Heart Attack - Supplements

Keep your lifelines clear and let blood flow freely to your heart. According to research or other evidence, the following self-care steps may be helpful.

Trim the unhealthy fat
Protect your heart and its blood supply by cutting meat, dairy fats, and foods containing trans fats out of your diet; fuel up with nuts, olive oil, fish, and other sources of healthy fats instead
Choose risk-reducing foods
Eat more whole grains, beans and other legumes, vegetables, and fruit
Discover CoQ10
Reduce complications following a heart attack by taking 120 mg a day of coenzyme Q10, a powerful antioxidant
Don’t forget the fish oil
Reduce the chances of having another heart attack by taking capsules that supply a total of 900 mg of omega-3 fatty acids per day

Also indexed as:

heart attack,
MI,
myocardial infarction

About this treatment

What Are "Star" Ratings?

a7_3star Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

Supplement	Amount	Why
Coenzyme Q10	500 to 800 mcg daily	Taking CoQ10 may help reduce complications following a heart attack.
Coenzyme Q10 500 to 800 mcg daily Coenzyme Q10 (CoQ10) also contributes to the energy-making mechanisms of the heart and has been reported to lower lipoprotein(a), a risk factor for heart disease.⁶⁷ Animal studies confirm CoQ10’s ability to protect heart muscle against reduced blood flow.⁶⁸^{, 69} In one double-blind trial, either 120 mg of CoQ10 or placebo was given to people who had recently survived a heart attack. After 28 days, the CoQ10 group had experienced significantly fewer repeat heart attacks, fewer deaths from heart disease, and less chest pain than the placebo group.⁷⁰ In another double-blind study of people suffering a heart attack, supplementation with 60 mg of coenzyme Q10 twice a day for one year significantly reduced the incidence of recurrent cardiac events (fatal or non-fatal heart attack). ⁷¹ Treatment was begun within 72 hours of the onset of the heart attack. CoQ10 used with selenium (see below) has also been reported to increase the rate of heart attack survival.⁷² The relation between selenium and protection from heart attacks remains uncertain. Low blood levels of selenium have been reported in people immediately following a heart attack,⁷³ suggesting that heart attacks may increase the need for selenium. However, other researchers claim that low selenium levels are present in people before they have a heart attack, suggesting that the lack of selenium might increase heart attack risk.⁷⁴ One report found that low blood levels of selenium increased the risk of heart attack only in smokers,⁷⁵ and another found the link only in former smokers.⁷⁶ Yet others have found no link between low blood levels of selenium and heart attack risk whatsoever.⁷⁷ In a double-blind trial, individuals who already had one heart attack were given 100 mcg of selenium per day or placebo for six months.⁷⁸ At the end of the trial, there were four deaths from heart disease in the placebo group but none in the selenium group (although the numbers were too small for this difference to be statistically significant). In other controlled research, a similar group was given placebo or 500 mcg of selenium six hours or less after a heart attack followed by an ongoing regimen of 100 mcg of selenium plus 100 mg of coenzyme Q10 per day.⁷⁹ One year later, six people had died from a repeat heart attack in the placebo group, compared with no heart attack deaths in the supplement group. Despite the lack of consistency in published research, some doctors recommend that people at risk for a heart attack supplement with selenium—most commonly 200 mcg per day. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
L-Carnitine	2 grams daily	Taking L-carnitine may help reduce damage and complications following a heart attack.
L-Carnitine 2 grams daily L-carnitine is an amino acid important for transporting fats that can be turned into energy in the heart. Clinical trials have reported that taking L-carnitine (4–6 grams per day) increases the chance of surviving a heart attack.⁸⁰^{, 81}^{, 82} In one double-blind trial, individuals with suspected heart attack were given 2 grams of L-carnitine per day for 28 days.⁸³ At the completion of this study, infarct size, as well as the number of nonfatal heart attacks, was lower in the group receiving L-carnitine versus the placebo group. Double-blind research using L-carnitine intravenously also shows promise.⁸⁴ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Vitamin C (Vitamin C Deficiency)	100 to 200 mg daily	Taking vitamin C may reduce heart attack risk and may improve the outcome for people who have already had a heart attack.
Vitamin C 100 to 200 mg daily Vitamin C has been reported to protect blood vessels from problems associated with heart attack risk in a variety of ways.⁸⁵^{, 86}^{, 87} However, research attempting to link vitamin C directly to protection from heart attacks has been inconsistent.⁸⁸^{, 89} The reason for this discrepancy appears related to the amount of vitamin C intake investigated in these studies. True or marginal vitamin C deficiencies do appear to increase the risk of suffering heart attacks.⁹⁰^{, 91} However, in trials comparing acceptable (i.e., non-deficient) vitamin C levels to even higher levels, additional vitamin C has not been protective.⁹² Therefore, though many doctors recommend that people at high risk for heart attack take vitamin C—often 1 gram per day—most evidence currently suggests that consuming as little as 100–200 mg of vitamin C per day from food or supplements may well be sufficient. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Fish Oil	850 to, 1700 mg omega-3 fatty acids	Supplementing with fish oil may reduce the chances of having another heart attack.
