Heart Attack

Health Condition

Heart Attack

  • L-Carnitine

    Taking L-carnitine may help reduce damage and complications following a heart attack.

    Dose:

    2 grams daily
    L-Carnitine
    ×
    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.1,2,3 In one double-blind trial, individuals with suspected heart attack were given 2 grams of L-carnitine per day for 28 days.4 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.5

  • Fish Oil

    Supplementing with fish oil may reduce the chances of having another heart attack.

    Dose:

    850 to, 1700 mg omega-3 fatty acids
    Fish Oil
    ×
    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.6 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.7 The largest published study on omega-3 fatty acids for heart attack prevention was the preliminary GISSI Prevenzione Trial,8 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.9 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.10

  • Folic Acid

    Taking folic acid may reduce blood levels of homocysteine. High homocysteine levels have been linked to an increased heart attack risk.

    Dose:

    500 to 800 mcg daily
    Folic Acid
    ×

    High blood levels of the amino acid homocysteine have been linked to an increased risk of heart attack in most,11,12,13,14 though not all,15,16 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.17Folic acid18,19 and vitamins B6 and B12 are known to lower homocysteine.20

    There is a clear association between low blood levels of folate and increased risk of heart attacks in men.21 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.

  • Magnesium Intravenous

    Magnesium given intravenously after a heart attack has been shown to decrease death and complications from heart attacks.

    Dose:

    Consult a qualified healthcare practitioner
    Magnesium Intravenous
    ×

    Blood levels of magnesium are lower in people who have a history of heart attack.22 Most trials have successfully used intravenous magnesium right after a heart attack occurs to decrease death and complications from heart attacks.23 By far the largest trial did not find magnesium to be effective.24 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.25 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.

  • N-Acetyl Cysteine

    In one study, NAC injections decreased the amount of tissue damage in people who had suffered a heart attack.

    Dose:

    Consult a qualified healthcare practitioner
    N-Acetyl Cysteine
    ×
    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.

  • Red Yeast Rice

    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. 

    Dose:

    300 mg twice a day (with doctor supervision)
    Red Yeast Rice
    ×
    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.26Xuezhikang 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.

  • Selenium

    Some doctors recommend that people at risk for a heart attack supplement with selenium.

    Dose:

    100 to 200 mcg daily
    Selenium
    ×
    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,27 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.28 One report found that low blood levels of selenium increased the risk of heart attack only in smokers,29 and another found the link only in former smokers.30 Yet others have found no link between low blood levels of selenium and heart attack risk whatsoever.31 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.32 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.33 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.

  • Vitamin E

    Supplementing with vitamin E, synthetic or natural, may help reduce heart attack risk.

    Dose:

    400 to 800 IU daily
    Vitamin E
    ×


    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.34 After 28 days, the infarct size of those receiving antioxidants was significantly smaller than the infarct size of the placebo group.

  • Astragalus

    Preliminary clinical trials in China suggest that astragalus may be beneficial for people after they have suffered a heart attack.

    Dose:

    Refer to label instructions
    Astragalus
    ×
    Preliminary clinical trials in China suggest that astragalus may be of benefit in people after they have suffered a heart attack.35,36 These studies did not attempt to show any survival or symptom reduction benefit. Therefore, further research is needed to determine whether astragaslus would be of benefit to people with heart attacks or angina.

  • Beta-Carotene

    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.

    Dose:

    Refer to label instructions
    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.37 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.38

    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.39 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.40 One population study found that eating a diet high in beta-carotene is associated with a lower rate of nonfatal heart attacks.41 However, beta-carotene supplementation may not offer the same protection provided by foods that contain beta-carotene. Most,42,43 but not all, trials44 have found that supplemental beta-carotene is not associated with a reduced risk of heart attacks.

  • Chondroitin Sulfate

    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.

    Dose:

    Refer to label instructions
    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.

  • Magnesium Oral

    Supplementing with magnesium may reduce heart attack risk.

    Dose:

    Refer to label instructions
    Magnesium Oral
    ×
    Except for a link between high levels of magnesium in drinking water and a low risk of heart attacks,45,46 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.47 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.48 While increasing dietary magnesium has reduced the risk of heart attacks,49 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.

  • Vitamin B12

    Taking vitamin B12 may reduce blood levels of homocysteine. High homocysteine levels have been linked to an increased heart attack risk.

