Doctors should ask heart patients if they take supplements to manage heart failure

Doctors should ask patients with heart failure whether they use supplements, specific diets, or other types of complementary and alternative medicine to help manage potential benefits and risks, the American Heart Association said in a scientific statement released Thursday.

Research shows that about one-third of people with heart failure use complementary and alternative medicine, a category that refers to non-traditional treatments used alongside or instead of prescribed drugs, to manage their conditions. However, most people don’t bring them up with their doctor, experts said.

“Many patients do not consistently report the use of alternative therapies to healthcare providers, and healthcare professionals do not routinely ask questions or monitor dietary supplements,” said Sheryl Chow, chair of the committee. AHA scientific statement writer and associate professor at the Western University of Health Sciences in California, told ABC News.

This is a concern because research shows that some alternative treatments can be risky for people with heart failure and can interact with prescribed medications. If providers don’t know what patients are using, they can’t respond to potential risks or safety issues, Chow said.

The AHA reviewed published data from studies on the effectiveness and safety of commonly used complementary and alternative medicines in patients with heart failure. His scientific statement highlighted which may be beneficial, may be harmful, and have mixed evidence. Fish oil has the strongest benefits and may help the heart pump better in people with heart failure, for example. Yoga and tai chi could help blood pressure, the study showed.

Other supplements may be riskier, researchers say. For example, high doses of vitamin D might interact with some common heart failure medications, such as calcium channel blockers. Some research shows that vitamin E is associated with an increased risk of hospitalization for heart failure.

PHOTO: A woman holds her heart in a doctor's office in an undated file photo.

Patients, however, tend to think that alternative medicine can’t be harmful, Rich Krasuski, a cardiologist at Duke University School of Medicine, who has conducted research with heart patients on alternative medicine.

“I think patients view natural or natural substances as somehow safer for them than taking a pharmacological agent,” he told ABC News.

Providers who work with patients with heart failure also may not realize that these patients are likely to use complementary or alternative therapies, Krasuski said. Doctors know that people with back pain or cancer tend to seek out alternatives, he says.

“In heart failure, we don’t often think about that,” he said.

Chow hopes the AHA’s statement will help fill the gap in complementary and alternative medicine awareness among heart failure patients, and give providers and patients an easy reference to turn to around the issue. .

“Patients don’t report when they use the therapies, but even if they do, what do providers do with that information?” said Chow. “In general, I feel like medical professionals don’t have great resources for their patients.”

That’s why Krasuski said he was happy to see this type of statement from the AHA. Rather than digging through research to find information about a specific supplement a patient might be taking, they can refer to this document.

It would also be a good starting point for conversations about alternative medicine with patients, he said. The conversations are not necessarily aimed at discouraging or ruling out alternative treatments. As long as a supplement or food group doesn’t affect proven medications, Krasuski said he has no problem with the patient using them.

“It’s important to recognize that these are all approaches patients are taking,” he said. “I think in order to improve their health, it’s important that we address not only traditional but also non-traditional types of therapy.”

Nicole Wetsman is Associate Producer in ABC News’ Medical Unit. She is based in New York.

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