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Best Heart Health Supplements in 2026: What Works for Cholesterol, Triglycerides and Blood Pressure

Heart health supplements ranked by evidence, from fish oil, psyllium and plant sterols to red yeast rice, CoQ10 and garlic, with picks for each target and the ones to skip.

Published

November 6, 2026

Read time

15 min read

Medically reviewed by

Rhonda Collins, FNP-C

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Quick Summary

The best supplements for heart health depend on which number you want to move. For LDL cholesterol, psyllium fiber and plant sterols have the most consistent trial evidence, and red yeast rice lowers LDL too but carries real safety caveats. For triglycerides, fish oil with EPA and DHA has the clearest effect. For blood pressure, garlic has small and inconsistent results. CoQ10 has mixed evidence for statin muscle aches. No supplement replaces a statin, blood pressure medicine or exercise, and the US Preventive Services Task Force recommends against vitamin E and beta-carotene for heart disease prevention ^[1].

Introduction

“Which heart health supplement is actually worth taking?”

The problem: the heart supplement aisle promises to “support healthy cholesterol” and “protect your heart,” yet few products have been tested against heart attacks or strokes. In a 28-day trial of 190 adults at raised heart risk, none of six popular supplements (fish oil, cinnamon, garlic, turmeric, plant sterols and red yeast rice) lowered LDL cholesterol significantly more than placebo, while a low-dose statin lowered it by about 35 percent more than placebo ^[2].

Why it matters: heart disease is driven by numbers you can measure: LDL cholesterol and ApoB, triglycerides, blood pressure, blood sugar and inherited Lp(a). A supplement is only worth taking if it moves one of those numbers by an amount that shows up on your next blood test.

How this guide picks:

• Evidence first: each ingredient is graded by what randomized trials and systematic reviews found for a specific target, not by the label’s claims.
• Grouped by target: triglycerides, LDL cholesterol, statin side effects and blood pressure each have different options.
• Catalog products only: every pick is a named product in Mito’s supplement catalog that was in stock when this guide was written.
• Mixed brands: no brand has more than two picks.

What this guide leaves out:

• Vitamin E, beta-carotene and multivitamins for heart prevention: the USPSTF recommends against vitamin E and beta-carotene for preventing heart disease and found the evidence insufficient for multivitamins ^[1].
• Nattokinase: in a three-year trial of 265 adults, it did not slow the progression of carotid artery thickening or change blood pressure compared with placebo ^[3]. It is marketed as an anticlotting enzyme, which is a reason to avoid it alongside blood thinners.
• Potassium pills: in people with kidney disease or who take ACE inhibitors or potassium-sparing diuretics, extra potassium can push blood levels too high ^[4].
• Berberine and citrus bergamot: berberine is studied mainly for blood sugar, and bergamot’s heart evidence is still thin.
• Magnesium: see our magnesium supplement brands guide instead.

Which heart health supplement fits your goal?

The table maps each heart target to the supplement with the best evidence for it, and says plainly how strong that evidence is.

Top picks

Reviews

Best for Lowering Triglycerides: Omega-3 Fish Oil

Fish oil’s clearest effect is on triglycerides. A Cochrane review of 86 trials in 162,796 people found that long-chain omega-3s lowered triglycerides by about 15 percent, with larger doses lowering them more, but had little or no effect on deaths or cardiovascular events overall, with a possible small reduction in coronary heart disease events ^[5]. In the VITAL trial of 25,871 US adults, 1 gram a day of omega-3s did not lower the rate of heart attack, stroke or cardiovascular death compared with placebo over about five years ^[17].

Prescription omega-3 is a different product. The American Heart Association’s 2019 advisory found that prescription omega-3 at 4 grams a day lowers very high triglycerides by 30 percent or more ^[6]. The REDUCE-IT trial, which found fewer cardiovascular events, used 4 grams a day of icosapent ethyl, a purified prescription EPA, in 8,179 people already taking a statin ^[18]. Its results do not carry over to over-the-counter fish oil at lower doses. Higher doses also carry a trade-off: in a 2021 meta-analysis of large trials, omega-3 supplements were linked to a 25 percent higher risk of atrial fibrillation overall, and 49 percent higher in trials of more than 1 gram a day ^[19]. For the broader evidence, see do omega-3 supplements actually do anything.

