Chondroitin sulfate, a supplement commonly associated with joint health, has sparked interest in some for its potential role in reducing the risk of heart attacks. While this might be news to some, the connection has been floating around the internet for decades. And while there are still questions- and maybe some cautions- much of the evidence seems compelling. This review delves into the intriguing research behind chondroitin sulfate and its fascinating implications for heart health.
What Is Chondroitin Sulfate?
Chondroitin sulfate is a naturally occurring molecule belonging to a group of compounds called glycosaminoglycans, which play an important role in the function and structure of cartilage, the connective tissue that cushions and protects joints. More specifically it:
- Provides structure and support: It contributes to the structure and integrity of hyaline joint cartilage of the elbows, knees, etc., providing structural integrity to support joints.
- Reduces friction and wear: It attracts and retains water, creating a lubricating gel that reduces friction and wear between joint surfaces, facilitating smooth movement.
- Acts as a shock absorber: Chondroitin helps to absorb and distribute forces exerted on the joints, protecting them from damage during impact and movement.
- Inhibits enzymes that degrade joint cartilage: Inhibiting the production of these enzymes slows the breakdown of cartilage and the progression of osteoarthritis.
- Supporting cartilage formation: Some research suggests chondroitin stimulates the production of chondrocytes, cells that manufacture new collagen. This can slow the development of arthritis.
- Reduce arthritis pain: One high-quality review revealed chondroitin sulfate appeared to reduce feelings of arthritis pain.
Types of Chondroitin Sulfate
There are several types of this molecule. The most common forms are referred to as A, B & C. Here's what they do:
Chondroitin sulfate A is the most abundant form of chondroitin sulfate in cartilage. It is thought to play a role in cartilage lubrication and shock absorption.
Chondroitin sulfate B is less abundant than type A but is still found in significant amounts in cartilage. It is thought to help protect cartilage from damage.
Chondroitin sulfate C is the least abundant form of chondroitin in cartilage. It is thought to play a role in cartilage repair.
There are other forms, too, including types D, E & F. Less is known about what these other forms do in the body.
What Type of Chondroitin Sulfate Is Used In Supplements?
Much of the early research involving the reduction of heart attacks has used chondroitin sulfate A. While the type A form is often used in supplements, companies do not have to disclose the type or types they use in their dietary supplements. It may be type A or a combination of all types in the hopes of providing more holistic benefits. Its possible all types have similar effects on heart health. If you are curious about the types used in your supplement preference, contact the company and ask.
Chondroitin Sulfate Heart Attack & Heart Disease Research
Clinical Study 1 (1968)
The first paper calling attention to the effects of chondroitin sulfate and heart health was published in 1968. In this seminal clinical trial, Lester Morrison, MD, gave chondroitin sulfate to 60 older people with heart disease for 1.5 years and compared the results to 60 similar people who were not given chondroitin.
Following the study, the doctor reported that among the 60 individuals taking chondroitin sulfate, there was only one fatal heart attack.
In contrast, among those who did not take the supplement, there were 13 heart attacks, seven of which were fatal. This preliminary report concluded that chondroitin sulfate not only lowered the risk of heart attacks but also the risk of fatal heart attacks.
- Supplement takers: 1 fatal heart attack
- Non-supplement takers: 13 total cardiac problems, including 7 fatal heart attacks
Clinical Study 2 (1971)
In 1971, Dr. Morrison published a subsequent paper titled “Reduction of Ischemic Coronary Heart Disease by Chondroitin Sulfate A,” which extended his original clinical trial to four years. Again, 60 individuals were given chondroitin supplements, and 60 served as controls and did not supplement.
Four years later, it was reported that there were only four fatal heart attacks among those taking the supplement, compared to nine fatal heart events in the control group. In total, there were six heart issues reported over four years in the supplement group, compared to 36 cardiac events in the control group.
- Supplement takers: 4 heart attack fatalities and 6 total heart-related events
- Non-supplement takers: 9 fatal heart attacks and 36 total heart-related events
Clinical Study 3 (1973)
The same researcher published another paper in 1973, titled “Coronary Heart Disease Reduction of Death Rate by Chondroitin Sulfate.” This study, which was a continuation of the first two clinical trials, involved 120 people—60 who received chondroitin sulfate, and 60 who did not.
Six years later, fewer heart attacks and other heart problems were reported in both men and women taking chondroitin sulfate compared to those not taking the supplement.
Specifically, there were six heart problems reported in the supplement group and 42 in the control group. Furthermore, there were only four fatal heart attacks in the supplement group compared to 14 in those not taking chondroitin sulfate.
