Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

The clinical significance and costs of herbs and food supplements used by complementary and alternative medicine for the treatment of cardiovascular diseases and hypertension

Subjects

Abstract

Complementary and alternative medicine (CAM) is widely used by people in the United States and other countries for the treatment of health conditions that include hypertension (HTN), cardiovascular disease (CVD), heart failure, hyperlipidemia and other condtions. The visits to CAM practitioners result in significant out-of-pocket expenses, as CAM is not covered by health insurance in the majority of cases. The reasons for this are that the products used are not closely regulated by governmental regulatory agencies and lack scientific evidence about their effectiveness and safety. The people regard these products as being ‘natural’ and, consequently, safe. However, there is evidence that these products can be contaminated and adulterated with other substances and could cause harm to the persons who take them. The responsibility falls on the health professionals, who should become familiar with the various CAM products, inquire their patients whether they taking any of these products and advise them accordingly. This review is based on a recent statement issued by the American Medical for the use of CAM for the treatment of HTN. For its preparation, a Medline search of the English language literature was performed between 2010 and 2014 restricted in the use of CAM for CVD and HTN, and from the 88 abstracts reviewed, 23 pertinent papers were selected. These papers together with collateral literature will be discussed in this review regarding CAM and CAM products on their effectiveness and safety for the treatment of CVD and HTN.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Barnes PM, Bloom B, Nahin RL . Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Rep 2008, 1–23.

  2. Nahin RL, Barnes PM, Stussman BJ, Bloom B . Costs of complememtary and alternative medicine (CAM) and frequency of visits to CAM practitioners. United States, 2007. Natl Health Stat Rep 2009, 1–14.

  3. Kirk J, Dunker KS . Dietary counseling: the ingredient for successfully addressing the use of herbal supplements and probiotics in chronic kidney disease. Adv Chronic Kidney Dis 2014; 21: 377–384.

    Article  Google Scholar 

  4. Glisson JK, Walker LA . How physicians should evaluate dietary supplements. Am J Med 2010; 123: 577–582.

    Article  Google Scholar 

  5. Yeh GY, Davis RB, Phillips RS . Use of complementary therapies in patients with cardiovascular disease. Am J Cardiol 2006; 98: 673–680.

    Article  Google Scholar 

  6. Brook RD, Appel LJ, Rubenfire M, Ogedegbe G, Bisognano JD, Elliott WJ et al. Beyond medications and diet: alternative approaches to lowering blood pressure. A scientific statement from the American Heart Association. Hypertension 2013; 61: 1360–1383.

    Article  CAS  Google Scholar 

  7. Richardson J . What patients expect from complimentary therapy. A qualitative study. Am J Public Health 2004; 94: 1049–1053.

    Article  Google Scholar 

  8. Honda K, Jacobson JS . Use of complementary and alternative medicine among United States adults: The influence of personality, coping strategies, and social support. Prev Med 2005; 40: 46–53.

    Article  Google Scholar 

  9. Bishop FL, Yardley L, Lewith GT . Why consumers maintain complementary and alternative medicine use: a qualitative study. J Alt Compl Med 2010; 16: 175–182.

    Article  Google Scholar 

  10. Mucalo I, Jovanovski E, Rahelic D, Bozikov V, Romic Z, Vuksan V . Effects of American ginseng (Panax quinquafolius L. on arterial stiffness in subjects with type-2 diabetes and concomitant hypertension. J Ethnopharmacol 2013; 150: 148–153.

    Article  CAS  Google Scholar 

  11. Jovanovski E, Bateman EA, Bhardwaj J, Faigrieve C, Mucalo I, Jenkins AL et al. Effect of Rg3-enriched Korean red ginseng (Panax ginseng) on arterial stiffness and blood pressure in healthy individuals: a randomized-controlled trial. J Am Soc Hypertens 2014; 8: 537–541.

    Article  CAS  Google Scholar 

  12. Stavro PM, Woo M, Heim TF, Leiter LA, Vuksan V . North American ginseng extracts have neutral effects on blood pressure in individuals with hypertension. Hypertension 2005; 46: 406–411.