Best for the most EPA and DHA per serving, in triglyceride form

1. Nordic Naturals ProOmega 2000

• Form: Lemon-flavored softgel, triglyceride form (rTG)
• EPA and DHA: 1,125 mg EPA and 875 mg DHA per 2 softgels
• Label Serving: 2 softgels
• Servings per Container: 30 or 60
• Best For: the most EPA and DHA per serving, in triglyceride form

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Ultra-concentrated EPA+DHA in the highly absorbable, triglyceride molecular form.

Pros

• 2,000 mg EPA and DHA per serving, the most of the fish oils here
• Triglyceride form, stated on the label
• No gluten, milk derivatives, wheat or soy

Cons

• Highest list price of the fish oils here
• Larger softgel than standard fish oil

Best for an IFOS-certified fish oil at a lower list price

2. Carlson Labs Elite Omega-3 Gems

• Form: Lemon-flavored softgel
• EPA and DHA: 800 mg EPA and 600 mg DHA per 2 softgels
• Label Serving: 2 softgels
• Servings per Container: 30, 60, 90 or 120
• Third-Party Testing: IFOS certified
• Best For: an IFOS-certified fish oil at a lower list price

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Carlson Elite Omega-3 Gems® is a professional-strength fish oil concentrate.

Pros

• IFOS certification for purity and freshness, stated on the product page
• Four bottle sizes

Cons

• Softgel shell is made from beef gelatin
• Oil form is not stated on the product page

Best for an EPA-dominant fish oil in one softgel a day

3. Wiley's Finest Peak EPA

• Form: Softgel, ethyl ester form, from wild Alaska pollock
• EPA and DHA: 750 mg EPA and 250 mg DHA per softgel
• Label Serving: 1 softgel
• Servings per Container: 30, 60 or 120
• Best For: an EPA-dominant fish oil in one softgel a day

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Peak EPA is purified and concentrated to provide a Peak dose of EPA in every softgel.

Pros

• One-softgel serving
• 750 mg EPA per softgel, stated on the label
• Fish gelatin softgel

Cons

• Ethyl ester form; the label says to take it with food
• No third-party certification stated on the product page

Best for a vegan EPA and DHA from algae

4. Nordic Naturals Algae Omega

• Form: Vegan softgel from microalgae oil
• EPA and DHA: 195 mg EPA and 390 mg DHA per 2 softgels
• Label Serving: 2 softgels
• Servings per Container: 30 or 60
• Best For: a vegan EPA and DHA from algae

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Made from microalgae, it offers a plant-based source of beneficial marine omega-3s EPA and DHA without the use of fish.

Pros

• Vegan, with no fish
• Supplies EPA as well as DHA

Cons

• Much less EPA and DHA per serving than the fish oils
• Label asks you to check with a physician first if you are allergic to iodine

Best for Lowering LDL Cholesterol: Psyllium Fiber

Psyllium is one of the few supplement ingredients with an FDA-authorized health claim about coronary heart disease. The claim requires 7 grams or more a day of soluble fiber from psyllium husk, eaten as part of a diet low in saturated fat and cholesterol ^[7]. In a meta-analysis of 28 randomized trials in 1,924 people, a median of about 10 grams of psyllium a day lowered LDL cholesterol by 0.33 mmol/L (about 13 mg/dL), and also lowered non-HDL cholesterol and ApoB ^[8]. It is also one of the least expensive options in this guide.

Best for plain psyllium husk with nothing added

1. NOW Foods Psyllium Husk Powder

• Form: Unflavored powder
• Soluble Fiber: 6 g per level tablespoon (about 9 g)
• Label Serving: 1 level tablespoon in at least 12 oz of liquid
• Servings per Container: About 37 or 75 (340 g or 680 g)
• Best For: plain psyllium husk with nothing added

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Excellent source of fiber.

Pros

• Single ingredient: psyllium seed husk
• Lowest list price in this guide
• Soluble fiber stated per serving

Cons

• Must be mixed and drunk quickly, with plenty of fluid
• The label advises starting small and building up over several weeks
• May contain traces of sesame

Best for Lowering LDL Cholesterol: Plant Sterols

Plant sterols are cholesterol-like compounds found in plants. A meta-analysis of 124 studies found that 0.6 to 3.3 grams a day lowered LDL cholesterol by an average of 6 to 12 percent, with the effect growing with dose up to about 3 grams a day ^[9]. Many sterol products are fortified spreads or dairy drinks. A sachet lets you add them to food you already eat.

