From the Guidelines
Eating flaxseed is not recommended as a primary strategy for secondary coronary artery disease (CAD) prevention due to insufficient evidence supporting its use in reducing the risk of acute CVD events in patients with chronic coronary disease. According to the 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease 1, nonprescription nutrition dietary supplements, including flaxseed, have insufficient evidence to support their use in reducing the risk of acute CVD events in patients with CCD.
While flaxseed may contain alpha-linolenic acid, lignans, and soluble fiber, which could potentially provide cardiovascular benefits, the current evidence does not support its use as a primary recommendation for secondary CAD prevention. Established secondary prevention strategies such as statins, antiplatelet therapy, blood pressure management, smoking cessation, regular exercise, and a heart-healthy diet should remain the primary focus.
Some studies suggest that a healthy dietary pattern, including whole grains and fiber, may improve management of CVD risk factors and target pathophysiologic mechanisms contributing to acute CVD events 1. However, the evidence for flaxseed specifically is limited, and its use should not replace established therapies. If considering flaxseed as a complementary approach, it is essential to choose ground rather than whole seeds for better nutrient absorption, store it in the refrigerator to prevent rancidity, and increase water intake to accommodate the additional fiber.
Key considerations for secondary CAD prevention include:
- Focusing on established therapies such as statins, antiplatelet therapy, and blood pressure management
- Promoting a heart-healthy diet with whole grains, fiber, and minimal saturated fat, sodium, refined carbohydrates, and sweetened beverages
- Encouraging regular exercise and smoking cessation
- Monitoring and managing cardiometabolic health, including weight loss goals for overweight and obese patients.
From the Research
Secondary CAD Prevention with Flaxseed
- The consumption of flaxseed has been associated with various cardiovascular benefits, including anti-hypertensive, anti-atherogenic, and anti-inflammatory effects 2, 3, 4.
- Flaxseed is a rich source of alpha-linolenic acid (ALA), a type of omega-3 fatty acid that has been shown to reduce the risk of coronary heart disease (CHD) 5, 6.
- Studies have suggested that dietary flaxseed may help improve lipid profiles, lower blood pressure, and reduce the risk of CHD events 5, 3, 6.
- The bioactive components of flaxseed, including ALA, lignans, and fiber, have been implicated in its beneficial cardiovascular effects 2, 4, 6.
- While the evidence is promising, more research is needed to fully understand the effects of flaxseed on cardiovascular disease and to determine the optimal form and dosage of flaxseed for secondary CAD prevention 3, 4.