The Benefits – and Serious Risks – of Alternative Heart Failure Treatments

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The Benefits – and Serious Risks – of Alternative Heart Failure Treatments

It is important for individuals with heart failure to inform their healthcare team, including pharmacists, about any over-the-counter treatments or other therapies, such as herbal supplements or exercise programs, that they are using in addition to those prescribed by a healthcare professional.

A recent scientific statement from the American Heart Association summarizes the current research on using complementary and alternative therapies for heart failure treatment.

The statement estimates that over 30% of people with heart failure in the United States use CAMs. The statement emphasizes the importance of involving the healthcare team in the use of CAMs for safety reasons. The American Heart Association estimates that 6 million people in the United States ages 20 and older have heart failure, which occurs when the heart is not functioning normally.

The statement defines complementary and alternative medicine therapy as medical practices, supplements, and approaches that do not conform to the standards of conventional, evidence-based practice guidelines. Complementary and alternative products are available without prescriptions or medical guidance at pharmacies, health food stores, and online retailers.

Examples of complementary and alternative therapies that heart failure patients might use include supplements such as Co-Q10, vitamin D, Ginkgo, grapefruit juice, devil’s claw, alcohol, aloe vera, and caffeine, or practices such as yoga and tai-chi. The statement writing group reviewed research published before Nov. 2021 on CAM among people with heart failure.

The statement writing group advises healthcare professionals to ask their patients with heart failure at every healthcare visit about their use of complementary and alternative therapies and talk about potential medication interactions, benefits, and potential side effects of CAM. In addition, they suggest that pharmacists are included in the multidisciplinary healthcare team to provide consultations about the use of complementary and alternative therapies for people with heart failure.

Alternative therapies that may benefit people with heart failure include:

Meanwhile, some therapies were found to have harmful effects, such as interactions with common heart failure medications and changes in heart contraction, blood pressure, electrolytes, and fluid levels:

Other therapies have been shown as ineffective based on current data, or have mixed findings, highlighting the importance of patients having a discussion with a healthcare professional about any non-prescribed treatments:

“Overall, more 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,” said Chow. “This scientific statement provides critical information to health care professionals who treat people with heart failure and may be used as a resource for consumers about the potential benefit and harm associated with complementary and alternative medicine products.”

This scientific statement was prepared by the volunteer writing group on behalf of the American Heart Association’s Clinical Pharmacology Committee and Heart Failure and Transplantation Committee of the Council on Clinical Cardiology; the Council on Epidemiology and Prevention; and the Council on Cardiovascular and Stroke Nursing. American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed healthcare decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.

The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers, and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers, and health insurance providers, and the Association’s overall financial information are available here.