Best for 2 g of plant sterols a day in a single sachet

1. Cardiosmile Liquid Plant Sterols

• Form: Liquid sachet, mixed into food or a drink
• Plant Sterols: 2,000 mg per sachet, including 1,400 mg beta-sitosterol
• Label Serving: 1 sachet
• Servings per Container: 30
• Best For: 2 g of plant sterols a day in a single sachet

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Cardiosmile is an innovation that allows you to add plant sterols (phytosterols) directly to any food you choose, without adding any extra fat.

Pros

• Plant sterol amount stated per sachet
• No calories, fat, gluten or lactose

Cons

• Should not be mixed with hot or acidic foods
• Label asks you to check with a practitioner first if you take a statin

LDL Cholesterol, With Caution: Red Yeast Rice

Red yeast rice is rice fermented with a mold that can produce monacolin K, a compound structurally identical to the prescription statin lovastatin ^[10]. In a meta-analysis of 20 trials that used products with a known monacolin K content, red yeast rice lowered LDL cholesterol by about 1 mmol/L (about 39 mg/dL) compared with placebo, but the authors rated the safety evidence as uncertain because few trials assessed it well ^[11]. The bigger problem is consistency. A 2017 analysis of 28 US brands found that none listed monacolin K on the label, and the amount ranged more than 60-fold, with none detected in two brands ^[10]. Products with added lovastatin cannot legally be sold as supplements in the US ^[10]. If you consider red yeast rice, choose a brand that tests for citrinin, a toxin that can form during fermentation, and retest your LDL cholesterol and liver enzymes after starting.

Best for a single-ingredient red yeast rice tested for citrinin

1. Thorne Red Yeast Rice

• Form: Capsule
• Key Ingredient: Red yeast rice (Monascus purpureus), 900 mg per capsule
• Label Serving: 1 capsule
• Servings per Container: 120
• Third-Party Testing: Third-party tested, per the product page
• Best For: a single-ingredient red yeast rice tested for citrinin

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Review with a clinician before buying

Red yeast rice can contain monacolin K, the same compound as the statin lovastatin. Do not combine it with a statin, and review it with a clinician first if you have liver disease or have had muscle pain on a statin. The label lists reports of raised liver enzymes and muscle pain.

Thorne’s Red Yeast Rice is formulated with Monascus purpureus, a red-pigmented yeast naturally produced on fermented rice.

Pros

• Citrinin stated as below 0.05 parts per million
• Single ingredient with the amount stated

Cons

• Monacolin K content is not stated on the label
• Contains an ingredient derived from soy
• Not for use in pregnancy, while nursing or when trying to conceive

Best for Statin Users and Heart Failure: CoQ10

CoQ10 is often taken for statin muscle aches. Individual trials have varied, but the overall evidence does not show that CoQ10 relieves statin muscle pain, and it probably has no meaningful effect on blood pressure ^[12]. Heart failure is where the data are strongest. In the Q-SYMBIO trial of 420 people with moderate to severe heart failure, 100 mg of CoQ10 three times a day added to standard treatment was followed by fewer major cardiovascular events over two years (15 percent compared with 26 percent on placebo) ^[13]. A Cochrane review rated the evidence on deaths as moderate quality, resting on that one trial, and found no convincing evidence overall to support or refute CoQ10 for heart failure ^[14].

Best for the ubiquinol form of CoQ10 in one softgel

1. Life Extension Super Ubiquinol CoQ10

• Form: Softgel, ubiquinol (Kaneka Ubiquinol)
• Key Ingredient: Ubiquinol, 100 mg per softgel
• Label Serving: 1 softgel with food
• Servings per Container: 60
• Best For: the ubiquinol form of CoQ10 in one softgel

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Review with a clinician before buying

CoQ10 may make the blood thinner warfarin less effective. Review it with a clinician first if you take warfarin or another anticoagulant.

Super Ubiquinol CoQ10 is formulated with a highly bioavailable ubiquinol form of coenzyme Q10.

