Heart failure improvement from a supplement containing copper

Witte et al.¹ improved ventricular function and quality of life in septuagenarian patients with chronic heart failure and ischaemic heart disease by supplementation with multiple micronutrients.The authors suggested that their regimen may provide relief from multiple deficiencies, reduction in oxidative stress, and be a first step towards identifying elements that can be eliminated from the supplement without loss of benefit. Copper is an antioxidant nutrient for cardiovascular health² that may have contributed to their success.

The Western diet is often low in copper,³ according to the pooled data from several articles on more than 900 diets chemically analysed. About 62 and 36% of diets of 80 randomly selected adults in Baltimore⁴ were below the recommended dietary allowance and the estimated average requirement for adults, respectively, 0.9 and 0.7 mg daily.⁵

Copper deficiency is the only nutritional insult that elevates cholesterol, blood pressure, homocysteine, and uric acid, has adverse effects on electrocardiograms and arteries, impairs glucose tolerance, and promotes thrombosis and oxidative damage. More than 80 anatomical, chemical, and physiological similarities between animals deficient in copper and people with ischaemic heart disease have been identified.^6,7 Copper deficiency in animals can induce cardiac enlargement,⁸ pleural effusion,⁹ and heart failure¹⁰ that are reversible with copper supplementation.

Dietary supplements including copper in this context may be inexpensive therapy rather than expensive placebos. The small size of this trial reveals that a follow-up trial can be relatively inexpensive and need not involve hundreds or thousands of people common in heart disease research. Perhaps, a trial with two to three times as much copper and a decrease in vitamins to nearer international recommended intakes will produce benefit in a shorter time.