Fish Oil 850 to, 1700 mg omega-3 fatty acids Fish oil contains the beneficial omega-3 fatty acids EPA and DHA, which have led to partial reversal of atherosclerosis in a double-blind trial.⁹³ In another double-blind trial, individuals were given either fish oil (containing about 1 gram of EPA and 2/3 gram of DHA) or mustard oil (containing about 3 grams alpha linolenic acid, another omega-3 fatty acid) 18 hours after a heart attack. Both groups experienced fewer nonfatal heart attacks compared to a placebo group, while the fish oil group also experienced fewer fatal heart attacks.⁹⁴ The largest published study on omega-3 fatty acids for heart attack prevention was the preliminary GISSI Prevenzione Trial,⁹⁵ which reported that 850 mg of omega-3 fatty acids from fish oil per day for 3.5 years resulted in a 20% reduction in total mortality and a 45% decrease in sudden death. Other investigators suggest that fish oil reduces the amount of heart muscle damage from a heart attack and enhances the effect of blood-thinning medication.⁹⁶ People wishing to supplement with fish oil should take fish oil supplements that include at least small amounts of vitamin E, which may protect this fragile oil against free radical damage.⁹⁷ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Folic Acid	500 to 800 mcg daily	Taking folic acid may reduce blood levels of homocysteine. High homocysteine levels have been linked to an increased heart attack risk.
Folic Acid 500 to 800 mcg daily High blood levels of the amino acid homocysteine have been linked to an increased risk of heart attack in most,⁹⁸ ^{, 99} ^{, 100} ^{, 101} though not all,¹⁰² ^{, 103} studies. A blood test screening for levels of homocysteine, followed by supplementation with 400 mcg of folic acid and 500 mcg of vitamin B12 per day could prevent a significant number of heart attacks, according to one analysis.¹⁰⁴ Folic acid¹⁰⁵ ^{, 106} and vitamins B6 and B12 are known to lower homocysteine.¹⁰⁷ There is a clear association between low blood levels of folate and increased risk of heart attacks in men.¹⁰⁸ Based on the available research, some doctors recommend 50 mg of vitamin B6, 100–300 mcg of vitamin B12, and 500–800 mcg of folic acid per day for people at high risk of heart attack. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Magnesium Intravenous	Consult a qualified healthcare practitioner	Magnesium given intravenously after a heart attack has been shown to decrease death and complications from heart attacks.
Magnesium Intravenous Consult a qualified healthcare practitioner Blood levels of magnesium are lower in people who have a history of heart attack.¹⁰⁹ Most trials have successfully used intravenous magnesium right after a heart attack occurs to decrease death and complications from heart attacks.¹¹⁰ By far the largest trial did not find magnesium to be effective.¹¹¹ However, other researchers have argued that delaying the initial infusion of magnesium and administering the magnesium for too short a period may have caused this negative result.¹¹² People with a history of heart attack or who are at risk should consult with their cardiologist about the possible use of immediate intravenous magnesium should they ever suffer another heart attack. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
N-Acetyl Cysteine	Consult a qualified healthcare practitioner	In one study, NAC injections decreased the amount of tissue damage in people who had suffered a heart attack.
N-Acetyl Cysteine Consult a qualified healthcare practitioner In one study, intravenous injections of NAC (N-acetyl cysteine) decreased the amount of tissue damage in people who had suffered a heart attack.[REF] Whether oral NAC would have the same effect is unknown. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Red Yeast Rice (Xuezhikang; for post-event treatment only, not acute attacks )	300 mg twice a day (with doctor's supervision)	In one trial that included patients with a previous history of a heart attack, supplementing with a particular brand of Chinese red yeast rice that contained 6 mg per day of lovastatin (a statin drug) reduced risk of death from heart disease.
Red Yeast Rice 300 mg twice a day (with doctor's supervision) In a double-blind trial that included patients with a previous history of a heart attack, supplementation with a particular brand of Chinese red yeast rice (Xuezhikang) in the amount of 300 mg twice a day for an average of 4.5 years reduced the death rate from heart disease by about one-third, compared with a placebo.¹¹³ Xuezhikang is grown by a method that increases its content of lovastatin (a statin drug), and patients in this study received about 6 mg per day of lovastatin from taking Xuezhikang. It is not known whether other red yeast rice products would produce similar benefits. What Else Is This Supplement Used For?

