Coronary Heart Disease

Heart disease remains the main cause of death in the UK even though the rate for heart disease has fallen due to medical advances and improvements in diet.  A variety of dietary factors can increase or reduce the risk of coronary heart disease.  Dietary change emphasising a reduction in saturated fats and an increase in fruit and vegetables as well as foods rich in omega-3 fats are now standard advice for those with or at risk of heart disease.  Nutritional supplements have not shown themselves to be of clear benefit with the exception of fish oil supplements.

Advice from the National Institute of Health and Clinical Excellence

The National Institute for Health and Clinical Excellence issued Clinical Guidance (No. 48) in May 2007 Myocardial Infarction: secondary prevention. This provides advice about exercise, smoking, diet and use of nutritional supplements and it advocates the use of fish oil preparations in certain circumstances but it also gives guidance on beta-carotene, antioxidants and folic acid.

• Beta-carotene
  “Advise patients not to take supplements containing beta-carotene”

• Antioxidants
  “Do not advise patients to take antioxidant supplements (vitamin E and/or C) to reduce cardiovascular risk”

• Folic acid
  “Do not advise patients to take folic acid supplements to reduce cardiovascular risk”

It should be noted that because of the high prevalence of mild deficiencies of vitamin C, folate and other B vitamins amongst the elderly in Britain, some who may not be able to adequately improve their diet may need to take supplements of these or other nutrients for reasons other than the prevention of coronary heart disease.  It is however extremely unlikely that a supplement of beta-carotene will be required by any elderly person.

www.nice.org.uk/nicemedia/pdf/CG48QuickRefGuide.pdf page 5 Lifestyle
Further advice on the prevention of heart disease can be obtained from the British Heart Foundation www.bhf.org.uk