Cardiovascular Dietary Supplements

Question 1

Describe: Omega-6 Fatty Acids

Answer 1

-dietary sources: meats, grains, seeds of plants
-overabundance in typical American diet
-pro-inflammatory
-increases risk of cardiovascular disease
-may increase coagulation

Question 2

Describe: Omega-3 Fatty Acids

Answer 2

-dietary sources: salmon, sardines, oily fish, fortified eggs, and dairy products, flax, and chia seeds
-lacking in the typical American diet
-anti-inflammatory
-decreases triglycerides

Question 3

What are the Omega-3 Fatty Acids?

Answer 3

Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA)

Question 4

What is the opinion of using Fish Oil for CV Disease Prevention?

Answer 4

-large population studies suggest eating both plant and marine source omega-3 FA reduces risk of coronary heart disease
-FDA= “supportive, but not conclusive showing reduced risk of coronary heart disease”
-AHA= “do not use as primary prevention of stroke”

Question 5

How does Fish Oil effect triglycerides?

Answer 5

significant reduction in triglycerides (TG), minimum 2 grams to see benefit, but 4 grams may lower triglycerides 25-50%

Question 6

Side Effects: Fish Oil

Answer 6

-decreased platelet aggregation
-gastrointestinal upset
-burping
-heartburn, indigestion
-bad taste in mouth
-diarrhea/loose stool

Question 7

What is Niacin?

Answer 7

Vitamin B3

Question 8

How does Niacin effect lipid profile?

Answer 8

-significant increases in HDL
-significant reduction inTG
-modest reductions in LDL

Question 9

What is the opinion of using Niacin for lipid management?

Answer 9

not recommended by AHA

Question 10

Side Effects: Niacin

Answer 10

-FLUSHING, very high incidence initially (~80%), but can be decreased by: slow dose titration, pretreating with aspirin, taking reg release with meals, using extended release formulation, take at bedtime
-dry skin and itching
-GI discomfort
-may increase serum uric acid levels at high doses (precipitate gout)
-increase blood glucose, glucose intolerance, an/or insulin resistance

Question 11

Avoid Niacin in patients:

Answer 11

-with gout
-diabetes
-liver or kidney dysfunction

Question 12

Drug Interactions: Niacin

Answer 12

-nicotine= increase flushing
-ethanol and hepatotoxic drugs
-statins (risk of myopathies)

Question 13

Therapeutic Uses of Garlic:

Answer 13

-hyperlipidemia
-atherosclerosis
-PVD
-hypertension
-cancer
-fungal infections
-insect repellent
-type 2 diabetes

Question 14

Drug Interactions: Garlic

Answer 14

-anticoagulants (increased INR)
-multiple HIV medications
-potential CYP 450 interactions

Question 15

Side Effects: Garlic

Answer 15

-decreased platelet function= discontinue 2 weeks before surgery
-breath and body odor
-heartburn
-indigestion
-GI irritation
-abdominal pain
-flatulence

Question 16

Describe: Red Yeast RICE

Answer 16

used to lower lipid concentrations (Monacolin K is primary component, natural analog of lovastatin)

Question 17

Describe: Coenzyme Q 10

Answer 17

coenzyme Q 10 is made naturally in our bodies. it is an antioxidant, membrane stabilizer, co-factor in metabolic pathways, including ATP production. several disease states associated with reduced levels and drugs can decrease the levels

Question 18

What is the opinion of using Coenzyme Q10 for heart failure?

Answer 18

may be beneficial as adjunctive therapy and more beneficial to individuals with mild disease

Question 19

Describe: Cinnamon

Answer 19

potentially reduce A1C but little evidence