What to take for heart health

Graded by the strength of the evidence — strongest first. Nothing here is sold to you.

Omega-3grade B— modest cardiovascular benefit; large recent trials were mixed

Berberinegrade B— Meta-analysis of RCTs: berberine improved several cardiovascular risk factors — lowering total and LDL cholesterol, triglycerides, and blood pressure — versus control. It is a risk-factor signal, not a demonstrated reduction in cardiovascular events.

Magnesiumgrade B— Meta-analysis of 38 RCTs (2709 participants): magnesium supplementation modestly lowered blood pressure — systolic by about 2.8 mm Hg and diastolic by about 2.0 mm Hg versus control. A small but consistent blood-pressure effect; not shown to reduce cardiovascular events directly.

Zincgrade B— GRADE-assessed meta-analysis of 75 studies: zinc supplementation significantly lowered several cardiometabolic risk markers — triglycerides, total cholesterol, fasting blood glucose, HbA1c, insulin resistance (HOMA-IR), and inflammatory markers (CRP, IL-6, TNF-alpha). A broad risk-factor signal across many biomarkers, not a demonstrated reduction in cardiovascular events.

Vitamin Cgrade C— Systematic review: overall there is limited evidence that vitamin C supplementation improves cardiovascular biomarkers in the general population. Subgroups — people with low baseline vitamin C status or higher cardiovascular risk — may be more responsive, but this is a tentative, subgroup-level signal.

CoQ10grade D— UK HTA review of 26 RCTs (n=2250) in heart failure: mortality RR 0.68 but CI crosses null (0.45-1.03); authors say stronger evidence is needed before this could inform prescribing.

Vitamin Dstudied, no effect— Meta-analysis of RCTs: vitamin D supplementation was NOT associated with a lower risk of cardiovascular events versus no supplementation. The authors explicitly state the findings do not support routine vitamin D supplementation for cardiovascular prevention.

Creatinestudied, no effect— Meta-analysis of 8 RCTs: creatine supplementation showed no statistically significant effect on total cholesterol, LDL, HDL, or triglycerides versus control. Certainty of evidence was rated very low to low due to methodological limitations in the included trials.