    Article  CAS  Google Scholar 

  13. Stavro PM, Woo M, Leiter LA, Heim TF, Sievenpiper JL, Vuksan V . Long-term intake of North American ginseng has no effect on 24-h blood pressure and renal function. Hypertension 2006; 47: 791–796.

    Article  CAS  Google Scholar 

  14. Tachjian A, Maria V, Jahangir A . Use of herbal products and potential interactions in patients with cardiovascular diseases. J Am Coll Cardiol 2010; 55: 515–525.

    Article  Google Scholar 

  15. Pirotta M, Densley K, Forsdike K, Carter M, Gunn J . St John’s wort use in Australian general practice patients with depressive symptoms: their characteristics and use of other health services. BMC Copml Alt Med 2014; 14: 204.

    Article  Google Scholar 

  16. Stage TB, Pedersen RS, Damkier P, Christensen MM, Feddersen S, Larsen JT et al. Intake of St John’s wort improves the glucose tolerance in healthy subjects that ingest metformin compared to metformin alone. Br J Clin Pharmacol 2014; 79 (2): 298–306.

    Article  Google Scholar 

  17. Zou QZ, Bi RG, Li JM, Feng JB, Yu AM, Chan HP, Zhen MX . Effect of mother wort on blood hyperviscosity. Am J Clin Med 1989; 17: 65–70.

    Article  CAS  Google Scholar 

  18. Solomon PR, Adams F, Silver A, Zimmer J, DeVeaux R . Ginkgo for memory enhancement: a randomized controlled trial. JAMA 2002; 288: 835–840.

    Article  Google Scholar 

  19. Xiong X, Liu W, Yang XC, Feng B, Zhang YQ, Li SJ et al. Ginkgo biloba extract for essential hypertension: a systematic review. Phytomedicine 2014; 15: 1131–1136.

    Article  Google Scholar 

  20. Brinkley TE, Lovato JK, Arnold AM, Furberg CD, Kuller LH, Burke GL et al. Effect of ginkgo biloba on blood pressure and incidence of hypertension in elderly men and women. Am J Hypertens 2010; 23: 528–533.

    Article  Google Scholar 

  21. Ried K, Frank OR, Stocks NP, Faller P, Sullivan T . Effect of garlic on blood pressure: A systematic review and meta-analysis. BMC Cardiovasc Dis 2008; 8: 13.

    Article  Google Scholar 

  22. Rohner A, Ried K, Sobenin IA, Bucher HC, Nordman AJ . A systematic review and meta-analysis on the effects of garlic preparations on blood pressure in individuals with hypertension. Am J Hypertens 2014; 28 (3): 414–423.

    Article  Google Scholar 

  23. Gardner CD, Lawson LD, Block E, Chatterjee LM, Kiazand A, Balise RR et al. Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Ann Intern Med 2007; 167: 346–353.

    Article  CAS  Google Scholar 

  24. Rasmussen CB, Glisson JK, Minor DS . Dietary supplements and hypertension: potential benefits and precautions. J Clin Hyprtens 2012; 14: 467–471.

    Article  CAS  Google Scholar 

  25. Apitz-Castro R, Cabrera S, Cruz MR, Ledesma E, Jain MK . Effects of garlic extract and of three pure components isolated from it on human platelet aggregation, arachidonate metabolism, release reaction and platelet ultrastructure. Thromb Res 1983; 32: 155–169.

    Article  CAS  Google Scholar 

  26. Pitler MH, Guo R, Ernst E . Hawthorn extract for treating chronic heart failure. Cochrane Database Syst Rev 2008, CD005312.

  27. Tauchert M . Efficacy and safety of crataegus oxycantha special extract WS1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. Am Heart J 2002; 143: 910–915.

    Article  CAS  Google Scholar 

  28. Wang J, Xiong X, Feng B . Effect of crataegus usage in cardiovascular disease prevention: an evidence-based approach. Eviv Based Complement Alternat Med 2013; 2013: 149363.

