoleic acid)B12
- Folic acid, Vitamin B6, and vitamin B12B6, B7, B10, B11
- Vitamin CB3, B5
- Vitamin EB2, B3, B5
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
Herbs and Supplements to Be Used With Caution
Talk to your doctor about any alternative therapy you are taking to make sure it does not interfere with your treatment plan. Some supplement discussed here have certain concerns such as:
- Vitamin C can reduce the effectiveness of certain medications, such as blood thinners.
- Vitamin E has a blood-thinning effect that may cause problems in those who also take blood thinners. If you have diabetes or are being treated for cancer, talk to your doctor before you take vitamin E.
A. Dietary changes
A1. Ong HT, Cheah JS. Statin alternatives or just placebo: an objective review of omega-3, red yeast rice and garlic in cardiovascular therapeutics. Chinese Medical Journal. 2008;121(16):1588–1594.
A2. Reinhart KM, Talati R, et al. The impact of garlic on lipid parameters: a systematic review and meta-analysis. Nutrition Research Reviews. 2009;22(1):39-48.
A3. Huang J, Frohlich J, et al. The impact of dietary changes and dietary supplements on lipid profile. Canadian Journal of Cardiology. 2011;27(4):488-505.
A4. Freedman ND, Park Y, et al. Association of coffee drinking with total and cause-specific mortality. N Engl J Med. 2012 May 17;366(20):1891-904
A5. Stabler SN, Tejani AM, et al. Garlic for the prevention of cardiovascular morbidity and mortality in hypertensive patients. Cochrane Database of Systematic Reviews. 2012;(8)CD007653.
A6. Ding M, Bhupathiraju SN, et al. Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies. Circulation. 2014 Feb 11;129(6):643-59.
A7. Zhang C, Qin YY, et al. Tea consumption and risk of cardiovascular outcomes and total mortality: a systematic review and meta-analysis of prospective observational studies. Eur J Epidemiol. 2015 Feb;30(2):103-13.
A8. Xiong XJ, Wang PQ, et al. Garlic for hypertension: A systematic review and meta-analysis of randomized controlled trials.Phytomedicine. 2015 Mar 15;22(3):352-61.
A9. Kwok CS, Boekholdt SM, et al. Habitual chocolate consumption and risk of cardiovascular disease among healthy men and women. Heart. 2015 Aug;101(16):1279-87.
A10. Larsson SC, Åkesson A, et al. Chocolate consumption and risk of myocardial infarction: a prospective study and meta-analysis. Heart. 2016 Jul 1;102(13):1017-22.
B1. Hooper L, Thompson RL, et al. Omega 3 fatty acids for prevention and treatment of cardiovascular disease. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD003177.
B2. Lee IM, Cook NR, et al. Vitamin E in the primary prevention of cardiovascular disease and cancer. The women’s health study: a randomized controlled trial. The Journal of the American Medical Association. 2005;294(1):56–65.
B3. Cook NR, Albert CM, et al. A randomized factorial trial of vitamins C and E and beta carotene in the secondary prevention of cardiovascular events in women: results from the Women's Antioxidant Cardiovascular Study. Arch Intern Med. 2007;167:1610-1618.
B4. Ong HT, Cheah JS. Statin alternatives or just placebo: an objective review of omega-3, red yeast rice and garlic in cardiovascular therapeutics. Chin Med J (Engl). 2008;121:1588-1594.
B5. Sesso HD, Buring JE, et al. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. JAMA. 2008;300:2123-2133.
B6. Mei W, Rong Y, et al. Effect of homocysteine interventions on the risk of cardiocerebrovascular events: a meta-analysis of randomised controlled trials. Int J Clin Pract. 2010 Jan;64(2):208-15.
B7. Miller ER 3rd, Juraschek S, et al. Meta-analysis of folic acid supplementation trials on risk of cardiovascular disease and risk interaction with baseline homocysteine levels. Am J Cardiol. 2010 Aug 15;106(4):517-27.
B8. Kwak SM, Myung SK, et al. Efficacy of omega-3 fatty acid supplements (eicosapentaenoic acid and docosahexaenoic acid) in the secondary prevention of cardiovascular disease: a meta-analysis of randomized, double-blind, placebo-controlled trials. Arch Intern Med. 2012 Apr 9.
B9. Rees K, Hartley L, et al. Selenium supplementation for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD009671.
B10. Martí-Carvajal AJ, Solà I, et al. Homocysteine-lowering interventions for preventing cardiovascular events. Cochrane Database Syst Rev. 2015 Jan 15;1:CD006612.
B11. Jenkins DJA, Spence JD, et al. Supplemental Vitamins and Minerals for CVD Prevention and Treatment. J Am Coll Cardiol. 2018 Jun 5;71(22):2570-2584.
B12. Hooper L, Al-Khudairy L, et al. Omega-6 fats for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2018 Jul 18;7:CD011094.
C. Other therapies
C1. Bradt J, Dileo C, et al. Music for stress and anxiety reduction in coronary heart disease patients. Cochrane Database Syst Rev. 2013 Dec 28;(12):CD006577.
C2. Hartley L, Dyakova M, et al. Yoga for the primary prevention of cardiovascular diseases. Cochrane Database Syst Rev. 2014;5:CD010072.
Last reviewed March 2019 by EBSCO NAT Review Board Richard Glickman-Simon, MD Last Updated: 3/2/2019