Table 2 Gradable intermediate outcomes for dietary supplements plus cardiovascular drugs (low grade evidence)

Lipid profile

Co-Q10 (200 mg/day)

Fenofibrate

No difference for HDL-C (one study): MD,1.55 mg/dL (95% CI −6.78, 3.68)

Mean age:

53 years

Mixed gender

High CHD risk

12 weeks treatment

Lipid profile

Garlic (4 g/day)

Nitrates

In favor of combination

Unknown age, gender

HDL-C (one study): MD, 8.40 mg/dL (95% CI 1.91, 14.89)

High CHD risk

12 weeks treatment

Lipid profile

Omega-3-fish oil (3.6 g/day omega-3 to 9.2 g/day fish oil)

Statins

In favor of combination

Mean age: 45 to 63 years

TG (two studies pooled): MD, -74.95 mg/dL (95% CI −95.80, -54.10)^a

Mixed CHD risk

No difference between combination and CV drug alone

Mixed gender

HDL-C (six studies pooled): MD, 2.26 mg/dL (95% CI −1.8, 6.3)

Up to 25 weeks treatment

LDL-C (five studies pooled): MD, 1.3 mg/dL (95% CI −3.6, 6.2)

Achieving LDL-C targets: RR 0.93 (95% CI 0.84, 1.03)

Achieving HDL-C targets (one study): and 1.00 (95% CI 0.90, 1.10)

Lipid profile

Omega-3-fish oil (1.8 g/day)+

Calcium channel blockers + aspirin

In favor of combination

Mean age: 57 y;

TG (two studies not pooled): MD −81.00 mg/dL (95% CI −125.30, -36.70) and MD −54.00 mg/dL (95% CI −94.1, -13.90)

85% men

High CHD risk

Up to 6 weeks treatment

Lipid profile

Omega-3-fish oil (3.2 g/day)

Calcium channel blockers + aspirin, or dipyridamole

In favor of CV drug alone

Mean age: 56 y;

LDL-C (one study): MD 21.00 mg/dL (95% CI 3.30, 38.70)

100% men

In favor of combination

High CHD risk

TG (one study): MD −81.0 mg/dL (95% CI -125.30, -36.70)

Up to 12 weeks treatment

Lipid profile

Vitamin E (900 mg/day)

Nifedipine

In favor of combination

Elderly; mixed gender

LDL-C (one study): MD −39.83 mg/dL (95% CI −71.29, -8.37)

High CHD risk

12 weeks treatment

In favor of combination

TG (one study): MD, -23.91 mg/dL (95% CI -35.89, -11.93)

Blood pressure

Omega-3-fish oil (2 g/day)+

Statins

In favor of combination

Mean age: 44 to 53 y; mixed gender

Systolic blood pressure (one study): MD, -8.50 mmHg (95% CI -16.3, -0.66)

Mixed CHD risk

5 weeks treatment

Systolic blood pressure (one study): median change from baseline −5.0 versus + 0.3 mmHg

No difference between combination and CV drug alone

Diastolic blood pressure (one study): MD, 0.20 mmHg (95% CI -4.76, 5.16)

Omega-3-fish oil (4 g/day fish oil)+

Statins

Diastolic blood pressure (one study): Median reductions from baseline -3.30 versus −1.80 to

Mean age: 58 y; Mixed gender

Unclear CHD risk

6 weeks treatment