The Advantages of Alternative Heart Failure Treatments—and Their Serious Risks

 Current research on employing complementary and alternative therapies for the treatment of heart failure is enumerated in a recent scientific statement from the American Heart Association.

The possible advantages and disadvantages of utilising complementary and alternative medicines (CAM) for treating heart failure symptoms are discussed in a new American Heart Association scientific statement that was just published in the journal Circulation.

According to the statement, nearly 30% of Americans who have heart failure use CAMs. In order to ensure patient safety, the statement underlines the value of consulting the medical staff when using CAMs. According to the American Heart Association, heart failure, which happens when the heart is not functioning normally, affects 6 million Americans aged 20 and older.

The definition of complementary and alternative medicine therapy in the statement is given as medical procedures, treatments, and regimens that do not adhere to accepted, evidence-based practise standards. Without a prescription or medical advice, pharmacies, health food stores, and online vendors provide complementary and alternative items.

"These products are not federally regulated, and they are available to consumers without having to demonstrate efficacy or safety to meet the same standards as prescription medications," said Sheryl L. Chow, Pharm.D., FAHA, chair of the scientific statement writing committee and associate clinical professor of medicine at the University of California, Davis. Chow is an associate professor of pharmacy practise and administration at Western University of Health Sciences in Pomona, California."Unless specifically requested, people rarely disclose to their medical team that they use supplements or other alternative therapies, and they may not be aware of any potential interactions with prescription medications or other consequences on their health. There is a high risk of injury when uncontrolled, widely available medicines are combined with a lack of patient disclosure.

Heart failure patients may employ complementary and alternative therapy, such as yoga and tai chi, or nutritional supplements including Co-Q10, vitamin D, Ginkgo, grapefruit juice, devil's claw, alcohol, aloe vera, and caffeine. Research on CAM among those with heart failure that was published before November 2021 was reviewed by the statement drafting group.

The statement drafting group recommends healthcare practitioners to discuss potential drug interactions, benefits, and side effects of CAM with patients with heart failure regarding their use of complementary and alternative therapies at each visit. Additionally, they recommend adding pharmacists to the multidisciplinary healthcare team to offer advice regarding the use of complementary and alternative medicines for patients with heart failure.

People with heart failure may benefit from complementary therapy like:

• The strongest evidence among complementary and alternative therapies for therapeutic benefit in patients with heart failure is found for omega-3 polyunsaturated fatty acids (PUFA, fish oil), which can be taken safely, moderately, and in conjunction with a patient's medical team. Omega-3 PUFA are linked to a decreased risk of heart failure as well as improved heart function in people who already have the condition. Doses of 4 grammes or higher should be avoided because there seems to be a dose-related increase in atrial fibrillation (an abnormal heart rhythm).
• In addition to regular medical care, yoga and tai chi may help increase exercise tolerance, enhance quality of life, and lower blood pressure.

Meanwhile, it was discovered that several treatments had negative side effects, including interactions with popular heart failure drugs and alterations in blood pressure, heart rate, electrolytes, and fluid levels:

• Vitamin D supplementation hasn't demonstrated any benefits and may even be hazardous when combined with heart failure drugs like digoxin, calcium channel blockers, and diuretics, even though low blood levels of vitamin D are linked to worse heart failure outcomes.
• The herbal supplement blue cohosh, which is derived from the root of a flowering plant found in hardwood woods, may result in tachycardia, a condition where the heart beats quickly, high blood pressure, chest pain, and maybe elevated blood sugar levels. Additionally, it might make drugs used to treat Type 2 diabetes and high blood pressure less effective.The herbal supplement blue cohosh, which is derived from the root of a flowering plant found in hardwood woods, may result in tachycardia, a condition where the heart beats quickly, high blood pressure, chest pain, and maybe elevated blood sugar levels. Additionally, it might make drugs used to treat Type 2 diabetes and high blood pressure less effective.
• Because it contains active compounds that are similar to but less effective than the heart failure medication digoxin, lily of the valley has long been used to treat mild heart failure. The root, stems, and bloom of this plant are used as supplements. When used with digoxin, it may be hazardous since it might result in hypokalemia, a condition where potassium levels are abnormally low. The effects of lily of the valley include fatigue, disorientation, and an irregular heartbeat.

Other treatments have been demonstrated to be ineffective based on recent research or have conflicting results, emphasising the significance of patients talking with a healthcare provider about any non-prescribed therapy:

• It hasn't been demonstrated that routine thiamine supplementation treats heart failure effectively unless a person is deficient in this particular nutrient.
• Alcohol research varies; some studies indicate that consuming low-to-moderate amounts (one to two drinks per day) may help prevent heart failure, while others indicate that excessive alcohol consumption or habitual drinking are toxic to the heart muscle and may have a role in the development of heart failure.
• There are conflicting results about vitamin E. Reduced risk of heart failure with intact ejection fraction, a condition in which the left ventricle is unable to adequately fill with blood in between heartbeats, may be one advantage. It has, however, also been linked to a higher incidence of hospitalisation in patients with heart failure.
• Co-Q10, also known as coenzyme Q10, is an antioxidant that is frequently consumed as a dietary supplement and can be found in trace levels in organ meats, fatty salmon, and soybean oil. It may aid with heart failure class, symptoms, and quality of life, according to small trials; nevertheless, it may interact with blood pressure medications and anti-clotting drugs. For a better understanding of its effects, larger trials are required.
• Studies have revealed that the flowering shrub hawthorn improves fatigue-related symptoms of heart failure and increases exercise tolerance. However, there is a chance that it could make heart failure worse, and there is conflicting evidence regarding whether it interacts with digoxin.

To better understand the risks and benefits of complementary and alternative medicine therapy for persons with heart failure, more high-quality research and adequately powered randomised controlled trials are required, according to Chow. This scientific statement "provides crucial knowledge to health care professionals who treat heart failure patients and may be utilised as a resource for consumers regarding the possible benefit and danger connected with complementary and alternative medicine items."

Reference: "Complementary and Alternative Medicines in the Management of Heart Failure: A Scientific Statement From the American Heart Association" by Sheryl L. Chow, Biykem Bozkurt, William L. Baker, Barry E. Bleske, Khadijah Breathett, Gregg C. Fonarow, Barry Greenberg, Prateeti Khazanie, Jacinthe Leclerc, Alanna A. Morris, Nosheen Reza, and C

The volunteer writing team created this scientific statement on behalf of the Council on Clinical Cardiology's Clinical Pharmacology Committee, Heart Failure and Transplantation Committee, Council on Epidemiology and Prevention, and Council on Cardiovascular and Stroke Nursing. Scientific findings from the American Heart Association assist people make well-informed healthcare decisions and raise awareness of the challenges surrounding cardiovascular illnesses and stroke. Scientific statements describe what is already known about a subject and what still needs to be studied. Although they provide information for the creation of guidelines, scientific statements do not offer treatment suggestions. The official clinical practise recommendations of the American Heart Association are provided by its guidelines.

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