    Google Scholar 

  29. Pagano E, Laudato M, Griffo M, Capasso R . Phytotherapy of benign prostatic hyperplasia. A minireview. Phytother Res 2014; 28: 949–955.

    Article  CAS  Google Scholar 

  30. Bressler R . Herb-drug interactions: interactions between saw palmetto and prescription medications. Geriatrics 2005; 60: 32–34.

    PubMed  Google Scholar 

  31. Cheng TO . Cardiovascular effects of danshen. Int J Cardiol 2007; 121: 9–22.

    Article  Google Scholar 

  32. Kang DG, Yun YG, Ryoo JH, Lee HS . Antihypertensive effect of water extract of danshen on renovascular hypertension through inhibition of the renin angiotensin system. Am J Clin Med 2002; 30: 87–93.

    Article  Google Scholar 

  33. Jia Y, Huang F, Zhang S, Leung SW . Is danshen (Salvia miltiorrhiza) dripping pill more effective than isosorbide dinitrate in treating angina pectoris?. A systematic review of randomized controlled trials. Inter J Cardiol 2012; 157: 330–340.

    Article  Google Scholar 

  34. Omar HR, Komarova I, El-Ghonemi M, Fathy A, Rashad R, Abdelmalak HD et al. Licorice abuse: time to send a warning message. Ther Adv Endocrinol Metab 2012; 3: 125–138.

    Article  Google Scholar 

  35. Robles BJ, Sandoval AR, Dardon JD, Blas CA . Lethal licorice lollies (licorice abuse causing pseudohyperaldosteronism). BMJ Case Rep 2013.

  36. Eriksson JW, Carlberg B, Hillorn V . Life-threatening ventricular tachycardia due to licorice-induced hypokalemia. J Intern Med 1999; 245: 307–310.

    Article  CAS  Google Scholar 

  37. Bisogni V, Rossi GP, Calo LA . Apparent mineraldocorticoid excess syndrome, an often forgotten or unrecognized cause of hypokalemia and hypertension: a case report and appraisal of the pathophysiology. Blood Press 2014; 23: 189–1992.

    Article  Google Scholar 

  38. Singh RB, Wander GS, Rastogi A, Shukla PK, Mittal A, Sharma JP et al. Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in patients with acute myocardial infarction. Cardiovasc Drugs Ther 1998; 12: 347–353.

    Article  CAS  Google Scholar 

  39. Morisco C, Trimarco B, Condorelli M . Effect of coenzyme Q10 therapy in patients with congestive heart failure: a long-term multicenter randomized study. Clin Invest 1993; 71: S134–S136.

    Article  CAS  Google Scholar 

  40. Hofman-Bang C, Rehnqvist N, Swedberg K, Wiklund I, Astrom H . Coenzyme Q10 as an adjunctive in the treatment of congestive heart failure. J Card Fail 1995; 1: 101–107.

    Article  CAS  Google Scholar 

  41. Watson PS, Scalia GM, Galbraith A, Burstow DJ, Bett N, Aroney CN . Lack of effect of coenzyme Q on left ventricular function in patients with congestive heart failure. J Am Coll Cardiol 1999; 33: 1549–1552.

    Article  CAS  Google Scholar 

  42. Marcoff L, Thompson PD . The role of coenzyme Q10 in statin-associated myopathy. J Am Coll Cardiol 2007; 49: 2231–2237.

    Article  CAS  Google Scholar 

  43. Bookstaver DA, Burkhalter NA, Hatzigeorgiou C . Effect of coenzyme Q10 supplementation on statin-induced myalgias. Am J Cardiol 2012; 110: 526–529.

    Article  CAS  Google Scholar 

  44. Hathcock JN, Shao A . Risk assessment of coenzyme Q10 (Ubiquinone). Reg Toxicol Pharmacol 2006; 45: 282–288.

    Article  CAS  Google Scholar 

  45. Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA, Willett WC . Vitamin E consumption and the risk of coronary artery disease in men. N Engl J Med 1993; 328: 1450–1456.

    Article  CAS  Google Scholar 

  46. Stampfer MJ, Hennekens CH, Manson JE, Colditz GA, Rosner B, Willett WC . Vitamin E consumption and the risk for coronary disease in women. N Engl J Med 1993; 328: 1444–1449.