Supplement	Amount	Why
Selenium	100 to 200 mcg daily	Some doctors recommend that people at risk for a heart attack supplement with selenium.
Selenium 100 to 200 mcg daily The relation between selenium and protection from heart attacks remains uncertain. Low blood levels of selenium have been reported in people immediately following a heart attack,¹¹⁴ suggesting that heart attacks may increase the need for selenium. However, other researchers claim that low selenium levels are present in people before they have a heart attack, suggesting that the lack of selenium might increase heart attack risk.¹¹⁵ One report found that low blood levels of selenium increased the risk of heart attack only in smokers,¹¹⁶ and another found the link only in former smokers.¹¹⁷ Yet others have found no link between low blood levels of selenium and heart attack risk whatsoever.¹¹⁸ In a double-blind trial, individuals who already had one heart attack were given 100 mcg of selenium per day or placebo for six months.¹¹⁹ At the end of the trial, there were four deaths from heart disease in the placebo group but none in the selenium group (although the numbers were too small for this difference to be statistically significant). In other controlled research, a similar group was given placebo or 500 mcg of selenium six hours or less after a heart attack followed by an ongoing regimen of 100 mcg of selenium plus 100 mg of coenzyme Q10 per day.¹²⁰ One year later, six people had died from a repeat heart attack in the placebo group, compared with no heart attack deaths in the supplement group. Despite the lack of consistency in published research, some doctors recommend that people at risk for a heart attack supplement with selenium—most commonly 200 mcg per day. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Vitamin A	50,000 IU daily	Taking vitamin A may reduce heart attack risk and may improve the outcome for people who have already had a heart attack.
Vitamin A 50,000 IU daily Blood levels of the antioxidant nutrients vitamins A, C, and E, and beta-carotene are reported to be lower in people with a history of heart attack, compared with healthy individuals.¹²¹ The number of free radical molecules is also higher, suggesting a need for antioxidants. Streptokinase, a drug therapy commonly used immediately following a heart attack, enhances the need for antioxidants.¹²² Taking antioxidant supplements may improve the outcome for people who have already had a heart attack. In one double-blind trial, people were given 50,000 IU of vitamin A per day, 1,000 mg of vitamin C per day, 600 IU of vitamin E per day, and approximately 41,500 IU of beta-carotene per day or placebo.¹²³ After 28 days, the infarct size of those receiving antioxidants was significantly smaller than the infarct size of the placebo group. Low levels of beta-carotene in fatty tissue have been linked to an increased incidence of heart attacks, particularly among smokers.¹²⁴ One population study found that eating a diet high in beta-carotene is associated with a lower rate of nonfatal heart attacks.¹²⁵ However, beta-carotene supplementation may not offer the same protection provided by foods that contain beta-carotene. Most,¹²⁶ ^{, 127} but not all, trials¹²⁸ have found that supplemental beta-carotene is not associated with a reduced risk of heart attacks. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Vitamin E	400 to 800 IU daily	Supplementing with vitamin E, synthetic or natural, may help reduce heart attack risk.
Vitamin E 400 to 800 IU daily Several studies[REF][REF] including two double-blind trials[REF][REF] have reported that 400 to 800 IU of natural vitamin E reduces the risk of heart attacks. However, other recent double-blind trials have found either limited benefit,[REF] or no benefit at all from supplementation with synthetic vitamin E.[REF] One of the negative trials used 400 IU of natural vitamin E[REF]—a similar amount and form to previous successful trials. In attempting to make sense of these inconsistent findings the following is clear: less than 400 IU of synthetic vitamin E, even when taken for years, does not protect against heart disease. Whether 400 to 800 IU of natural vitamin E is or is not protective remains unclear. Taking antioxidant supplements may improve the outcome for people who have already had a heart attack. In one double-blind trial, people were given 50,000 IU of vitamin A per day, 1,000 mg of vitamin C per day, 600 IU of vitamin E per day, and approximately 41,500 IU of beta-carotene per day or placebo.¹²⁹ After 28 days, the infarct size of those receiving antioxidants was significantly smaller than the infarct size of the placebo group. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Astragalus	Refer to label instructions	Preliminary clinical trials in China suggest that astragalus may be beneficial for people after they have suffered a heart attack. Learn More
Beta-Carotene	Refer to label instructions	Supplementing with beta-carotene may reduce the likelihood of a heart attack and may improve the outcome for people who have already had a heart attack.
Beta-Carotene Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements. Blood levels of the antioxidant nutrients vitamins A, C, and E, and beta-carotene are reported to be lower in people with a history of heart attack, compared with healthy individuals.¹³⁰ The number of free radical molecules is also higher, suggesting a need for antioxidants. Streptokinase, a drug therapy commonly used immediately following a heart attack, enhances the need for antioxidants.¹³¹ Taking antioxidant supplements may improve the outcome for people who have already had a heart attack. In one double-blind trial, people were given 50,000 IU of vitamin A per day, 1,000 mg of vitamin C per day, 600 IU of vitamin E per day, and approximately 41,500 IU of beta-carotene per day or placebo.¹³² After 28 days, the infarct size of those receiving antioxidants was significantly smaller than the infarct size of the placebo group. Low levels of beta-carotene in fatty tissue have been linked to an increased incidence of heart attacks, particularly among smokers.¹³³ One population study found that eating a diet high in beta-carotene is associated with a lower rate of nonfatal heart attacks.¹³⁴ However, beta-carotene supplementation may not offer the same protection provided by foods that contain beta-carotene. Most,¹³⁵ ^{, 136} but not all, trials¹³⁷ have found that supplemental beta-carotene is not associated with a reduced risk of heart attacks. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Chondroitin Sulfate	Refer to label instructions	Taking chondroitin sulfate may reduce the risk of heart attack in people with a history of heart disease or who are at risk for heart attack.
Chondroitin Sulfate Years ago, researchers reported that taking for six years substantially reduced the risk of fatal and nonfatal heart attacks in people with . Chondroitin may work by inhibiting and by acting as an anticoagulant. The few doctors aware of these older studies sometimes recommend that people with a history of heart disease or who are at risk for heart attack take approximately 500 mg of chondroitin sulfate three times per day. What Else Is This Supplement Used For?

