Naturoceutical Agents in the Management of Cardiovascular Disease

Abstract

During the past decade, complementary and alternative medicine (CAM) has grown in attractiveness to the Western public, and in recognition by practitioners of traditional medicine. The incorporation of effective CAM therapies into traditional practice is termed 'integrative medicine'. One form of CAM demonstrating exponential growth through mass public consumerism is the use of naturoceuticals. Naturoceutical (or nutraceutical) agents are defined as mega-dose vitamins, herbal products or other 'natural' supplements purchased and consumed with premeditated 'pharmaceutical' intention to treat or prevent an illness or disease. Dietary supplements per se, are intended to supply adequate nutrients that may be lacking from the diet, and are thus, generally health promoting. A regulatory paradox exists since naturoceuticals are classified as dietary supplements although many possess measurable pharmacologic activity. In reference to cardiovascular disorders, consumers use naturoceuticals for three distinctly recognizable purposes. These are the primary and secondary prevention of cardiovascular diseases and the treatment of diagnosed disorders such as heart failure, angina pectoris or arrhythmia. The evidence base supporting the routine use of naturoceutical products for these intentions is sparse, although the likelihood of harm from their consumption is low for an average, healthy adult. Evidence of significant harm (including fatalities) has been observed when certain herbal products are used in excess or in combination with, other herbs or prescription drugs. The safety of use at the extremes of age, or by persons with cardiac, renal or hepatic impairment is also a concern. Healthcare professionals should routinely document patient naturoceutical use, be alert for and report suspected adverse effects. Until well-designed clinical trials determine the proper indication(s), dose safety profile and risk/benefit ratio for these products, their routine use should not be advocated. Thus, the role of naturoceutical agents in the integrative management of cardiovascular disorders remains undefined.

Uninformed Complementary and Alternative Supplement Use: A Risky Behavior for Cardiovascular Patients

“…This highlights the importance of health care providers, and cardiologists in particular, learning more about CAS. The potential risks of severe interaction between CAS and prescribed medication for cardiovascular patients highlights the need for further research on concurrent or integrated use of CAM and conventional medicine (Hermann, 2002). Another review of CAS use in cardiovascular disease concluded that the potential for interaction between commonly used supplements and commonly prescribed medications used in cardiovascular disease is great and advised that more research be conducted (Miller et al, 2004).…”

“…In a study specifically examining CAM use by cardiovascular patients, one survey showed that 40% of 107 cardiovascular disease patients were CAS users (Wood et al, 2003). An in-depth review of the use of naturoceutical agents (CAS) in the management of cardiovascular disease in 2002 suggested that the lack of clinical studies and scientific data leaves a gap in health care providers' knowledge of the effects of CAS use (Hermann, 2002).…”

“…Several articles addressed the possibility of negative interactions between common cardiovascular medications and CAS (Chagan, Ioselovich, Asherova, & Cheng, 2002;Hermann, 2002; U.S. GAO, 2001;Wood et al, 2003;Zick et al, 2005). However, only one article, a literature review, addressed the issue that several CAS with properties that could promote cardiovascular health might also present the possibility of negative drug interactions (Miller, Liebowitz, & Newby, 2004).…”

Treatment with low-dose resveratrol reverses cardiac impairment in obese prone but not in obese resistant rats

“…Therefore, it is critical to explore newer therapies to prevent the development of heart failure associated with obesity. One such avenue may be the use of foods or food-derived compounds which have authenticated medical benefits and fewer complications [13,14].…”

Olea europaea leaf extract exerts L-type Ca2+ channel antagonistic effects

“…In history plants had been the most important source for remedies and plant-derived drugs gained in importance in the treatment of cardiovascular diseases, e.g., digitalis and digitoxin derived from the foxglove or amiodarone derived from amni visnaga. In recent years there was not only a rise in public interest in naturoceuticals, but also clinical and pharmaceutical researchers rediscovered traditionally used phytotherapy as a source for new therapeutical approaches (Hermann, 2002;Gilani and Rahman, 2005).…”