The Truth About 5 Common Dietary Supplements for Vascular Health

Contributor: Lee Kirksey, MD

People often ask how dietary supplements can affect heart health. Could taking particular vitamins or supplements be beneficial for peripheral artery disease (PAD)?

First, let’s talk a little about PAD. This disease causes inflammation of the layers of the blood vessel wall and can involve cholesterol deposits.

PAD is strongly associated with coronary artery disease (CAD). In fact, people with PAD have three to five times the risk of death from cardiovascular events when compared to those with coronary artery disease alone. The carotid arteries may also be affected, increasing the risk of a mini-stroke (transient ischemic attack, or TIA) or major stroke (cerebrovascular accident or CVA).

Clearly, atherosclerosis (hardening of the arteries) in people with PAD is a more advanced and virulent form of this inflammatory disease. As a result, it is likely more important for people with PAD to take any measures they can to reduce the progression of this disease of the blood vessel wall.

Some vitamins and supplements may be helpful to people with PAD, while others may introduce risks or drawbacks that need careful consideration. Another factor to consider is whether ample enough research exists to recommend a particular supplement. Lastly, if you are taking supplements, be sure to update your physician because interactions may occur with prescribed medications.

If you have PAD, here’s what you need to know about five common dietary supplements :

1. Omega-3 fatty acids or what is called long-chain n-3 polyunsaturated fatty acids are found mostly in fish sources. While there is not clear evidence that omega-3 supplementation improves walking ability or reduces overall death rates, taking large doses over an extended period does appear to provide a health benefit for people with PAD.
2. Folate and B vitamins have low risk as supplements, but there is little evidence of improvement in PAD or lowered cardiovascular risk with these agents. They also can be harmful in patients with kidney disease. Low-dose intake (400 mcg) has been recommended for overall health.
3. Vitamin C has been shown to be decreased in people with PAD. However, no studies show a reduction in PAD or cardiovascular risk with supplementation, and at least one study shows an increased risk of cardiovascular disease in those taking increased doses. No dosing has been recommended clearly for cardiovascular risk reduction.
4. Vitamin D has also shown to be reduced in people with PAD. But again, supplementation has failed to show beneficial effects for those with PAD, and when levels are normal, increased dosing may increase the risk of calcium deposition in blood vessels. Daily doses of 700 IU are recommended for overall health, but increased dosing, particularly without evidence of a deficit, is unwarranted and may be harmful.
5. Vitamin E has been shown to be decreased in people with PAD, and deficiencies are thought to worsen PAD symptoms. But vitamin E supplementation has not consistently proven to reduce the risk of PAD progression. Also, this vitamin should be used with caution in patients taking blood thinners, as it can increase the bleeding risk.

Talk to your doctor about how vitamin and mineral supplements could be part of an overall treatment plan. Your doctor will also discuss the following lifestyle changes, which are critical for managing your PAD:

• Quitting smoking. Ask your doctor about smoking cessation programs available in your community. Many health insurers now provide reimbursement for participation in smoking cessation.
• Eating a balanced diet that is high in fiber and low in cholesterol, fat and sodium. Limit fat to 30 percent of your total daily calories. Saturated fat should account for no more than 7 percent of your total calories. Avoid trans fats, including products made with partially hydrogenated and hydrogenated vegetable oils. If you are overweight, losing weight will help you lower your total cholesterol and raise your HDL (good) cholesterol. A registered dietitian can help you make the right dietary changes.
• Exercising. Begin a regular exercise program, such as walking. Walking is very important and can aid the treatment of PAD. Patients who walk regularly can expect a marked improvement in the distance they are able to walk before experiencing leg pain. Swimming is another activity that offers strength-building and conditioning benefits.
• Managing other health conditions, such as high blood pressure, diabetes or high cholesterol.
• Practicing good foot and skin care to prevent infection and reduce the risk of complications. If you can’t perform these tasks yourself, consultation with a podiatrist may be helpful.