The University Record, April 15, 2002

Heart patients taking risky alternative meds

By Kara Gavin
Health System Public Relations

Nearly three-quarters of heart patients surveyed in a new U-M study used some kind of alternative medicine approach to help them heal, but dietary supplements chosen by one-third of them could actually interact with their heart medications to raise their risk of further health problems.

Fortunately, the vast majority of those who used alternative medicine techniques told their doctors about it, and also kept up with their prescription medications. The findings, which were presented at the American College of Cardiology Session, concern U-M researchers enough that they have launched a larger study of the issue.

“Heart patients seem to be turning to alternative therapies even more than the general population, even while they stick to mainstream drugs too,” says Eva Kline-Rogers, the U-M nurse practitioner who coordinated the study for the Cardiovascular Center and Complementary and Alternative Medicine Research Center. “But they may not know that some of these substances could pose a hazard when taken with certain heart medications, and if they don’t tell their doctors, the risk may go undetected. We need to encourage patients to be cautious, learn the risks, and share information with their health care providers.”

The study, involving 145 people, started after U-M cardiologists and nurses noticed that some patients came to their appointments with lists of all the prescription drugs, over-the-counter medicines, vitamins, minerals and food supplements that they were taking—wondering which they could cut out to save money or reduce hassle.

The physicians would explain that the prescription medications had years of research evidence behind them to show that they worked, while many alternative treatments, even vitamins, had little or no scientific proof to back them up and could cause side effects.

Previous studies by other teams show that nearly half of all Americans use alternative techniques—everything from multivitamins to “energy healing”—at an annual cost of some $21 billion. Research also suggests that patients could face a risk of bleeding problems, including gastrointestinal bleeding or surgical complications, if they take certain mainstream medications along with certain alternative substances.

Many heart patients have a prescription to take aspirin, Coumadin (warfarin) or Plavix (clopidogrel), to thin their blood, prevent clotting, and reduce their risk of heart attack, stroke or other problems. But dietary supplements like gingko biloba, ginseng, garlic, vitamin E, fish oil or coenzyme Q10 also can cause blood-thinning (anticoagulant) effects, and doses aren’t carefully studied and controlled like those for medicines. The total anti-clotting effect from taking both at once, or other interactions between drugs and supplements, is what worries experts.

Other complementary or alternative medicine (CAM) treatment approaches, from prayer, meditation and yoga to chiropractic and acupuncture sessions, do not pose a specific hazard when combined with conventional heart treatments.

In addition to Kline-Rogers, the study authors include U-M pre-med students Prasanth Lingam and Sumit Sharma, U-M-Pfizer pharmacoeconomics fellow Christopher McBurney, Pharm.D.; U-M CAM Research Center co-director Sara Warber, and cardiologists Rajendra Mehta and Kim Eagle. The study was conducted under the Michigan Cardiovascular Outcomes Research and Reporting Program, or M-CORRP.