- Supplement takers: 6 total heart problems, which included 4 fatal heart attacks
- Non-supplement takers: 42 total cardiac problems, including 14 fatal heart attacks
Putting things another way, there were more than three times as many deaths from heart attacks in those who did not take chondroitin sulfate supplements.
Clinical Study 4 (1979)
Fast forward a few years to 1979, another study this time, involving 48 elderly individuals living in a senior living facility were treated with chondroitin sulfate and followed for five years. Compared to those individuals who did not take the supplement, these researchers also reported that chondroitin sulfate reduces the risk of dying from heart disease.
Additionally, the supplement appeared to lower cholesterol levels, and it caused the blood to take longer before it began to form blood clots.
Additional Proof For Chondroitin Heart Health Benefits
Skip ahead a few decades to 2021, a paper titled “Risk of Acute Myocardial Infarction Among New Users of Chondroitin Sulfate: A Nested Case-Control Study” was published.
This study followed over 23,000 people who had acute heart attacks and over 117,000 people who didn’t for up to 14 years.
The data revealed a staggering statistic: chondroitin supplements were associated with a 40% reduction in heart attacks. These heart-healthy benefits were also seen in both men and women, regardless of age, and in both short-term and long-term users of the supplement too.
It also seemed to work equally well in people who were taking NSAIDs like aspirin and those who were not. Additionally, the supplement appeared to work best in those who were at high risk and intermediate risk of heart attacks.
Interestingly, it was also reported that glucosamine sulfate supplements were not associated with a reduction in heart attack risk, which is the opposite outcome of other investigations.
One possible drawback to this study was the observation that chondroitin sulfate use was more common in healthy people. This opens the possibility that healthy lifestyle habits may have influenced the outcomes.
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More Possible Proof?
Another study published in 2021, titled “Glucosamine and Chondroitin and Mortality in a US NHANES Cohort,” followed 16,000 people for almost nine years.
The researchers reported that the use of both chondroitin sulfate and glucosamine sulfate was associated with a whopping 65% reduction in heart disease death and an almost 40% reduction in dying from all causes.
However, one disadvantage of this study was that the amounts of chondroitin sulfate and glucosamine sulfate consumed by people were not reported.
How Does Chondroitin Sulfate Reduce Heart Attacks?
If this well-known arthritis supplement really does work, how does it provide cardiac benefits? While this is still up for discussion, some research hints at possible mechanisms.
One possibility is that there may be an anti-inflammation effect occuring. For example, both glucosamine and chondroitin sulfate appear to reduce C-reactive protein, an effect that seems to be even greater in women.
Furthermore, when animals are given chondroitin, it has been shown to latch onto plaque in the arteries and reduce the size of those plaques.
Chondroitin Sulfate Dosage To Improve Heart Health
If you’re interested in trying this supplement, you’re probably wondering about the optimal dosage. The amounts used in the studies have ranged from about 1.5 grams to 4.5 grams per day.
In some of the earliest clinical trials, a loading phase was used where people were given about 10 grams for the first several months, after which the dosage was reduced to about 1.5 grams per day thereafter.
However, at least one paper reported heart health benefits in people consuming less than 800 mg a day.
|1.5 g to 10 g
|1 MI in CS group. vs 7 in the control group
|1.5 g to 10 g
|4 out of 60 fatal MI after 4 yrs. and 6 out of 60 total heart problems. Vs. 9 fatal MI and 36 total heart issues in controls
|1.5 g to 10 g
|4 out of 60 fatal MI after 6 yrs. and 6 out of 60 total heart issues. vs. 14 fatal MI and 42 total heart tissues in controls
|CS reduces mortality and cholesterol. Anti-blood clotting effect
|< 800 mg or less
|40% reduction in heart attacks, esp. in those at intermediate and high risk. Effect greater in women.
|39% reduced all-cause mortality & 65% reduction in CVD mortality
- MI= myocardial infarction (heart attack)
- CS = chondroitin sulfate
- CVD = cardiovascular disease (heart disease)
Chondroitin Sulfate Cautions and Side Effects
All these studies have their limitations, and better clinical trials are needed figure out how well chondroitin sulfate helps heart health. If you’re intrigued and want to try this for yourself, it’s crucial to run this past your doctor because there is evidence that chondroitin sulfate is a blood thinner, which could have implications if you’re taking blood thinners.
Additionally, I personally am still uncertain about the idea of men using this supplement because of highly preliminary research that appears to show it may be linked to prostate cancer. When in doubt, always consult with your doctor.