Supplement	Amount	Why
Magnesium Oral	Refer to label instructions	Supplementing with magnesium may reduce heart attack risk.
Magnesium Oral Except for a link between high levels of magnesium in drinking water and a low risk of heart attacks,¹³⁸ ^{, 139} little evidence suggests that oral magnesium reduces heart attack risk. One trial found that magnesium pills taken for one year actually increased complications for people who had suffered a heart attack.¹⁴⁰ While another study reported that 400–800 mg of magnesium per day for two years decreased both deaths and complications due to heart attacks, results are difficult to interpret because those taking oral magnesium had previously received intravenous magnesium as well.¹⁴¹ While increasing dietary magnesium has reduced the risk of heart attacks,¹⁴² foods high in magnesium may contain other protective factors that might be responsible for this positive effect. Therefore, evidence supporting supplemental oral magnesium to reduce the risk of heart attacks remains weak. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Vitamin B12	Refer to label instructions	Taking vitamin B12 may reduce blood levels of homocysteine. High homocysteine levels have been linked to an increased heart attack risk.
Vitamin B12 High blood levels of the amino acid homocysteine have been linked to an increased risk of heart attack in most,¹⁴³ ^{, 144} ^{, 145} ^{, 146} though not all,¹⁴⁷ ^{, 148} studies. A blood test screening for levels of homocysteine, followed by supplementation with 400 mcg of folic acid and 500 mcg of vitamin B12 per day could prevent a significant number of heart attacks, according to one analysis.¹⁴⁹ Folic acid¹⁵⁰ ^{, 151} and vitamins B6 and B12 are known to lower homocysteine.¹⁵² There is a clear association between low blood levels of folate and increased risk of heart attacks in men.¹⁵³ Based on the available research, some doctors recommend 50 mg of vitamin B6, 100–300 mcg of vitamin B12, and 500–800 mcg of folic acid per day for people at high risk of heart attack. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Vitamin B6	Refer to label instructions	Taking vitamin B6 may reduce blood levels of homocysteine. High homocysteine levels have been linked to an increased heart attack risk.
Vitamin B6 High blood levels of the amino acid homocysteine have been linked to an increased risk of heart attack in most,¹⁵⁴ ^{, 155} ^{, 156} ^{, 157} though not all,¹⁵⁸ ^{, 159} studies. A blood test screening for levels of homocysteine, followed by supplementation with 400 mcg of folic acid and 500 mcg of vitamin B12 per day could prevent a significant number of heart attacks, according to one analysis.¹⁶⁰ Folic acid¹⁶¹ ^{, 162} and vitamins B6 and B12 are known to lower homocysteine.¹⁶³ There is a clear association between low blood levels of folate and increased risk of heart attacks in men.¹⁶⁴ Based on the available research, some doctors recommend 50 mg of vitamin B6, 100–300 mcg of vitamin B12, and 500–800 mcg of folic acid per day for people at high risk of heart attack. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Vitamin C	Refer to label instructions	Vitamin C has been reported to protect blood vessels from problems associated with heart attack risk in a variety of ways.
Vitamin C Vitamin C has been reported to protect blood vessels from problems associated with heart attack risk in a variety of ways.¹⁶⁵^{, 166}^{, 167} However, research attempting to link vitamin C directly to protection from heart attacks has been inconsistent.¹⁶⁸^{, 169} The reason for this discrepancy appears related to the amount of vitamin C intake investigated in these studies. True or marginal vitamin C deficiencies do appear to increase the risk of suffering heart attacks.¹⁷⁰^{, 171} However, in trials comparing acceptable (i.e., non-deficient) vitamin C levels to even higher levels, additional vitamin C has not been protective.¹⁷² Therefore, though many doctors recommend that people at high risk for heart attack take vitamin C—often 1 gram per day—most evidence currently suggests that consuming as little as 100–200 mg of vitamin C per day from food or supplements may well be sufficient. What Else Is This Supplement Used For? See Drug Interactions

