Commonly used drugs may worsen heart failure, says American Heart Association

1st August 2016

Commonly used medications and nutritional supplements may cause or worsen heart failure, says the American Heart Association (AHA) in its first scientific statement on the issue.

The statement provides comprehensive information about drugs and “natural” remedies that may have serious unintended consequences for people with heart failure.

Heart failure patients, particularly older ones, may have five or more separate medical conditions and take seven or more prescription medications daily, often prescribed by different healthcare providers.

“Since many of the drugs heart failure patients are taking are prescribed for conditions such as cancer, neurological conditions or infections, it is crucial but difficult for healthcare providers to reconcile whether a medication is interacting with heart failure drugs or making heart failure worse,” said Professor Robert Page, chair of the writing committee for the new statement published in the AHA journal Circulation.

He said healthcare providers should talk to heart failure patients during every visit about all prescription and over-the-counter medications they’re taking, as well as nutritional supplements and herbs.

Non-steroidal anti-inflammatory drugs, including commonly used painkillers such as ibuprofen, can trigger or worsen heart failure by causing sodium and fluid retention and making diuretic medications less effective.

Over-the-counter heartburn medications and cold remedies may also contain significant amounts of sodium, which is usually restricted in patients with heart failure.

“Patients have been taught to read food labels for sodium content, but they also need to read labels on over-the-counter medications and natural supplements,” said Professor Page, from University of Colorado schools of pharmacy and medicine.

Many supplements in complementary and alternative medicines can be dangerous for people with heart failure, including products containing ephedra (which raises blood pressure) and others that interfere with one or more commonly used heart failure medication, including St John’s wort, ginseng, hawthorn, danshen and green tea.

The statement also notes that nutritional supplements, herbs and other “natural” remedies should not be used to treat or manage heart failure symptoms.

“Keep a list of all your medications and doses to show at every medical visit, and inform a healthcare provider treating your heart failure before stopping or starting any medication,” Professor Page said.

See Beware herbal medicine and over-the-counter pills, featured in Cardiomyopathy UK's My Life magazine.