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Alternative HF therapies may worsen symptoms and interact with prescription medications

 


December 8, 2022

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Disclosure: Chow does not report related financial disclosures. See Scientific Statements for relevant financial disclosures of all other authors.


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Complementary and alternative therapy Because heart failure can exacerbate symptoms and interact with prescribed medications, clinicians and patients should be aware that there is no federal regulation for such treatments, the researchers wrote. ing.

In a new American Heart Association scientific statement, researchers say medical professionals should ask patients about the use of complementary and alternative therapies during clinic visits, provide guidance on risks and benefits, and use such therapies as part of a care plan. . More than 30% of her HF patients in the United States are estimated to use complementary and alternative medicine, according to the statement.



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Complementary and alternative therapies for heart failure can potentially exacerbate symptoms and interact with prescribed medications, and clinicians and patients should be aware that there are no federal regulations for such therapies. .

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“These products are not federally regulated and are available to consumers without the need to demonstrate efficacy and safety to meet the same standards as prescription drugs.” Sheryl L. Chow, PharmD, FAHAassociate professor of pharmaceutical practice at Western College 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 talk to their health care team about the use of alternative therapies for cancer and may be unaware of possible interactions with prescription medications and other health effects. The combination of available treatments and the lack of patient disclosure can do a lot of harm.”

Potential profitable agent

Observational studies and clinical trials in people with heart failure are investigating the use of several complementary and alternative medicines. Some reports have linked the use of certain medications with improvement in her HF symptoms. functional capacity, quality of lifeand, according to researchers, the major adverse CV event.

“Although complementary and alternative medicine agents do not replace standard, guideline-based medical therapy, heart failure clinicians should be familiar with the clinical efficacy of complementary and alternative medicine in heart failure patients. , because these drugs may be used to treat heart failure, and patients may prefer to take these drugs independently of the advice of their health care professionals,” the researchers said. I am writing.

The researchers highlighted several alternative therapies that may benefit people with heart failure, such as omega-3 polyunsaturated fatty acids. Omega-3 polyunsaturated fatty acids have the strongest evidence of clinical benefit in people with heart failure and can be used safely and in moderation in consultation with your healthcare team. .

Additionally, yoga and tai chi, in addition to standard treatments, may help improve exercise tolerance and quality of life and lower blood pressure, the authors write.

Alternative therapies to avoid

The statement found that some treatments have adverse effects, including interactions with common HF medications and changes in heart contraction, blood pressure, electrolytes, and fluid levels. It contains the herbal supplement blue cohosh, which can cause tachycardia, elevated blood pressure, chest pain, and raise blood sugar levels, which may reduce the effectiveness of medications used to treat high blood pressure and type 2 diabetes.

Lily of the valley can cause hypokalemia, which can be harmful when taken with digoxin, and may be associated with arrhythmias, confusion, and fatigue, the researchers wrote.

Other treatments and supplements, such as routine thiamin supplementation, vitamin E, coenzyme Q10, and hawthorn, have been shown to be ineffective or with mixed results for symptoms of heart failure, according to researchers.

“Overall, we need better-quality research and stronger randomized controlled trials to better understand the risks and benefits of complementary and alternative medicine therapies for heart failure patients,” Chow said in a release. This scientific statement provides important information for health professionals treating people with heart failure and may be used as a resource for consumers about the potential benefits and harms associated with complementary and alternative medicine products. I have.”

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