References

Last Review: 05-11-2011

Learn more about Aisle7, the company.

The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2011.

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

Care Circle

It Seems That You Are Not Logged In...

Join Now

Log In
Help

Welcome to Care Circle, an exclusive tool to help you take care of yourself and your loved ones. Here's how it works:

Create profiles for yourself and your loved ones.
Select the topics and conditions that interest each of you.
Get customized news updates, original content, tools, and expert advice for each Care Circle member delivered directly to your personalized homepage.

The information you input is strictly private; you choose who has access to your Care Circle.

Adding Someone
Saving Content
Adding Additional Topics & Conditions
Deleting Topics & Conditions

How do I add myself or someone else to my care circle?

Click on "Add someone." Fill out the short profile. Choose an avatar. Select the topics and conditions that interest this person from the pulldown menu. You can select as many as you want, but you must choose at least one. Click on "Add Someone" again. You should start getting updates immediately.

How do I save content to my Care Circle?

Click on "Manage My Care Circle." Select the tab of the person for whom you're saving content. Put your cursor over the piece of content that you want to save; a disk icon will appear in the righthand corner. Click on the disk and the piece of content will be moved to a save folder.

How do I add additional topics and conditions for someone in my Care Circle?

Click on "Manage My Care Circle." Select the tab for the person whose preferences you'd like to update. Under "Add More to Follow," select additional topics and conditions.

How do I delete topics and conditions for someone in my Care Circle?

Click on "Manage My Care Circle." Select the tab for the person whose preferences you'd like to update. Under "Follows," scroll over the topic or condition you want to delete. An "X" should appear on the righthand side. Click on the "X" and the topic or condition will be deleted from the list.