    Dose:

    Refer to label instructions
    Vitamin B12
    ×

    High blood levels of the amino acid homocysteine have been linked to an increased risk of heart attack in most,50,51,52,53 though not all,54,55 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.56Folic acid57,58 and vitamins B6 and B12 are known to lower homocysteine.59

    There is a clear association between low blood levels of folate and increased risk of heart attacks in men.60 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.

  • Vitamin B6

    Taking vitamin B6 may reduce blood levels of homocysteine. High homocysteine levels have been linked to an increased heart attack risk.

    Dose:

    Refer to label instructions
    Vitamin B6
    ×

    High blood levels of the amino acid homocysteine have been linked to an increased risk of heart attack in most,61,62,63,64 though not all,65,66 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.67Folic acid68,69 and vitamins B6 and B12 are known to lower homocysteine.70

    There is a clear association between low blood levels of folate and increased risk of heart attacks in men.71 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.

  • Vitamin C

    Vitamin C has been reported to protect blood vessels from problems associated with heart attack risk in a variety of ways.

    Dose:

    Refer to label instructions
    Vitamin C
    ×
    Vitamin C has been reported to protect blood vessels from problems associated with heart attack risk in a variety of ways.72,73,74 However, research attempting to link vitamin C directly to protection from heart attacks has been inconsistent.75,76 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.77,78 However, in trials comparing acceptable (i.e., non-deficient) vitamin C levels to even higher levels, additional vitamin C has not been protective.79 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 Are Star Ratings
×
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

References

1. Davini P, Bigalli A, Lamanna F, Boem A. Controlled study on L-carnitine therapeutic efficacy in post-infarction. Drugs Exp Clin Res 1992;18:355-65.

2. De Pasquale B, Righetti G, Menotti A. L-carnitine for the treatment of acute myocardial infarct. Cardiologia 1990;35:591-6 [in Italian].

3. Iliceto S, Scrutinio D, Bruzzi P, et al. Effects of L-carnitine administration on left ventricular remodeling after acute anterior. J Am Coll Cardiol 1995;26:380-7.

4. Singh RB, Niaz MA, Agarwal P, et al. A randomised double-blind placebo-controlled trial of L-carnitine in suspected acute myocardial infarction. Postgrad Med J 1996;72:45-50.

5. Martina B, Zuber M, Weiss P, et al. Anti-arrhythmia treatment using L-carnitine in acute myocardial infarct. Schweiz Med Wochenschr 1992;122:1352-5 [in German].

6. von Schacky C, Angerer P, Kothny W, et al. The effect of dietary omega-3 fatty acids on coronary atherosclerosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1999;130:554-62.

7. Singh RB, Niaz MA, Sharma JP, et al. Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction: the Indian experiment of infarct survival--4. Cardiovasc Drugs 1997;11:485-91.

8. [No authors listed]. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. Lancet 1999;354:447-55.

9. Landmark K, Abdelnoor M, Urdal P, et al. Use of fish oils appears to reduce infarct size as estimated from peak creatine kinase and lactate dehydrogenase activities. Cardiology 1998;89:94-102.

10. Wander RC, Du SH, Ketchum SO, Rowe KE. Alpha-tocopherol influences in vivo indices of lipid peroxidation in postmenopausal women given fish oil. J Nutr 1996;126:643-52.

11. Israelsson B, Brattstrom LE, Hultberg BL. Homocysteine and myocardial infarction. Atherosclerosis 1988;71:227-33.

12. Ridker PM, Manson JE, Buring JE, et al. Homocysteine and risk of cardiovascular disease among postmenopausal women. JAMA 1999;281:1817-21.

13. Bots ML, Launer LJ, Lindemans J, et al. Homocysteine and short-term risk of myocardial infarction and stroke in the elderly: the Rotterdam Study. Arch Intern Med 1999;159:38-44.

14. Stampfer MJ, Malinow R, Willett WC, et al. A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians. JAMA 1992;268:877-81.

15. Folsom AR, Nieto FJ, McGovern PG, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins. Circulation 1998;98:204-10.

16. Kuller LH, Evans RW. Homocysteine, vitamins, and cardiovascular disease. Circulation 1998;98:196-9 [editorial/review].

17. Nallamothu BK, Fendrick AM, Rubenfire M, et al. Potential clinical and economic effects of homocyst(e)ine lowering. Arch Intern Med 2000;160:3406-12.