Pros

• Ubiquinol, the reduced form of CoQ10, from a named supplier
• Non-GMO and gluten-free

Cons

• Only one bottle size
• Gelatin softgel, so not vegetarian

Best for a hypoallergenic CoQ10 capsule with a short ingredient list

2. Pure Encapsulations CoQ10 120 mg

• Form: Vegetarian capsule
• Key Ingredient: Coenzyme Q10, 120 mg per capsule
• Label Serving: 1 capsule
• Servings per Container: 30, 60 or 120
• Best For: a hypoallergenic CoQ10 capsule with a short ingredient list

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Review with a clinician before buying

The label warns that CoQ10 may react with blood thinning medications. Review it with a clinician first if you take warfarin or another anticoagulant.

CoQ10 provides support to enhance energy levels within cells to provide increased energy and exercise stamina.

Pros

• Vegetarian and hypoallergenic
• Three bottle sizes

Cons

• No third-party certification stated on the product page

Blood Pressure (Weaker Evidence): Garlic

Garlic supplements have small effects on blood pressure. A 2016 meta-analysis of 20 trials in 970 people found systolic blood pressure about 5 mmHg lower than placebo overall, and about 9 mmHg lower in trials of people with high blood pressure ^[15]. A Cochrane review found too little evidence to tell whether garlic changes heart attacks, strokes or deaths, and judged the blood pressure results imprecise ^[16]. Garlic supplements may increase bleeding risk, especially with blood thinners, aspirin or before surgery ^[20].

Best for a coated garlic tablet with a stated allicin amount

1. Nature's Way Garlicin Cardio

• Form: Coated tablet
• Key Ingredient: Garlic bulb powder, 350 mg per tablet, releasing 3,200 mcg allicin
• Label Serving: 1 tablet
• Servings per Container: 90
• Best For: a coated garlic tablet with a stated allicin amount

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Review with a clinician before buying

The label says not to use it if you have a bleeding disorder, take blood thinning medication, or are within a week of surgery. Review it with a clinician first if any apply.

Nature's Way Garlicin utilizes SmartRelease Garlic, which is a proprietary garlic formulation specially coated to protect from stomach acid.

Pros

• Single ingredient: garlic bulb powder
• Coated to reduce garlic taste and smell
• Allicin yield stated per tablet

Cons

• Blood pressure effects in trials were small
• Contains titanium dioxide color

What to look for in a heart health supplement

1. A Target You Can Measure

Start from the number you want to move: LDL cholesterol or ApoB, triglycerides, or blood pressure. Then test it before you start and again a few months later. If the number has not moved, the supplement is not doing that job for you.

2. Stated Amounts of the Active Ingredient

Trials used specific amounts: grams of soluble fiber from psyllium, grams of plant sterols, or EPA and DHA in milligrams ^[8][9]. Choose a label that states the active amount per serving, not just the total fish oil or a proprietary blend. For fish oil, add up EPA and DHA rather than reading the headline milligrams.

3. Interactions With Your Medicines

Red yeast rice should not be taken with a statin ^[10]. CoQ10 may make warfarin less effective ^[12], and garlic may raise bleeding risk with blood thinners or aspirin ^[20]. If you take any heart medicine, check new supplements with the clinician who prescribes it.

4. Purity Testing for Oils and Fermented Products

Fish oils can oxidize and carry contaminants, and red yeast rice can contain citrinin. Look for an independent seal such as IFOS, NSF or USP, or a stated contaminant test. For what each seal covers, see how to choose a supplement brand.

5. Claims That Overreach

Be wary of labels that promise to “clean your arteries,” “reverse plaque” or replace medication. No supplement in this guide has trial evidence for those claims, and the trial that compared six popular supplements with a low-dose statin found none lowered LDL cholesterol more than placebo ^[2].

Cost Comparison

Current prices show on each product card above, in the “From” line, and come live from Mito’s catalog. The price band below compares each product’s lowest list price in the catalog on November 6, 2026 with the other picks in this guide, from budget through mid to premium.

Best value: NOW Foods Psyllium Husk Powder is the lowest-priced pick and is one of the two best-supported LDL options here. For fish oil, Carlson Elite Omega-3 Gems adds IFOS certification at a budget list price.

Highest dose of EPA and DHA: Nordic Naturals ProOmega 2000 supplies 2,000 mg per serving, at a premium list price.

