Dietary supplements are the second-most commonly used complementary and alternative medicine (CAM) in many chronic conditions such as arthritis, cancer, depression and anxiety. In this systematic review, the prevalence of dietary supplement use by cardiac patients was assessed to identify commonly used supplements. Databases searched included Medline, EMBASE, CINAHL, AMED, Meditext, H&S and IPA. Over 500 articles were retrieved, and 20 studies met the criteria for this review.

Wide variability in the prevalence of dietary supplement use was found in the publications reviewed.  The results indicate that supplement use is common in cardiac patients (26-42%). A range of 18-43% patients reported taking a vitamin/mineral supplement, and 7-21% used herbal supplements. The authors report that the potential for negative interaction in supplement users is high. Supplements such as fish oil, hawthorn, garlic, ginseng, ginkgo, glucosamine and parsley have antiplatelet properties and may interact with prescription antiplatelets or anticoagulants. Supplements such as capsicum and ginseng have been shown to affect blood pressure, and potassium intake may result in adverse outcomes when used in combination with commonly prescribed cardiovascular medications, such as angiotensin-converting enzyme inhibitors, aldosterone-receptor antagonists, or angiotensin-receptor blockers.

Many users indicated that supplements were taken specifically for heart health, and 16-64% of users reported using supplements alongside prescription medications. However, 39-95% of treating physicians were unaware of patients' supplement use. There were no conclusive findings related to the health factors associated with this use, although many commonly used supplements have the potential to interfere with the intended action of prescription medications.

Reference
Bin, Y.S. and Kiat, H. 2011. "Prevalence of Dietary Supplement Use in Patients with Proven or Suspected Cardiovascular Disease." Evidence-Based Complementary and Alternative Medicine. Volume 2011, Article ID 632829.

Keywords: Herbs, botanicals, Vitamins, minerals, cardiovascular disease

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