One of the most common reasons that people take nutritional supplements is to improve their heart health.

Problem: Very few cardiologists are aware of the ways in which heart supplements work synergistically—that is, by taking carefully selected supplements in combinations, you will heighten the effectiveness of each one. Over the past 22 years, I have treated thousands of heart patients with this approach.

What you need to know to make the most of your non-drug regimen for better heart health....

The Essential Three

There are three daily supplements that I recommend to anyone who is concerned about heart health…

  • Fish oil capsules primarily lower harmful blood fats known as triglycerides but also have a mild blood pressure-lowering effect.

Typical dose: 1 gram (g) total of the omega3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for blood pressure benefits. To reduce triglyceride levels, the typical daily dose is 2 g to 4 g total of EPA and DHA.

Caution: Fish oil can increase bleeding risk, so talk to your doctor if you take a blood thinner, such as warfarin (Coumadin).

  • CoQ10 helps enhance energy production in cells and inhibits blood clot formation.

Typical dose: 50 milligrams (mg) to 100 mg per day. CoQ10, which is commonly taken with the classic HDL-boosting treatment niacin (vitamin B-3), also helps minimize side effects, such as muscle weakness, in people taking cholesterol-lowering statin drugs.

  • Red yeast rice is an extract of red yeast that is fermented on rice and is available in tablet, capsule, powder and liquid form. Long used by the Chinese, it mimics the action of cholesterol lowering statin drugs.

Typical dose: 600 mg twice daily.

Red yeast rice is often used in combination with plant sterols, naturally occurring chemical compounds found in small amounts in fruits, vegetables and nuts...and added to food products, including butter substitutes, such as Promise activ and Benecol spreads.

Typical dose: About 400 mg daily of plant sterols.

*To find a doctor to oversee your heart health supplement regimen, consult the American Board of Integrative Holistic Medicine,

Also important: Low levels of vitamin D (below 15 nanograms per milliliter) have been linked to a 62% increase, on average, in heart attack risk.

Typical dose: 5,000 international units (IU) of vitamin D-3 per day for those who are deficient in the least 1,000 IU daily for all other adults.

Better Blood Pressure Control

The heart-friendly properties of fish oil are so well-documented that the American Heart Association endorses its use (by eating fatty fish at least twice weekly and/or taking fish oil capsules).

To enhance fish oil's blood pressure-lowering effect, ask your doctor about adding…

  • L-arginine. This amino acid boosts the body's production of the chemical compound nitric oxide, which causes the blood vessels to dilate, thereby lowering blood pressure.

Typical dose: 150 mg daily.

L-arginine is also used to treat erectile dysfunction and claudication (impeded blood flow in the extremities) and has a mild and beneficial HDL-boosting effect.

Caution: L-arginine should not be taken by children or pregnant or nursing women, or by anyone with genital herpes-it can stimulate activity of the herpes virus. Possible side effects include indigestion, nausea and headache.

  • Lycopene. This phytochemical is found in tomatoes—especially processed tomato sauce-watermelon, pink grapefruit, red bell peppers and papaya. I usually recommend that patients try L-arginine first, then add lycopene, if necessary, for blood pressure reduction.

Research conducted at Ben-Gurion University in Israel has shown that lycopene lowers systolic (top number) blood pressure by up to 10 points and diastolic (bottom number) by up to four points

A potent antioxidant, lycopene is also thought to have potential cancer-preventive effects, but this has not been proven.

Typical dose: 10 mg daily.

In rare cases, lycopene supplements can cause diarrhea and/or nausea. Because tomatoes and other acidic foods can aggravate ulcer pain, people with stomach ulcers should consult their doctors before consuming tomatoes and tomato-based products regularly.

Boost HDL Cholesterol

In addition to taking CoQ10 and niacin, ask your doctor about trying…

  • Policosanol. This plant-wax derivative has been found to boost HDL levels by more than 7%. The research on policosanol is considered controversial by some, but I have found it to be an effective HDL booster in my practice.

Typical dose: 10 mg daily.

There is also some evidence that policosanol may have LDL- and triglyceride-lowering benefits. There are no known side effects associated with policosanol.

Bonus: Used together, CoQ10, niacin and policosanol will allow you to raise your HDL levels while taking much lower doses of niacin (about 20 mg daily). A lower niacin dose reduces the risk for facial flushing, a common side effect in people who take the vitamin.

Reduce LDL Cholesterol

Red yeast rice extract and plant sterols (both described earlier) are well-known natural methods of lowering LDL cholesterol levels.

To lower your LDL cholesterol further, ask your doctor about adding policosanol (described earlier), along with…

  • Pantethine. This is a more biologically active form of pantothenic acid (vitamin B-5).

Typical dose: 600 mg daily.

Numerous small studies have found that pantethine significantly lowers LDL cholesterol and triglycerides.

  • Grape seed extract. This antioxidant-rich substance reduces the blood's tendency to clot and helps lower blood pressure by boosting levels of the chemical compound nitric oxide found in the body. Some research shows that grape seed extract also reduces LDL cholesterol.

Typical dose: 200 mg daily.

In addition, studies suggest that grape seed extract helps protect against Alzheimer's disease.

Caution: Because grape seed extract has a blood-thinning effect, it should not be taken by anyone who uses warfarin or other blood-thinning medications or supplements.

Best Nutrients for Heart Health

Food is our best source of nutrients. That's because food sources offer a variety of minerals, vitamins and antioxidants that work synergistically to boost the nutritional value of each. I urge all of my patients to get ample amounts of the following heart-healthy nutrients from food…

  • Antioxidants, which help prevent plaque formation on the walls of your arteries. Good sources are pomegranate, blueberries, and fruits and vegetables in general.
  • Magnesium, which helps regulate blood pressure and stabilize heart rhythm. Good sources are dark green, leafy beans... peas...and peanut butter.
  • Potassium, which helps regulate blood pressure and heart function. Good sources are apricots, cantaloupe, melons, kiwi, oranges (and orange juice), bananas, lima beans, tomatoes, prunes, avocados.. as well as meat, fish and poultry.

Caution: If you have kidney disease, consult your doctor before consuming potassium-rich foods.

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