18. Landgren F, Israelsson B, Lindgren A, et al. Plasma homocysteine in acute myocardial infarction: homocysteine-lowering effect of folic acid. J Intern Med 1995;237:381-8.

19. Ward M, McNulty H, McPartlin J, et al. Plasma homocysteine, a risk factor for cardiovascular disease, is lowered by physiological doses of folic acid. QJM 1997;90:519-24.

20. Lobo A, Naso A, Arheart K, et al. Reduction of homocysteine levels in coronary artery disease by low-dose folic acid combined with vitamins B6 and B12. Am J Cardiol 1999;83:821-5.

21. Voutilainen S, Lakka TA, Porkkala-Sarataho E, et al. Low serum folate concentrations are associated with an excess incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Eur J Clin Nutr 2000;54:424-8.

22. Singh RB, Rastogi SS, Ghosh S, Niaz MA. Dietary and serum magnesium levels in patients with acute myocardial infarction, coronary artery disease and noncardiac diagnoses. J Am Coll Nutr 1994;13:139-43.

23. Hampton EM, Whang DD, Whang R. Intravenous magnesium therapy in acute myocardial infarction. Ann Pharmacother 1994;28:212-9 [review].

24. [No authors listed]. ISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. Lancet 1995;345:669-85.

25. Seelig MS, Elin RJ. Is there a place for magnesium in the treatment of acute myocardial infarction? Am Heart J 1996;132:471-7.

26. Lu Z, Kou W, Du B, et al. Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction. Am J Cardiol 2008;101:1689-93.

27. Auzepy P, Blondeau M, Richard C, et al. Serum selenium deficiency in myocardial infarction and congestive cardiomyopathy. Acta Cardiol 1987;42:161-6.

28. Oster O, Drexler M, Schenk J, et al. The serum selenium concentration of patients with acute myocardial infarction. Ann Clin Res 1986;18:36-42.

29. Beaglehole R, Jackson R, Watkinson J, et al. Decreased blood selenium and risk of myocardial infarction. Int J Epidemiol 1990;19:918-22.

30. Kardinaal AFM, Kok FJ, Kohlmeier L, et al. Association between toenail selenium and risk of acute myocardial infarction in European men. Am J Epidemiol 1997;145:373-9.

31. Salvini S, Hennekenes CH, Morris JS, et al. Plasma levels of the antioxidant selenium and risk of myocardial infarction among U.S. physicians. Am J Cardiol 1995;76:1218-21.

32. Korpela H, Kumpulainen J, Jussila E, et al. Effect of selenium supplementation after acute myocardial infarction. Res Commun Chem Pathol Pharmacol 1989;65:249-52.

33. Kuklinski B, Weissenbacher E, Fahnrich A. Coenzyme Q10 and antioxidants in acute myocardial infarction. Mol Aspects Med 1994;15 Suppl:s143-7.

34. Singh RB, Niaz MA, Rastogi SS, Tastogi S. Usefulness of antioxidant vitamins in suspected acute myocardial infarction (the Indian experiment of infarct survival-3). Am J Cardiol 1996;77:232-6.

35. Chen LX, Liao JZ, Guo WQ. Effects of Astragalus membranaceus on left ventricular function and oxygen free radical in acute myocardial infarction patients and mechanism of its cardiotonic action. Chung Kuo Chung His I Chieh Ho Tsa Chih 1995;15:141-3 [in Chinese].

36. Shi HM, Dai RH, Wang SY. Primary research on the clinical significance of ventricular late potentials (VLPs), and the impact of mexiletine, lidocaine and Astragalus membranaceus on VLPs. Chung His I Chieh Ho Tsa Chih 1991;11:259, 265-7 [in Chinese].

37. Singh RB, Niaz MA, Sharma JP, et al. Plasma levels of antioxidant vitamins and oxidative stress in patients with acute myocardial infarction. Acta Cardiol 1994;49:441-52.

38. Levy Y, Bartha P, Ben-Amotz A, et al. Plasma antioxidants and lipid peroxidation in acute myocardial infarction and thrombolysis. J Am Coll Nutr 1998;17:337-41.

39. Singh RB, Niaz MA, Rastogi SS, Tastogi S. Usefulness of antioxidant vitamins in suspected acute myocardial infarction (the Indian experiment of infarct survival-3). Am J Cardiol 1996;77:232-6.

