Micronutrients CHD

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Suggested daily dose


To reduce elevated blood homocysteine

Folic acid plus 0.5-1.0 mg folic acid; 10-20 |ig vitamin B12 vitamin B12

Vitamin B6 50 mg

Reduces blood homocysteine levels12

Reduces blood homocysteine levels; lowers risk of platelet aggregation12

To reduce elevated blood cholesterol Niacin (in form of Begin with 100 mg and gradually nicotinic acid) increase over several weeks to

1-3 g. Take with meals

Lowers LDL cholesterol and raises HDLs, thereby reducing risk of heart attack.13 Side effects (flushing) can be minimized by raising the dose gradually and taking the niacin with meals. Should betaken only under medical supervision at doses >1 g/day because of rare but potentially serious side effects, including liver inflammation and hyperglycemia

To reduce risk of oxidation of blood cholesterol Vitamin C 1-2 g

Vitamin E and sele- 200-400 mg vitamin E, 200 |ig nium selenium

Protects againstfat oxidation; lowers tendency for platelet aggregation; lowers blood cholesterol.14 May reduce frequency and severity of angina

Protects against LDL cholesterol oxidation; lowers tendencyfor platelet aggregation.15-17 May reduce frequency and severity of angina

To reduce elevated cholesterol and blood pressure Calcium and magne- 600 mg calcium; 300 mg mag-sium nesium. Can be taken as do lomite tablets

Omega-3 fatty acids 2-3 g EPA and DHA as fish oil capsules

Calcium helps lower elevated cholesterol levels and may protect against atherosclerosis. Magnesium reduces cholesterol levels and raises HDLs; also reduces risk of dysrhythmias and reduces severity of angina.18 Reduces risk of atherosclerosis by reducing blood cholesterol and triglycerides, lowering blood pressure, and reducing tendencyfor platelet aggregation.3

To improve myocardial energy metabolism Carnitine 1-2 g

Coenzyme Q10

60-120 mg

Lowers total blood cholesterol while increasing HDLs. Reduces symptoms of angina by increasing efficiency of energy metabolism in the myocardium19

Reduces symptoms of angina by increasing efficiency of energy metabolism in the myocardium. Supports heart function and cardic output in hearts weakened by atherosclerosis20

Fig. 5.8: Vitamin E supplements in men with coronary heart disease (CHD). 2002 men with CHD and a previous myocardial infarction were given 400-800 mg/day of vitamin E for 2-3 years. In the vitamin E group the risk of a major cardiovascular event (MCE) and nonfatal myocardial infarction (MI) was reduced 47 % and 68%, respectively. (From Stephens NG, etal. Lancet. 1996;347:781)




lowest intakes

Folic acid

Vitamin B6

Folic acid

highest intakes

Quintiles of vitamin intake o

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