The growing number of Americans who are taking traditional herbal medications for heart problems are unaware of the dangers those treatments pose, a new report says.

“They may be safe,” said Dr. Arshad Jahangir, a consultant cardiologist at the Mayo Clinic in Arizona, and author of a report in the Feb. 9 issue of the Journal of the American College of Cardiology. “But in the United States, where patients often take multiple medications, there is a potential for harm.”

While up-to-date statistics aren’t available, it appears that more than 15 million Americans are using herbal remedies and the number is growing, Jahangir said.

“Consumers of these products think they are not getting proper attention from their physicians,” he said. “The typical hands-on communication between physician and patient is getting compromised, and they are seeking that type of relationship.”

Popular herbal remedies such as St. John’s wort “have been used traditionally in populations where there are no other medications to use,” Jahangir said. But now multiple medications are common for older people, so “anyone taking herbal products needs to pay attention to the advice of their medical providers, and they often don’t ask for that advice,” he said.

Herbal medications can affect the activity of prescription drugs, dampening or enhancing their effects, Jahangir said. For example, St. John’s wort, which is used for a number of conditions, including depression and sleep disturbances, has its major effect on the liver, which is involved in the metabolism of many drugs, especially those for heart disease, he said.

“If you take it on top of these medications, their activity will be reduced — blood pressure medications, rhythm-controlling medications,” Jahangir said. “Most important, it can have an effect for transplant patients, since it is immunosuppressive.”

Other herbs can also be problematic.

Ginkgo biloba, which is supposed to sharpen the mind, increases bleeding risk in those taking the blood-thinner warfarin or aspirin, while garlic, which is believed to boost the immune system, can increase the chances of bleeding among those taking warfarin, the researchers noted.

Even grapefruit juice, recommended as an aid in weight-loss programs, has potential dangers, he noted. It interferes with enzymes that break down drugs in the digestive system, including the statins used to lower cholesterol levels and amiodarone (Cordarone), used to treat and prevent abnormal heart rhythms, Jahangir said.

“Anyone taking alternative medical and herbal products needs to bring it to the attention of their medical providers,” Jahangir said. “Often they don’t, and physicians don’t actively seek that information.”

There is no formal count of Americans taking such medications, said Dr. Wallace Sampson, clinical professor emeritus of medicine at Stanford University, and founder and editor emeritus of the Scientific Review of Alternative Medicine, a decided skeptic on the issue. The most-cited data come from a survey whose results were published in 1993. The best current estimate is that up to 30 percent of the U.S. population turn to herbal remedies and similar unapproved medications, Sampson noted.

There are periodic reports about the potential dangers of such remedies, Sampson added. “There are quite a number of them in the medical literature, targeted to different specialties,” he said. “Cardiac ones are quite high on the list, also drugs that affect the immune system.”

Most controlled studies of alternative medications have not shown benefit, “but when you do enough studies you get a few positive results and that keeps the field alive,” Sampson said.

Negative results haven’t killed the hope that herbal medications can help, he said: “It’s a free country, and all you can do is educate and hope people learn.”

Technorati Tags: blood pressure medications, herbal medications, Herbal remedies, potential dangers of herbal remedies

read comments (0)

Taking ginkgo biloba, St. John’s wort and other widely used herbal supplements may be risky for people on heart disease medication, especially the elderly, according to a medical review released on Monday.

Some herbal remedies may increase the potency of prescription drugs for heart disease or make them less effective, a team of experts concluded.

Mixing herbs and drugs also could cause serious heart rhythm problems and bleeding, according to the review published in the Journal of the American College of Cardiology.

Use of herbal supplements among elderly patients is especially concerning because they typically have more than one disease, take multiple medications and already are at greater risk of bleeding, the report said.

Previous studies have sounded alarms about use of herbal supplements which are not regulated like traditional medicines. This review examined how supplements and cardiovascular drugs may interact.

“We can see the effect of some of these herb-drug interactions — some of which can be life-threatening — on tests for blood clotting, liver enzymes and, with some medications, on electrocardiogram,” Dr. Arshad Jahangir of the Mayo Clinic in Arizona said in a telephone interview.

Many patients fail to disclose their use of herbal remedies so healthcare providers should be more probing, Jahangir said in a telephone interview.

“We need to be actively ask about alternative or complementary medicine patients may be seeking on their own to assess these potential interactions or side affects,” said Jahangir, a cardiologist.

“They don’t even consider that herbs could have a negative effect,” he said. “Their impression is that ‘natural’ is safe,”

Jahangir said doctors and patients need to know about the potential harm herbal products can have, citing reports that more than 15 million Americans use herbal remedies.

The Council for Responsible Nutrition, an industry trade association, said the article represents a biased, poorly written and contrived attack on herbal supplements.

“Many herbal supplements offer healthful benefits and fiber, garlic, and Hawthorne provide heart health benefits, and the potential risk for a drug interaction can be eliminated by speaking openly with your doctor,” the group’s vice president, Douglas MacKay, said in a statement.

“If consumers are buying from reputable companies, they can feel confident in the quality and safety of these products,” MacKay added.

Ginkgo biloba is taken to sharpen cognitive skills and St. John’s wort is used to fight depression and sleep disorders.

The Nutritional Business Journal, an industry publication, estimates U.S. consumer sales of supplements climbed more than 6 percent in 2008 to reach $25.2 billion.

(Editing by Maggie Fox and Bill Trott)

Technorati Tags: drug interaction, healthcare, heart drugs, Herbal remedies, Mixing herbs and drugs

read comments (0)