40. Kardinaal AFM, Kok FJ, Ringstad J, et al. Antioxidants in adipose tissue and risk of myocardial infarction: the EURAMIC study. Lancet 1993;342:1379-84.

41. Tavani A, Negri E, D'Avanzo B, La Vecchia C. Beta-carotene intake and risk of nonfatal acute myocardial infarction in women. Eur J Epidemiol 1997;13:631-7.

42. Rapola JM, Virtamo J, Ripatti S, et al. Randomised trial of alpha-tocopherol and beta-carotene supplements on incidence of major coronary events in men with previous myocardial infraction. Lancet 1997;349:1715-20.

43. Virtamo J, Rapola JM, Ripatti S, et al. Effect of vitamin E and beta carotene on the incidence of primary nonfatal myocardial infarction and fatal coronary heart disease. Arch Intern Med 1998;158:668-75.

44. Klipstein-Grobusch K, Geleijnse JM, den Breeijen JH, et al. Dietary antioxidants and risk of myocardial infarction in the elderly: the Rotterdam Study. Am J Clin Nutr 1999;69:261-6.

45. Marx A, Neutra RR. Magnesium in drinking water and ischemic heart disease. Epidemiol Rev 1997;19:258-72.

46. Rubenowitz E, Molin I, Axelsson G, Rylander R. Magnesium in drinking water in relation to morbidity and mortality from acute myocardial infarction. Epidemiology 2000;11:416-21.

47. Galloe AM, Rasmussen HS, Jorgensen LN, et al. Influence of oral magnesium supplementation on cardiac events among survivors of an acute myocardial infarction. BMJ 1993;307:585-7.

48. Singh RB, Singh NK, Niaz MA, Sharma JP. Effect of treatment with magnesium and potassium on mortality and reinfarction of patients with suspected acute myocardial infarction. Int J Clin Pharmacol Ther 1996;34:219-25.

49. Singh RB. Effect of dietary magnesium supplementation in the prevention of coronary heart disease and sudden cardiac death. Magnesium Trace Elem 1990;9:143-51.

50. Israelsson B, Brattstrom LE, Hultberg BL. Homocysteine and myocardial infarction. Atherosclerosis 1988;71:227-33.

51. Ridker PM, Manson JE, Buring JE, et al. Homocysteine and risk of cardiovascular disease among postmenopausal women. JAMA 1999;281:1817-21.

52. Bots ML, Launer LJ, Lindemans J, et al. Homocysteine and short-term risk of myocardial infarction and stroke in the elderly: the Rotterdam Study. Arch Intern Med 1999;159:38-44.

53. Stampfer MJ, Malinow R, Willett WC, et al. A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians. JAMA 1992;268:877-81.

54. Folsom AR, Nieto FJ, McGovern PG, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins. Circulation 1998;98:204-10.

55. Kuller LH, Evans RW. Homocysteine, vitamins, and cardiovascular disease. Circulation 1998;98:196-9 [editorial/review].

56. Nallamothu BK, Fendrick AM, Rubenfire M, et al. Potential clinical and economic effects of homocyst(e)ine lowering. Arch Intern Med 2000;160:3406-12.

57. Landgren F, Israelsson B, Lindgren A, et al. Plasma homocysteine in acute myocardial infarction: homocysteine-lowering effect of folic acid. J Intern Med 1995;237:381-8.

58. Ward M, McNulty H, McPartlin J, et al. Plasma homocysteine, a risk factor for cardiovascular disease, is lowered by physiological doses of folic acid. QJM 1997;90:519-24.

59. Lobo A, Naso A, Arheart K, et al. Reduction of homocysteine levels in coronary artery disease by low-dose folic acid combined with vitamins B6 and B12. Am J Cardiol 1999;83:821-5.

60. Voutilainen S, Lakka TA, Porkkala-Sarataho E, et al. Low serum folate concentrations are associated with an excess incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Eur J Clin Nutr 2000;54:424-8.

61. Israelsson B, Brattstrom LE, Hultberg BL. Homocysteine and myocardial infarction. Atherosclerosis 1988;71:227-33.

62. Ridker PM, Manson JE, Buring JE, et al. Homocysteine and risk of cardiovascular disease among postmenopausal women. JAMA 1999;281:1817-21.

63. Bots ML, Launer LJ, Lindemans J, et al. Homocysteine and short-term risk of myocardial infarction and stroke in the elderly: the Rotterdam Study. Arch Intern Med 1999;159:38-44.

