Alternative therapies for heart failure may offer benefits, but some have risks

Using complementary and alternative medicines to manage heart failure symptoms offers some benefits but also risks, according to a new science report from the American Heart Association.

The scientific statement, published Thursday in the AHA journal Circulation, encourages people to disclose their use of such treatments to their health care team to ensure they are using them safely.

"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," writing committee chair Sheryl L. Chow said in a news release. Chow is an associate professor of pharmacy practice and administration at Western University of Health Sciences in Pomona, California, and an associate clinical professor of medicine at the University of California, Irvine.

"People rarely tell their health care team about their use of supplements or other alternative therapies unless specifically asked, and they may not be aware of the possibility of interactions with prescription medicines or other effects on their health," she said. "The combination of unregulated, readily accessible therapies and the lack of patient disclosure creates significant potential for harm."

Approximately 6 million U.S. adults have heart failure, a condition that occurs when the heart doesn't pump as well as it should. More than 30% of them use complementary and alternative medicines, or CAM, according to the new report.

The committee defined CAM as any medical practice, supplement or approach that does not conform to standard, conventional medicine. The types of CAM people with heart failure might use include supplements such as fish oil and vitamin D, or practices such as yoga and tai chi. The report looked at the safety and effectiveness of these treatments, analyzing research published prior to November 2021.

The report found people with heart failure might benefit from some alternative therapies, including omega-3 polyunsaturated fatty acids such as those found in fish oil. Studies have shown an association between consuming omega-3 fatty acids and reduced heart failure risk, as well as improvements in heart-pumping ability in people who already have heart failure.

However, the report also found that high doses (4 grams or more) of omega-3 fatty acids could increase irregular heart rhythms and should be avoided.

Yoga and tai chi, when added to standard medical care, could help people with heart failure increase their tolerance for exercise, improve quality of life and lower their blood pressure, the report found.

Some therapies – such as vitamin D supplements, the herbal supplement blue cohosh, and parts of the plant lily of the valley – were found to have harmful effects, including harmful interactions with heart medications.

There was mixed data on other therapies, such as alcohol. Some research has linked drinking low to moderate amounts (one or two drinks per day) with preventing heart failure, while drinking excessively or habitually has been shown to contribute to heart failure.

The committee concluded people with heart failure should have a conversation with health care professionals about using anything not prescribed by a doctor to ensure patient safety.

"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," Chow said.

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