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Table 3 Gradable intermediate outcomes for dietary supplements plus cardiovascular drugs (insufficient grade evidence) a

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

Item Supplement (dose) Cardiovascular drug Number of studies, sample size, characteristic (treatment duration)
All lipids (Low and high density lipoproteins-cholesterol, triglycerides, total cholesterol) Coenzyme Q10 (100 to 200 mg/day) Statins Two studies; 49 hypercholesterolemic patients [57], and 44 patients with statin-induced myopathic pain [39]; (12 weeks)
  Coenzyme Q10 (200 mg/day) Fenofibrate Participants with type II diabetes and high CHD risk
  Garlic (4 g/day) Warfarin Single study [59]; 48 participants with prosthetic heart valves, or diagnosed with deep vein thrombosis, valvular heart disease or atrial fibrillation
  Garlic (4 mL/day) Statins + aspirin Single study [62]; 23 participants with, or at high risk for, coronary artery disease (1 year)
  Garlic (4 g/day) Nitrates Single study [61]; 60 participants with coronary
    artery disease (1 year)
  Ginkgo biloba (120 mg/day) Aspirin Single study [64]; 50 young healthy men (1 week)
  Omega-3 fatty acids (4 g/day) Fenofibrate Single study [55]; 167 participants with unclear CHD risk (8 weeks)
  Omega-3 fatty acids (3 g/day) Calcium channel blockers Single study [49], 22 participants with variant angina (16 weeks)
  Omega-3 fatty acids (4 g/day) Niacin + aspirin Single study [77]; 14 participants with atherogenic dyslipidemia (12 weeks)
  Omega-3 fatty acids (10 g/day) Aspirin Two studies [80, 84]; 30 healthy participants (2 to 3 weeks)
  Vitamin E (0.6/day) Gemfibrozil Single study [88]; 67 participants with hyperlipidemia (4 weeks)
  Vitamin E (100 mg/day, 100 IU/day) Statins Pooled results for four studies[89, 9193]; 192 highly selective participants (24 weeks)
Triglycerides Omega-3 fatty acids (4 g/day) ACE inhibitors Two studies [78, 79]; 58 participant with renal dysfunction or hypertension (6 to 25 weeks)
  Omega-3 fatty acids (4 to 9 g/day) Statins Three studies [38, 72, 82]; 420 highly selected participants with low or unclear CHD risk (4 to 18 weeks)
  Vitamin E (900 mg/day) Antiplatelet agents Single study [86]; 16 participants with high CHD risk (6 weeks)
Low density lipoprotein-cholesterol Omega-3-fish oil (1.8 g/day) Calcium channel blockers + aspirin Single study [50]; 107 participants with pre-coronary angioplasty (6 weeks)
High density lipoprotein-cholesterol Vitamin E (900 mg/day) Nifedipine Single study [94]; 30 participants with high CHD risk (16 weeks)
  Omega-3 fatty acids (1.8 g/day) Calcium channel blockers + aspirin Single study [50]; 107 participants with pre-coronary angioplasty (6 weeks)
  Omega-3 fatty acids (3.2 g/day) Calcium channel blockers + aspirin +  dipyridamole Single study [51]; 82 participants with post-coronary angioplasty (12 weeks)
Blood pressure (systolic and diastolic) Coenzyme Q10 (200 mg/day) Fenofibrate Single study[56]; 80 participants with type II diabetes and high CHD risk (12 weeks)
  Garlic (4 g/day) Warfarin Single study [59]; 48 participants with prosthetic heart valves, or diagnosed with deep vein thrombosis, valvular heart disease or atrial fibrillation
  Ginkgo biloba (120 mg/day) Aspirin Single study [64]; 50 young healthy male volunteers (1 week)
  Ginkgo biloba (120 mg/day) Cilostazol Single study [67]; 10 healthy South Asian men (1 day)
  Omega-3 fatty acids (10 g/day) Aspirin Two studies [80, 84]; 30 healthy participants (2 to 3 weeks)
  Omega-3 fatty acids (4 g/day) Beta-adrenergic antagonists Single study [85]; 25 participants with unclear CHD risk (6 weeks)
  Vitamin E (600 mg/day) Furosemide Single study [87]; 24 hypertensive participants (4 weeks)
   Gemfibrozil Single study [88]; 67 participants with hyperlipidemia (4 weeks)
  Vitamin E (900 mg/day) Nifedipine Single study [94]; 30 participants with high CHD risk (16 weeks)
International normalized ratio Echinacea (5 g/day) Warfarin Single study [97]; 12 healthy volunteers (2 weeks)
  Garlic (4 g/day)   Two studies; 48 participants with high CHD risk [59](12 weeks), and 16 healthy men with known CYP2C9 and VKORC1 genotype [60] (2 weeks)
  Ginger (3.6 g/day)   Single study [63];12 healthy male volunteers (7 days)
  Ginkgo biloba (12 g/day)   
  Panax ginseng (1.5-2 g/day)   Two studies; seven healthy men [70] (1 week), 25 patients with ischemic stroke [68] (2 weeks)
  Omega-3-fish oil (4 mg/day)   Single study [54]; 11 participants with unclear CHD risk (4 weeks)
  1. aInconclusive results: studies had an imprecise statistically non-significant pooled estimate (the 95% CIs were wide enough to be compatible with either clinical benefit, true no difference or harm). ACE: angiotensin-converting enzyme; CHD: coronary heart disease.