64. Stampfer MJ, Malinow R, Willett WC, et al. A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians. JAMA 1992;268:877-81.

65. Folsom AR, Nieto FJ, McGovern PG, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins. Circulation 1998;98:204-10.

66. Kuller LH, Evans RW. Homocysteine, vitamins, and cardiovascular disease. Circulation 1998;98:196-9 [editorial/review].

67. Nallamothu BK, Fendrick AM, Rubenfire M, et al. Potential clinical and economic effects of homocyst(e)ine lowering. Arch Intern Med 2000;160:3406-12.

68. Landgren F, Israelsson B, Lindgren A, et al. Plasma homocysteine in acute myocardial infarction: homocysteine-lowering effect of folic acid. J Intern Med 1995;237:381-8.

69. Ward M, McNulty H, McPartlin J, et al. Plasma homocysteine, a risk factor for cardiovascular disease, is lowered by physiological doses of folic acid. QJM 1997;90:519-24.

70. Lobo A, Naso A, Arheart K, et al. Reduction of homocysteine levels in coronary artery disease by low-dose folic acid combined with vitamins B6 and B12. Am J Cardiol 1999;83:821-5.

71. Voutilainen S, Lakka TA, Porkkala-Sarataho E, et al. Low serum folate concentrations are associated with an excess incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Eur J Clin Nutr 2000;54:424-8.

72. Chambers JC, McGregor A, Jean-Marie J, et al. Demonstration of rapid onset vascular endothelial dysfunction after hyperhomocysteinemia. An effect reversible with vitamin C therapy. Circulation 1999;99:1156-60.

73. Fuller CJ, Grundy SM, Norkus EP, Jialal I. Effect of ascorbate supplementation on low density lipoprotein oxidation in smokers. Atherosclerosis 1996;119:139-50.

74. Rath M, Pauling L. Solution to the puzzle of human cardiovascular disease: Its primary cause is ascorbate deficiency leading to the deposition of lipoprotein (a) and fibrinogen/fibrin in the vascular wall. J Orthomol Med 1992;6:125-34.

75. Manson JE, Stampfer MJ, Willett WC, et al. A prospective study of vitamin C and incidence of coronary heart disease in women. Circulation 1992;85:865 [abstract].

76. Klipstein-Grobusch K, Geleijnse JM, den Breeijen JH, et al. Dietary antioxidants and risk of myocardial infarction in the elderly: the Rotterdam Study. Am J Clin Nutr 1999;69:261-6.

77. Nyyssönen K, Parvianinen MT, Salonen R, et al. Vitamin C deficiency and risk of myocardial infarction: prospective population study of men from eastern Finland. BMJ 1997;314:634-8.

78. Simon JA, Hudes ES, Browner WS. Serum ascorbic acid and cardiovascular disease prevalence in U.S. adults. Epidemiology 1998;9:316-21.

79. Rimm EB, Stampfer MJ, Ascherio A, et al. Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med 1993;328:1450-6.

80. Pietinen P, Rimm EB, Korhonen P, et al. Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Prevention Study. Circulation 1996;94:2720-7.

81. Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr 1999;69:30-42.

82. Rimm EB, Ascherio A, Giovannucci E, et al. Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. JAMA 1996;275:447-51.

83. Wolk A, Manson JE, Stampfer MJ, et al. Long-term intake of dietary fiber and decreased risk of coronary heart disease among women. JAMA 1999;281:1998-2004.

84. Strandhagen E, Hansson PO, Bosaeus I, et al. High fruit intake may reduce mortality among middle-aged and elderly men. The Study of Men Born in 1913. Eur J Clin Nutr 2000;54:337-41.

85. He J, Ogden LG, Vupputuri S, et al. Dietary sodium intake and subsequent risk of cardiovascular disease in overweight adults. JAMA 1999;282:2027-34.

86. Rosenberg L, Palmer JR, Kelly JP, et al. Coffee drinking and nonfatal myocardial infarction in men under 55 years of age. Am J Epidemiol 1988;128:570-8.

87. Palmer JR, Rosenberg L, Rao RS, Shapiro S. Coffee consumption and myocardial infarction in women. Am J Epidemiol 1995;141:724-31.