Test This with Mito

Heart supplements are only worth taking if they move a number, so test before you start and again a few months later. Mito offers tests for each target, with physician-guided interpretation:

• Mito Core Panel: 100+ biomarkers, including LDL cholesterol, triglycerides, ApoB, Lp(a) and hs-CRP, along with blood sugar, kidney and liver markers. It sets the baseline for every target in this guide. Our guide to heart disease beyond cholesterol explains which of these markers matter most.
• Advanced Cholesterol Panel: a standard lipid profile plus ApoB, Lp(a) and LDL particle number and size. It is the closer read if you are using psyllium, plant sterols or red yeast rice to lower LDL. See how to lower ApoB for what moves it.
• Omega-3 and Omega-6 Fatty Acid Profile: measures EPA, DHA and the omega-3 index in your blood, so you can see whether a fish oil is actually raising your omega-3 level.
• Lipoprotein(a) Blood Test: a single Lp(a) measurement. Lp(a) is largely inherited, so most people only need it checked once.
• Coronary Artery Calcium (CAC) Scan: a CT scan that scores hardened plaque in the heart’s arteries, a screening test for people without symptoms. See our calcium score test guide for what the score means.

How to decide:

• No recent labs: the Mito Core Panel covers the lipid, ApoB and Lp(a) baseline in one draw.
• Taking a supplement to lower LDL cholesterol: the Advanced Cholesterol Panel before you start and a few months later.
• Taking fish oil: the Omega-3 and Omega-6 Fatty Acid Profile to see whether your omega-3 index has changed.
• Lp(a) never checked and you do not need the full panel: the standalone Lp(a) test.
• Borderline heart risk and unsure about a statin: the CAC scan, whose score can help settle whether a statin is worth taking now.

For lifestyle steps that move the same numbers, see how to lower cholesterol naturally.

Key Takeaways

• No supplement replaces a statin, blood pressure medicine or exercise: in a head-to-head trial, six popular supplements did not lower LDL cholesterol more than placebo ^[2].
• Psyllium and plant sterols have the most consistent LDL evidence among the supplements here ^[8][9].
• Fish oil lowers triglycerides but has shown little effect on heart events at over-the-counter doses, and higher doses are linked to atrial fibrillation ^[5][17][19].
• Red yeast rice lowers LDL but is unpredictable: its active compound matches lovastatin, its content varies widely, and it should not be combined with a statin ^[10].
• CoQ10 and garlic have weaker evidence, and both can interact with blood thinners ^[12][20].
• Skip vitamin E, beta-carotene and nattokinase for heart prevention ^[1][3].

Related Content

• Omega-3 Supplements: Do They Actually Do Anything for You?
• How to Lower ApoB Levels: 6 Strategies for a Healthier Heart
• Heart Disease Beyond Cholesterol: Which Blood Tests Matter Beyond LDL
• Calcium Score Test: What Your Coronary Calcium Score Means
• Best Magnesium Supplements: Brands Ranked by Quality
• How to Lower Cholesterol Naturally

Medical Disclaimer

This article is for educational and informational purposes only and does not constitute medical advice. The information provided should not be used for diagnosing or treating a health condition. Always consult with your doctor or qualified healthcare provider before starting any new supplement, making changes to your diet, or if you have questions about a medical condition.

References

1. US Preventive Services Task Force. Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer: US Preventive Services Task Force recommendation statement. JAMA. 2022;327(23):2326-2333. PMID: 35727271

2. Laffin LJ, Bruemmer D, Garcia M, et al. Comparative effects of low-dose rosuvastatin, placebo, and dietary supplements on lipids and inflammatory biomarkers. J Am Coll Cardiol. 2023;81(1):1-12. PMID: 36351465

3. Hodis HN, Mack WJ, Meiselman HJ, et al. Nattokinase atherothrombotic prevention study: a randomized controlled trial. Clin Hemorheol Microcirc. 2021;78(4):339-353. PMID: 33843667

4. NIH Office of Dietary Supplements. Potassium: Fact Sheet for Health Professionals. ods.od.nih.gov

5. Abdelhamid AS, Brown TJ, Brainard JS, et al. Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2020;3(3):CD003177. PMID: 32114706

6. Skulas-Ray AC, Wilson PWF, Harris WS, et al. Omega-3 fatty acids for the management of hypertriglyceridemia: a science advisory from the American Heart Association. Circulation. 2019;140(12):e673-e691. PMID: 31422671

7. US Food and Drug Administration. 21 CFR 101.81, Health claims: soluble fiber from certain foods and risk of coronary heart disease (CHD). ecfr.gov

