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

From: Interactions of commonly used dietary supplements with cardiovascular drugs: a systematic review

Outcome measures Dietary supplement Cardiovascular drug(s) Conclusion effect estimate Applicability
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
  1. aBoth studies recruited participant with higher baseline levels of triglyceride (>200 mg/dL). CHD: coronary heart disease; CI: confidence interval; CV: cardiovascular; HDL-C: high density lipoprotein-cholesterol; LDL-cholesterol: low density lipoprotein-C; MD: mean difference (post-treatment values); RR: relative risk; TG: triglycerides.