88. Greenland S. A meta-analysis of coffee, myocardial infarction, and coronary death. Epidemiology 1993;4:366-74.

89. Myers MG, Basinski A. Coffee and coronary heart disease. Arch Intern Med 1992;152:1767-2.

90. Stolzen berg-Solomon RZ, Miller ER III, Maguire MG, et al. Association of dietary protein intake and coffee consumption with serum homocysteine concentrations in an older population. Am J Clin Nutr 1999;69:467-75.

91. Nygård O, Refsum H, Velanb PM, et al. Coffee consumption and plasma total homocysteine: The Hordaland Homocysteine Study. Am J Clin Nutr 1997;65:136-43.

92. Shekelle RB, Stamler J. Dietary cholesterol and ischaemic heart disease. Lancet 1989;1:1177-9.

93. Hu FB, Stampfer MJ, Rimm EB, et al. A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA 1999;281:1387-94.

94. Raloff J. Oxidized lipids: a key to heart disease? Sci News 1985;127:278.

95. Levy Y, Maor I, Presser D, Aviram M. Consumption of eggs with meals increases the susceptibility of human plasma and low-density lipoprotein to lipid peroxidation. Ann Nutr Metabol 1996;40:243-51.

96. Daviglus ML, Stamler J, Orencia AJ, et al. Fish consumption and the 30-year risk of fatal myocardial infarction. N Engl J Med 1997;336:1046-53.

97. Burr ML, Fehily AM, Gilbert JF, et al. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989;ii:757-61.

98. Landmark K, Abdelnoor M, Kilhovd B, Dorum HP. Eating fish may reduce infarct size and the occurrence of Q wave infarcts. Eur J Clin Nutr 1998;52:40-4.

99. Morris MC, Manson JE, Rosner B, et al. Fish consumption and cardiovascular disease in the physicians' health study: a prospective study. Am J Epidemiol 1995;142:166-75.

100. von Schacky C, Angerer P, Kothny W, et al. The effect of dietary omega-3 fatty acids on coronary atherosclerosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1999;130:554-62.

101. Hu FB, Stampfer MJ, Manson JE, et al. Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study. BMJ 1998;317:1341-5.

102. Fraser GE, Sabaté J, Beeson WL, Strahan TM. A possible protective effect of nut consumption on risk of coronary heart disease. Arch Intern Med 1992;152:1416-24.

103. Abbey M, Noakes M, Belling GB, Nestel PJ. Partial replacement of saturated fatty acids with almonds or walnuts lowers total plasma cholesterol and low-density-lipoprotein cholesterol. Am J Clin Nutr 1994;59:995-9.

104. Sabaté J, Frasser GE, Burke K, et al. Effects of walnuts on serum lipid levels and blood pressure in normal men. N Engl J Med 1993;328:603-7.

105. Fraser GE. Nut consumption, lipids, and risk of a coronary event. Clin Cardiol 1999;22(7 Suppl):III11-5 [review].

106. Durak I, Köksal I, Kaçmaz M, et al. Hazelnut supplementation enhances plasma antioxidant potential and lowers plasma cholesterol levels. Clin Chim Actia 1999;284:113-5 [letter].

107. Edwards K, Kwaw I, Matud J, Kurtz I. Effect of pistachio nuts on serum lipid levels in patients with moderate hypercholesterolemia. J Am Coll Nutr 1999;18:229-32.

108. Mirkin G. Walnuts and serum lipids. N Engl J Med 1993;329:358 [letter].

109. Mann GV. Walnuts and serum lipids. N Engl J Med 1993;329:358 [letter].

110. Fraser GE, Jaceldo K, Sabaté J, et al. Changes in body weight with a daily supplement of 340 calories from almonds for six months. FASEB J 1999;13:A539 [abstract].

111. Hu FB, Stampfer MJ, Manson JE, et al. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 1997;337:1491-9.

112. Willett WC, Stampfer MJ, Manson JE, et al. Intake of trans fatty acids and risk of coronary heart disease among women. Lancet 1993;341:581-5.

113. Gramenzi A, Gentile A, Fasoli M, et al. Association between certain foods and risk of acute myocardial infarction in women. BMJ 1990;300:771-3.

114. Hu FB, Stampfer MJ, Manson JE, et al. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 1997;337:1491-9.

115. Willett WC, Stampfer MJ, Manson JE, et al. Intake of trans fatty acids and risk of coronary heart disease among women. Lancet 1993;341:581-5.

