Do not place alternative therapy above traditional medicine
“It is essential for us to educate our patients about potential interactions with heart failure medications“said the moderator of the session Biykem Bozkurt, MDan advanced heart failure and heart transplantation cardiologist and professor of medicine at Baylor College of Medicine in Houston. Dr. Bozkurt pointed out that standard therapies today have a crucial impact on the survival of people with heart failure, and that it is a myth that “widely marketed” herbal or alternative therapies should can now be used in place of standard therapies, which are proven to improve the cardiovascular system. deaths and hospitalizations for heart failure.
Other research presented at the AHA meeting supported this hypothesis. A Cleveland Clinic essay published in the Journal of the American College of Cardiology showed that six dietary supplements commonly used and marketed to improve heart health did not decrease LDL cholesterol compared to a low-dose cholesterol-lowering medication (also called statin) or a placebo. The six supplements studied included fish oil, garliccinnamon, turmericplant sterols and red yeast rice.
Read product labels to ensure safe medication use
Some alternative medicines may do more harm than good, panelist says Prateeti Khazanie, MD, specializing in advanced heart failure and transplant cardiology at the UCHealth Heart Failure Clinic at the Anschutz Medical Campus in Colorado. Dr. Khazanie shared the story of a patient who drank herbal tea that contained a lot of licorice root. Too much licorice can reduce the potassium levels and disrupt normal heart function.
“He was probably drinking 5 to 10 cups of this tea a day and his blood pressure was incredibly high,” Khazanie said. “But we were able to take him off the licorice root tea and found that his blood pressure had gone down and he didn’t need as much medication.”
This is why it is important to read product labels. She added that the upcoming AHA guidelines will highlight several other products – depending on the dose and medications taken – that can be potentially harmful, such as grapefruit juice, gingko, bitter orange, blue cohosh and Vitamin E supplements.
Patient-doctor communication is essential
For Khazanie, healthcare professionals should know what alternative products patients can take so they can better advise them and work with them as partners on their health.
However, figuring out how to talk to patients about alternative medicine can be difficult, Khazanie noted. “Some complementary and alternative medications come in the form of tea or other supplements that they take and they don’t really think of them as medicine,” she said. On top of that, some patients want to feel empowered by their decision to take something natural rather than “unnatural.” So Khazanie says health care providers need to learn how to communicate in a way that doesn’t underestimate a patient’s opinion.
Some alternatives may offer certain advantages
Not all alternative medicine is “bad” for your heart. Panelist Barry Bleske, Doctor of Pharmacyprofessor and chair of the Department of Pharmacy Practice and Administrative Sciences at the University of New Mexico Health Sciences in Albuquerque, noted that fish oil is recommended as a potential complementary therapy to reduce cardiovascular deaths and hospitalizations in people suffering from heart failure with reduced ejection fraction. (when the left ventricle muscle does not pump enough oxygen-rich blood to the body).
He also noted that some studies have shown CoQ10 (coenzyme Q10) supplements and Vitamin D as potentially beneficial, but research has produced mixed results.
“Some of these alternative treatments seem safe: there are no really significant drug interactions,” Dr. Bleske said. “So if the patient takes it, it probably won’t interact with their heart failure medication and could possibly help them in some ways.” I have patients who have taken coenzyme Q and say it is the best thing they have ever taken.
Mind-body practice can be a powerful tool
Bleske also noted that mind-body practices such as yoga and tai chi fall into the category of safe practices that can improve physical health and mental attitude, thus contributing positively to medical treatment that a patient can receive. Another study presented at AHA Sessions (which has not been published in a peer-reviewed journal) showed that mindfulness behavior, teaching individuals to develop a healthy relationship with their diet, exercise, and medication adherence, could lead to a significant drop in blood pressure.
In some cases, a “natural” product may provide no real benefit but produce a placebo effect in which patients improve simply because they believe the product works. “The mind is a powerful thing,” Bleske said. “If people believe that something works and it improves their lives, that all contributes to making it a positive therapy. »
Since many of these supplements and herbal remedies are sold in pharmacies, pharmacists William Baker, Doctor of Pharmacypanelist and associate professor of pharmacy practice at the University of Connecticut at Storrs, says pharmacists can help educate consumers about these products.
“Pharmacists may be more readily available than a doctor and they may be able to give expert advice on the suitability of a product for a patient,” says Dr. Baker. “I worked in a retail pharmacy and people often asked my opinion. Many people just assume that a supplement will work because it’s sold in stores, but I might advise them if I’m not sure if the product is going to be beneficial or if it might be harmful.
