Cardiovascular diseases remain the leading cause of death worldwide, therefore, maintaining heart and vascular health is essential for a high-quality life. In addition to lifestyle changes such as adopting a balanced diet, engaging in regular physical activity, and quitting smoking and alcohol consumption, an increasing number of individuals are turning to dietary supplements that claim to support cardiovascular health. Today, the market offers a wide variety of such products, which, compared to medicines, are subject to less stringent regulation, and their efficacy and safety are often not adequately supported by clinical evidence. Nevertheless, many consumers perceive them as safe because they are of natural origin, which can lead to inappropriate or even risky use. In this master’s thesis, we aimed to evaluate the composition and safety of dietary supplements and herbal medicinal products with effects on the cardiovascular system. We randomly selected 60 dietary supplements and 8 herbal medicinal products available on the Slovenian market. Their compositions were analyzed, and 14 commonly occurring ingredients were examined in greater detail. The average number of active ingredients per product was 2.96, with omega-3 fatty acids (49.3%), coenzyme Q10 (25.4%), hawthorn (16.4%), wild olive (9.0%), and mistletoe (9.0%) being the most frequent. The most common vitamins were vitamin E (25.4%), vitamin B1 (13.4%), and vitamin D (10.4%). Based on scientific literature, we determined the effective doses for cardiovascular action, mechanisms of action, safety profiles, adverse effects, and potential interactions with drugs and other supplement ingredients. Most ingredients showed an effect on blood pressure reduction (78.6%). The proportion of selected dietary supplements considered appropriate for use in the context of cardiovascular health is 50%. The doses of coenzyme Q10, resveratrol, aged garlic extract, monacolin, and royal jelly in the products were equal to or higher than those shown to be effective in studies. Based on this, these substances should be regarded as medicinal products. We found that 45.8% of ingredients may cause adverse effects, with every product containing at least one such component. The most frequent adverse effects were associated with resveratrol, hawthorn, monacolin, ginkgo, vitamin A, vitamin D, and chromium. More serious adverse reactions were observed for monacolin, quercetin, ginkgo, green tea, resveratrol, vitamin A, and vitamin D. Taurine, fenugreek, grapevine, omega-3 fatty acids, and coenzyme Q10 showed only mild adverse effects and were considered safer. Products containing a higher number of ingredients were associated with a greater risk of adverse effects.
Safety concerns were identified in 30.9% of products, primarily due to exceeding the recommended daily intake levels of vitamins and minerals established by the Slovenian Agency for Medicinal Products and Medical Devices. A total of 33.3% of ingredients were found to have potential interactions, most notably resveratrol, quercetin, monacolin, and green tea.
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