Alternative Treatment Medication

Not very popular with some colleagues, there is definitely an increasing interest in the use of alternative medicine in the treatment of hypertension. On this page the treatment with alternative drugs is discussed. In my personal opinion, adjustments to lifestyle, especially in the area of stress reduction are more important. These are discussed on the page Lifestyle adjustments. Here a listing of chemical compounds in herbs and other, sometimes called more 'natural' products is dicsussed.

DIETARY SUPPLEMENTS AND NATURAL PRODUCTS.


A number of food components have been recommended and endorsed for lowering the risk of cardiovascular disease, including plant sterols and stanol esters, soluble fibers, omega-3 fatty acids, garlic, soy, tea, and moderate alcohol intake. In the USA, the Dietary Supplement Health and Education Act (DSHEA) of 1994 amended the federal Food, Drug, and Cosmetic Act by defining as a dietary supplement any product (other than tobacco) that contains a vitamin, mineral, herb or other botanical, or amino acid and is intended as a supplement to the diet. In the United States today, products intended to supplement the diet may be marketed as dietary supplements providing that their intended use is not to diagnose, treat, cure, or prevent disease (a claim reserved for conventional drugs) and that they not be represented as conventional foods. The U.S. Food and Drug Administration (FDA) has estimated that there were more than 29,000 different dietary supplement products on the market in 2000, with an average of 1,000 new products being added annually. Several countries (e.g., Germany, France, Sweden, Canada, and Australia) have implemented strategies for licensing herbal remedies, including premarket approval. However, premarket approval and licensing are not required in the United States.

There are a number of approved drug substances that originate from plants, such as digoxin, atropine, reserpine, and amiodarone. However, only a few commercial herbal products available in the United States have been tested for cardiovascular indications: hawthorn (heart failure and coronary insufficiency), garlic (atherosclerosis), ginkgo (arterial occlusive disease), and horse chestnut (chronic venous insufficiency). Few U.S. products benefit from rigorous characterization and standardization necessary for clinical study. Herbal products, unlike most conventional drugs, provide a complex mixture of bioactive entities, which may or may not have therapeutic activity. The active ingredient is frequently not known and complete characterization of all the chemical constituents is lacking (Table 47-1). As with conventional drugs, many herbal products are therapeutic at one dose and toxic at another. Concurrent use of herbs may mimic, magnify, or oppose the effect of drugs. The importance of unrecognized interactions between herbs and conventional drugs is particularly relevant in cardiology because many cardiovascular drugs have a narrow therapeutic window (Table 47-2). Table 47-3 lists sources for more information on dietary supplements and herbal medicines.