116. Gramenzi A, Gentile A, Fasoli M, et al. Association between certain foods and risk of acute myocardial infarction in women. BMJ 1990;300:771-3.

117. Gramenzi A, Gentile A, Fasoli M, et al. Association between certain foods and risk of acute myocardial infarction in women. BMJ 1990;300:771-3.

118. Hu FB, Stampfer MJ, Manson JE, et al. Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study. BMJ 1998;317:1341-5.

119. de Lorgeril M, Renaud S, Mamelle N, et al. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994;343:1454-9.

120. de Lorgeril M, Salen P, Martin JL, et al. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 1999;99:779-85.

121. Rice RD. Mediterranean diet. Lancet 1994;344:893-4 [letter].

122. Liu S, Willett WC, Stampfer MJ, et al. A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr 2000;71:1455-61.

123. Yudkin J, Morland J. Sugar intake and myocardial infarction. Am J Clin Nutr 1967;20:503-6.

124. Platt L, Ball KP, Brigden WW, et al. Dietary sugar intake in men with myocardial infarction. Lancet 1970 Dec 19;2:1265-71.

125. Yudkin J, Kang SS, Bruckdorfer KR. Effects of high dietary sugar. Br Med J 1980;281:1396.

126. Albrink MJ, Ullrich IH. Interaction of dietary sucrose and fiber on serum lipids in healthy young men fed high carbohydrate diets. Am J Clin Nutr 1986;43:419-28.

127. Reiser S. Effect of dietary sugars on metabolic risk factors associated with heart disease. Nutr Health 1985;3:203-16.

128. Liu K, Stamler J, Trevisan M, Moss D. Dietary lipids, sugar, fiber, and mortality from coronary heart disease. Bivariate analysis of international data. Arteriosclerosis 1982;2:221-7.

129. Rosenberg L, Slone D, Shapiro S, et al. Alcoholic beverages and myocardial infarction in young women. Am J Public Health 1981;71:82-5.

130. Kono S, Handa K, Kawano T, et al. Alcohol intake and nonfatal acute myocardial infarction in Japan. Am J Cardiol 1991;68:1011-4.

131. Jackson R, Scragg R, Beaglehole R. Does recent alcohol consumption reduce the risk of acute myocardial infarction and coronary death in regular drinkers? Am J Epidemiol 1992;136:819-24.

132. Hammar N, Romelsjo A, Alfredsson L. Alcohol consumption, drinking pattern and acute myocardial infarction. A case referent study based on the Swedish Twin Register. J Intern Med 1997;241:125-31.

133. Bianchi C, Negri E, La Vecchia C, Franceschi S. Alcohol consumption and the risk of acute myocardial infarction in women. J Epidemiol Community Health 1993;47:308-11.

134. Gaziano JM, Hennekens CH, Godfried SL, et al. Type of alcoholic beverage and risk of myocardial infarction. Am J Cardiol 1999;83:52-7.

135. Hart CL, Smith GD, Hole DJ, Hawthorne VM. Alcohol consumption and mortality from all causes, coronary heart disease, and stroke: results from a prospective cohort study of Scottish men with 21 years of follow up. BMJ 1999;318:1725-9.

136. Law M, Wald N. Why heart disease mortality is low in France: the time lag explanation. BMJ 1999;318:1471-80 [review].

137. Gaziano JM, Buring JE, Breslow JL, et al. Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 1993;329:1829-34.

138. Renaud S, de Lorgeril M. Wine, alcohol, platelets and the French paradox for coronary heart disease. Lancet 1992;339:1523-6.

139. Sharpe PC, McGrath LT, McClean E, et al. Effect of red wine consumption on lipoprotein (a) and other risk factors for atherosclerosis. Q J Med 1995;88:101-8.

140. Holman CDJ, English DR, Milne E, Winter MG. Meta-analysis of alcohol and all-cause mortality: a validation of NHMRC recommendations. Med J Aust 1996;64:141-5.

141. Singh RB, Rastogi SS, Verma R, et al. An Indian experiment with nutritional modulation in acute myocardial infarction. Am J Cardiol 1992;69:879-85.

142. Singh RB, Niaz MA, Ghosh S, et al. Effect on mortality and reinfarction of adding fruits and vegetables to a prudent diet in the Indian Experiment of Infarct Survival (IEIS). J Am Coll Nutr 1993;12:255-61.

143. Prescott E, Hippe M, Schnohr P, et al. Smoking and risk of myocardial infarction in women and men: longitudinal population study. BMJ 1998;316:1043-7.