8. Jovanovski E, Yashpal S, Komishon A, et al. Effect of psyllium (Plantago ovata) fiber on LDL cholesterol and alternative lipid targets, non-HDL cholesterol and apolipoprotein B: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2018;108(5):922-932. PMID: 30239559

9. Ras RT, Geleijnse JM, Trautwein EA. LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies. Br J Nutr. 2014;112(2):214-219. PMID: 24780090

10. National Center for Complementary and Integrative Health. Red Yeast Rice. nccih.nih.gov

11. Gerards MC, Terlou RJ, Yu H, et al. Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain: a systematic review and meta-analysis. Atherosclerosis. 2015;240(2):415-423. PMID: 25897793

12. National Center for Complementary and Integrative Health. Coenzyme Q10. nccih.nih.gov

13. Mortensen SA, Rosenfeldt F, Kumar A, et al. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail. 2014;2(6):641-649. PMID: 25282031

14. Al Saadi T, Assaf Y, Farwati M, et al. Coenzyme Q10 for heart failure. Cochrane Database Syst Rev. 2021;2(2):CD008684. PMID: 35608922

15. Ried K. Garlic lowers blood pressure in hypertensive individuals, regulates serum cholesterol, and stimulates immunity: an updated meta-analysis and review. J Nutr. 2016;146(2):389S-396S. PMID: 26764326

16. Stabler SN, Tejani AM, Huynh F, Fowkes C. Garlic for the prevention of cardiovascular morbidity and mortality in hypertensive patients. Cochrane Database Syst Rev. 2012;(8):CD007653. PMID: 22895963

17. Manson JE, Cook NR, Lee IM, et al. Marine n-3 fatty acids and prevention of cardiovascular disease and cancer. N Engl J Med. 2019;380(1):23-32. PMID: 30415637

18. Bhatt DL, Steg PG, Miller M, et al. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. N Engl J Med. 2019;380(1):11-22. PMID: 30415628

19. Gencer B, Djousse L, Al-Ramady OT, et al. Effect of long-term marine omega-3 fatty acids supplementation on the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes: a systematic review and meta-analysis. Circulation. 2021;144(25):1981-1990. PMID: 34612056

20. National Center for Complementary and Integrative Health. Garlic. nccih.nih.gov

Frequently asked questions

What is the best supplement for overall heart health?

No single supplement covers overall heart health, and none replaces exercise, diet, not smoking, or the medicines that lower LDL cholesterol and blood pressure. The best choice depends on the number you want to move. Psyllium fiber and plant sterols have the most consistent trial evidence for lowering LDL cholesterol. Fish oil lowers triglycerides, by about 15 percent on average across trials. Garlic has small, inconsistent effects on blood pressure. The US Preventive Services Task Force recommends against vitamin E and beta-carotene for heart disease prevention and found too little evidence to recommend a multivitamin.

How can I make my heart stronger?

Regular physical activity is the foundation of heart fitness. The rest of the foundation is keeping LDL cholesterol, blood pressure and blood sugar in range, not smoking, sleeping well and keeping a healthy weight. Supplements play a small supporting role at most. If you have symptoms such as chest pain or breathlessness on exertion, see a doctor rather than starting a supplement.

Can I take heart health supplements with a statin?

Some combinations are common and some are not. Psyllium, plant sterols and fish oil are often used alongside a statin, though the Cardiosmile label asks you to check with a practitioner first. Red yeast rice should not be combined with a statin, because it can contain monacolin K, a compound structurally identical to the statin lovastatin. CoQ10 is often taken for statin muscle aches, but the overall evidence does not show that it relieves them.

Does fish oil raise the risk of atrial fibrillation?

In large trials, omega-3 supplements were linked to a higher risk of atrial fibrillation, an irregular heart rhythm. A 2021 meta-analysis of seven trials in 81,210 people found a 25 percent higher risk overall, and a 49 percent higher risk in trials that used more than 1 gram a day. That risk matters most if you already have atrial fibrillation or are at high risk of it.

Is over-the-counter fish oil the same as prescription omega-3?

No. The REDUCE-IT trial, which found fewer heart attacks and strokes, tested 4 grams a day of icosapent ethyl, a purified prescription form of EPA, in people already taking a statin who had high triglycerides and heart disease or diabetes. Over-the-counter fish oil is a different product, usually taken at a much lower dose, and the large VITAL trial of 1 gram a day did not find fewer cardiovascular events.