    Article  CAS  Google Scholar 

  47. Stephens NG, Parsons A, Schofield PM, Kelly F, Cheesman K, Mitchinson MJ . Randomized controlled trial of vitamin E in patients with coronary disease: Cambridge Heart AntiOxidant Study (CHAOS). Lancet 1996; 347: 781–786.

    Article  CAS  Google Scholar 

  48. Rapola JM, Virtamo J, Ripatti S, Huttunen JK, Albanes D, Taylor PR et al. Randomized trial of alpha-tocopherol and beta-carotine supplements on incidence of major coronary events in men with previous myocardial infarction. Lancet 1997; 349: 1715–1720.

    Article  CAS  Google Scholar 

  49. Duffy SJ, Gokce N, Holbrook M, Huang A, Frei B, Keaney JF Jr et al. Treatment of hypertension with ascorbic acid. Lancet 1999; 354: 2048–2049.

    Article  CAS  Google Scholar 

  50. Taddei S, Virdis A, Ghiadoni L, Magagna A, Salvetti A . Vitamin C improves endothelium-dependent vasodilation restoring nitric oxide activity in essential hypertension. Circulation 1998; 97: 2222–2229.

    Article  CAS  Google Scholar 

  51. Allard ML, Jeejeebhoy KN, Sole MJ . The management of conditioned nutritional requirements in heart failure. Heart Fail Rev 2006; 11: 75–82.

    Article  CAS  Google Scholar 

  52. Dinicolantonio JJ, Lavie CJ, Niazi AK, O’Keefe JH, Hu T . Effects of thiamine on cardiac function in patients with systolic heart failure: systematic review and meta-analysis of randomized, double-blind, placebo-controlled trials. Ochsner J 2013; 13: 495–499.

    PubMed  PubMed Central  Google Scholar 

  53. Connor SL, Connor WE . Are fish oils beneficial in the prevention and treatment of coronary artery disease? Am J Clin Nutr 1997; 66: 1020S–1031S.

    Article  CAS  Google Scholar 

  54. Harris WS . Omega-3 fatty acids serum lipoproteins: human studies. Am J Clin Nutr 1997; 65: 1645S–1654S.

    Article  CAS  Google Scholar 

  55. Morris MC, Sacks F, Rosner B . Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation 1993; 88: 523–533.

    Article  CAS  Google Scholar 

  56. Von Schacky C, Angerer P, Korhny W, Theisen K, Mudra H . The effect of dietary omega-3 fatty acids on coronary atherosclerosis: A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1999; 130: 554–562.

    Article  CAS  Google Scholar 

  57. Dinicolantonio JJ, Lavie CJ, Fares H, Menezes AR, O’keefe JH . L-carnitine in the secondary prevention of cardiovascular disease: systematic review and meta-analysis. Mayo Clin Proc 2013; 88: 544–551.

    Article  CAS  Google Scholar 

  58. McNamara SH . FDA regulation of ingredients in dietary supplements after the passage of the Dietary Supplement Health and Education Act 1994: an update. Food Drug Law J 1996; 51: 313–318.

    CAS  PubMed  Google Scholar 

  59. Saper RB, Phillips RS, Sehgal A, Khouri N, Davis RB, Panquin J et al. Lead, mercury, and arsenic in US-and Indian-manufacrured ayurvedic medicines sold via the Internet. JAMA 2008; 300: 915–923.

    Article  CAS  Google Scholar 

  60. Fortman SP, Burda BU, Senger CA, Lin JS, Whitlock EP . Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: an updated systematic evidence review for the US Preventive Services Task Force. Ann Intern Med 2013; 159: 824–834.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S G Chrysant.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chrysant, S. The clinical significance and costs of herbs and food supplements used by complementary and alternative medicine for the treatment of cardiovascular diseases and hypertension. J Hum Hypertens 30, 1–6 (2016). https://doi.org/10.1038/jhh.2015.42

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2015.42

This article is cited by

Search

Quick links