Ideally, with a healthy diet no one would ever need vitamins or extra minerals or other nutrients, but even a conscientious eater can have trouble getting her RDAs. In part that’s a reflection of the standard American diet and our penchant for fast food. Depleted soils play a role as well, as does excess processing. As a result, James Roberts, MD, coauthor with Stephen Sinatra, MD of Reverse Heart Disease Now, recommends everyone take a health food store-type six-a-day vitamin that includes all the Bs and major antioxidants like C and E. They also recommend taking fish oil (for a host of reasons) and magnesium and vitamin D, two nutrients they feel most everyone lacks in sufficient quantities.

For those who want to address specific results from blood tests, Stephen DeVries, MD, author of What Your Doctor May Not Tell You About Cholesterol, recommends the following—but only after consultation with your doctor:• Fish Oil (1 to 4 grams daily). It can lower triglycerides 25 to 40 percent and reduce inflammation.

• Niacin (500 to 2,000 mg daily). It raises HDL and lowers LDL, Lp(a), and triglyceride levels.
• Red yeast rice (600 to 1,200 mg twice a day with food). The natural component of the statin Mevacor, it can lower LDL cholesterol by 25 percent.
• Stanols and sterols (2 g daily). By blocking the absorption of dietary cholesterol, these plant fats can lower LDL 10 to 20 percent.
• Coenzyme Q10 (100 to 300 mg daily). To replace CoQ10 lost to statins and red yeast rice; also to lower blood pressure and improve symptoms of heart failure.
• L-carnitine (1 g twice a day). It can lower Lp(a) by 8 percent.
To this list Roberts and Sinatra would add
• L-arginine (2,000 to 3,000 mg three times daily). It improves the health and flexibility of the endothelium, the single layer of cells lining the interior wall of blood vessels.
• Vitamin C (1,000 mg daily in two doses). Among many other benefits, this antioxidant cuts down on plaque formation, helps control blood pressure, and reins in CRP and Lp(a).
• Nattokinase (for prevention, 2,000 fibrin units a day). A natural clot buster for people with high fibrinogen, homocysteine, Lp(a), and CRP levels.
• Vitamin K-2 (eat natto, a fermented soy dish, two to three times a week). Studies indicate this crucial bone building vitamin also decalcifies hard plaque formations.
• D-ribose (5 g daily for cardiovascular prevention; 10 to 15 g daily for people with heart failure and other forms of ischemic CVD; 15 to 30 g daily for people with advanced heart failure or frequent angina). In concert with CoQ10, magnesium, and L-carnitine, D-ribose allows heart mitochondria to produce ATP, the fuel heart cells need to pump blood.

Source: Reverse Heart Disease Now by James C. Roberts, MD, and Stephen T. Sinatra, MD, with Martin Zucker (John Wiley & Sons, 2007)