Alternative therapies for HF could worsen symptoms, interact with prescribed medications

Complementary and alternative therapies because IC could potentially worsen symptoms and interact with prescribed medications, and clinicians and patients should be aware of the lack of federal regulation for such therapies, the researchers wrote.

In a new scientific statement from the American Heart Association, researchers noted that healthcare professionals should ask patients about the use of complementary and alternative therapies during clinic visits, provide advice on their risks and benefits and determine whether it is possible to safely integrate these therapies into the care plan. According to the statement, it is estimated that more than 30% of people with IC in the United States use complementary and alternative medicine.

“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 drugs,” Sheryl L. Chow, PharmD, FAHA, associate professor of pharmaceutical practice at Western University of Health Sciences, associate clinical professor of medicine at the University of California, Irvine, and chair of the scientific statement writing group, said in a press release. “People rarely tell their healthcare team about their use of supplements or other alternative therapies unless specifically requested, and they may not be aware of the possibility of interactions with prescription drugs or other side effects. on their health. The combination of unregulated and easily accessible therapies and the lack of disclosure to patients creates the potential for significant harm.

Agents with possible advantage

The use of several complementary and alternative medicine agents has been examined in observational studies and clinical trials in people with HF. In some reports, the use of specific agents has been associated with an improvement in symptoms of HF, functional capacity, quality of lifeand major adverse CV events, according to the researchers.

“Although complementary and alternative medicine agents should not supplant or replace standard medical treatment directed by guidelines, IC clinicians should be familiar with the clinical effects of complementary and alternative medicine agents in patients with ‘IC, as these agents may be used in the treatment of IC and non-HF conditions, and patients may prefer to take these agents regardless of the advice of a healthcare professional,’ the researchers wrote. .

Researchers have highlighted some alternative therapies that may provide benefits for people with IC, including omega-3 polyunsaturated fatty acids, which show the strongest evidence of clinical benefit in people with IC. and can be used safely, in moderation, in consultation with a healthcare team. .

Additionally, yoga and tai chi, in addition to standard treatment, can help improve exercise tolerance and quality of life and lower blood pressure, the authors wrote.

Alternative therapies to avoid

The statement noted that some therapies have been shown to have harmful effects, such as interactions with common HF medications and changes in heart contraction, blood pressure, electrolytes and fluid levels. These include the blue cluster herbal supplement, which could cause tachycardia, high BP, chest pain and may increase blood sugar, and could potentially decrease the effect of medications taken to treat high blood pressure and Type 2 diabetes.

Thrush can be harmful when taken with digoxin by causing hypokalemia, and may be associated with arrhythmia, confusion and fatigue, the researchers wrote.

According to the researchers, other treatments or supplements have been shown to be ineffective for HF symptoms or have mixed results, including routine supplementation with thiamine, vitamin E, coenzyme Q10, and hawthorn.

“Overall, more high-quality research and well-powered randomized controlled trials are needed to better understand the risks and benefits of complementary and alternative medicine therapies for people with heart failure,” Chow said in the press release. “This scientific statement provides essential information for healthcare professionals who treat people with heart failure and can be used as a resource for consumers about the potential benefits and harms associated with complementary and alternative medicine products.”