144. Nyboe J, Jensen G, Appleyard M, Schnohr P. Smoking and the risk of first acute myocardial infarction. Am Heart J 1991;122:438.

145. Rosenberg L, Palmer JR, Shapiro S. Decline in the risk of myocardial infarction among women who stop smoking. N Engl J Med 1990;322:213-7.

146. Zhu B, Sun Y, Sievers RE, et al. Exposure to environmental tobacco smoke increases myocardial infarct size in rats. Circulation 1994;89:1282-90.

147. Zhu B, Parmley WW. Hemodynamic and vascular effects of active and passive smoking. Am Heart J 1995;130:1270-5 [review].

148. Wilson K, Gibson N, Willan A, Cook D. Effect of smoking cessation on mortality after myocardial infarction: meta-analysis of cohort studies. Arch Intern Med 2000;160:939-44 [review].

149. Mittleman MA, Maclure M, Tofler GH, et al. Triggering of acute myocardial infarction by heavy physical exertion. Protection against triggering by regular exertion. Determinants of Myocardial Infarction Onset Study Investigators. N Engl J Med 1993;329:1677-83.

150. Willich SN, Lewis M, Lowel H, et al. Physical exertion as a trigger of acute myocardial infarction. Triggers and Mechanisms of Myocardial Infarction Study Group. N Engl J Med 1993;329:1684-90.

151. Mittleman MA, Siscovick DS. Physical exertion as a trigger of myocardial infarction and sudden cardiac death. Cardiol Clin 1996;14:263-70 [review].

152. Muller JE, Mittleman A, Maclure M, et al. Triggering myocardial infarction by sexual activity. Low absolute risk and prevention by regular physical exertion. Determinants of Myocardial Infarction Onset Study Investigators. JAMA 1996;275:1405-9.

153. Schargrodsky H, Rozlosnik J, Ciruzzi M, et al. Body weight and nonfatal myocardial infarction in a case-control study from Argentina. Soz Praventivmed 1994;39:126-33.

154. Tavani A, Negri E, D'Avanzo B, La Vecchia C. Body weight and risk of nonfatal acute myocardial infarction among women: a case-control study from northern Italy. Prev Med 1997;26:550-5.

155. Kawachi I, Sparrow D, Kubzansky LD, et al. Prospective study of a self-report type A scale and risk of coronary heart disease: test of the MMPI-2 type A scale. Circulation 1998;98:405-12.

156. Raymond C. Distrust, rage may be ‘toxic core' that puts ‘type A' person at risk. JAMA 1989;261:813.

157. Dimsdale JE. A perspective on type A behavior and coronary disease. N Engl J Med 1988;318:110-2 [editorial].

158. Friedman M, Thoresen CE, Gill JJ, et al. Alteration of type A behavior and reduction in cardiac recurrences in postmyocardial infarction patients. Am Heart J 1984;108:237-48.

159. Kawachi I, Sparrow D, Spiro A 3rd, et al. A prospective study of anger and coronary heart disease. The Normative Aging Study. Circulation 1996;94:2090-5.

160. Kubzansky LD, Kawachi I, Spiro A 3rd, et al. Is worrying bad for your heart? A prospective study of worry and coronary heart disease in the Normative Aging Study. Circulation 1997;95:818-24.

161. Hammar N, Alfredsson L, Johnson JV. Job strain, social support at work, and incidence of myocardial infarction. Occup Environ Med 1998;55:548-53.

162. Knox SS, Adelman A, Ellison RC, et al. Hostility, social support, and carotid artery atherosclerosis in the National Heart, Lung, and Blood Institute Family Heart Study. Am J Cardiol 2000;86:1086-9.

163. Knox SS, Siegmund KD, Weidner G, et al. Hostility, social support, and coronary heart disease in the National Heart, Lung, and Blood Institute Family Heart Study. Am J Cardiol 1998;82:1192-6.

164. Orth-Gomer K, Wamala SP, Horsten M, et al. Marital stress worsens prognosis in women with coronary heart disease: the Stockholm female coronary risk study. JAMA 2000;284:3008-14.

165. Allen C, Glasziou P, Del Mar C. Bed rest: a potentially harmful treatment needing more careful evaluation. Lancet 1999;354:1229-33 [review].

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The information presented by TraceGains 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 December 2024.

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