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STATE-OF-THE-ART PAPER

Use of Herbal Products and Potential Interactions in Patients With Cardiovascular Diseases

Ara Tachjian, MD^_*, Viqar Maria, MBBS^_* and Arshad Jahangir, MD^,_*

^_* Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona

Manuscript received June 11, 2008; accepted July 30, 2009.

^_* Reprint requests and correspondence: Dr. Arshad Jahangir, Division of Cardiovascular Diseases, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, Arizona 85259 (Email: jahangir.arshad{at}mayo.edu).

More than 15 million people in the U.S. consume herbal remedies or high-dose vitamins. The number of visits to providers of complementary and alternative medicine exceeds those to primary care physicians, for annual out-of-pocket costs of $30 billion. Use of herbal products forms the bulk of treatments, particularly by elderly people who also consume multiple prescription medications for comorbid conditions, which increases the risk of adverse herb-drug-disease interactions. Despite the paucity of scientific evidence supporting the safety or efficacy of herbal products, their widespread promotion in the popular media and the unsubstantiated health care claims about their efficacy drive consumer demand. In this review, we highlight commonly used herbs and their interactions with cardiovascular drugs. We also discuss health-related issues of herbal products and suggest ways to improve their safety to better protect the public from untoward effects.

Key Words: cardiovascular agents • complementary therapies • drug approval • herbal medicine • herb–drug interaction

Abbreviations and Acronyms   BPH = benign prostatic hypertrophy   CAM = complementary and alternative medicine   CHF = congestive heart failure   FDA = U.S. Food and Drug Administration

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