Sun
19
Apr
Congestive Heart Failure
When the heart sustains injury that weakens its pumping ability, a complicated physiological state called congestive heart failure (CHF) can develop. Fluid builds up in the lungs and lower extremities, the heart enlarges, and many symptoms develop, including severe fatigue, difficulty breathing while lying down, and altered brain function.
Medical treatment for this condition is quite effective and sophisticated and consists of several drugs used in combination.
Medical treatment for this condition is quite effective and sophisticated and consists of several drugs used in combination.
Treatment
Principal Proposed Treatments for Congestive Heart Failure:
CHF is too serious a condition for self-treatment. The supervision of a qualified health-care professional is essential. However, given medical supervision, some of the following treatments may be quite useful. The herb hawthorn appears to be effective for mild CHF, and may be helpful for more severe CHF, as well. However, while standard drugs have been shown to help reduce hospitalizations and mortality associated with CHF, there is no similar evidence for hawthorn.
Also, adding the supplement coenzyme Q10 to standard treatment may improve results. Finally, the supplement vitamin B1 (thiamin) may be helpful for individuals who take loop diuretics (such as furosemide) for CHF.
Hawthorn
At least 9 double-blind, placebo-controlled trials, involving a total of about 500 participants have found hawthorn effective for the treatment of mild to moderate congestive heart failure; in addition, one study of more than 200 individuals found hawthorn helpful in more severe CHF as well.
In the most recent of these studies, 209 individuals with relatively advanced congestive heart failure (technically, New York Heart Association [NYHA] class III) were given either 1800 mg or 900 mg of standardized hawthorn extract or matching placebo. The results after 16 weeks of therapy showed significant improvements in the hawthorn groups as compared to the placebo groups. Benefits in the high-dose hawthorn group included a reduction in subjective symptoms, as well as an increase in exercise capacity. Subjective symptoms improved to about the same extent in the lower-dose hawthorn group, but there was no improvement in exercise capacity.
A comparative study suggests that hawthorn extract (900 mg) is about as effective as a low dose of the conventional drug captopril. However, while captopril and other standard drugs in the same family have been shown to help reduce hospitalizations and mortality associated with CHF, there is no similar evidence for hawthorn.
Like other treatments used for CHF, hawthorn improves the hearts pumping ability. However, it may offer some important advantages over certain conventional drugs used for this condition.
Digoxin, as well as other medications that increase the power of the heart, also make the heart more susceptible to dangerous irregularities of rhythm. In contrast, preliminary evidence indicates that hawthorn may have the unusual property of both strengthening the heart and stabilizing it against arrhythmias. It is thought to do so by lengthening what is called the refractory period. This term refers to the short period following a heartbeat during which the heart cannot beat again. Many irregularities of heart rhythm begin with an early beat. Digoxin shortens the refractory period, making such a premature beat more likely, while hawthorn protects against such potentially dangerous breaks in the hearts even rhythm.
Another advantage of hawthorn involves toxicity. With digoxin, the difference between the proper dosage and the toxic dosage is dangerously small. Hawthorn has an enormous range of safe dosing.
However, keep in mind that digoxin is itself an outdated drug. There are many newer drugs for CHF (such as ACE inhibitors) that are much more effective and have been proven to save lives. Hawthorn has not been shown to provide the same benefit. And it is not clear whether one can safely combine hawthorn with other drugs that affect the heart.
For more information, including dosage and safety issues, see the full hawthorn article.
Coenzyme Q10 (CoQ10)
People with CHF have significantly lower levels of CoQ10 in heart muscle cells than healthy people. This fact alone does not prove that CoQ10 supplements will help CHF; however, it prompted medical researchers to try using CoQ10 as a treatment for heart failure.
In the largest study, 641 individuals with moderate to severe congestive heart failure were monitored for one year. Half were given 2 mg/kg of body weight of CoQ10 daily; the rest were given placebo. Standard therapy was continued in both groups. The participants treated with CoQ10 experienced a significant reduction in the severity of their symptoms. No such improvement was seen in the placebo group. The people who took CoQ10 also had significantly fewer hospitalizations for heart failure.
Similarly positive results were also seen in other double-blind studies involving a total of over 250 participants.
However, two recent and very well-designed double-blind studies enrolling a total of about 85 individuals with congestive heart failure failed to find any evidence of benefit. The reason for this discrepancy is not clear.
For more information, including dosage and safety issues, see the full CoQ10 article.
Vitamin B1
Evidence suggests that the strong diuretics (technically, loop diuretics such as furosemide) commonly used to treat CHF may interfere with the body’s metabolism of vitamin B1 (thiamin).
Since the heart depends on vitamin B1 for proper function, this finding suggests that taking a supplement may be advisable; and, in fact, preliminary evidence suggests that thiamin supplementation may indeed improve heart function in individuals with CHF.
Other Proposed Treatments for Congestive Heart Failure:
Several studies (primarily by one research group) suggest that the amino acid taurine may be useful in CHF and may be more effective than CoQ10.
Another treatment for CHF that has some evidence is the expensive supplement L-carnitine, especially when given in the special form called propionyl-L-carnitine. Carnitine is frequently combined with CoQ10.
Three small, double-blind studies enrolling a total of about 70 individuals with congestive heart failure found that the supplement arginine significantly improves symptoms of CHF, as well as objective measurements of heart function.
Evidence suggests that the sports supplement creatine may offer some help for the sensation of fatigue that often accompanies CHF.
Combination therapy with several of the supplements mentioned above may also be helpful. A double-blind trial of 41 individuals found that use of a supplement containing taurine, CoQ10, creatine, and carnitine, as well as other nutrients, improved objective measures of heart function.
Additionally, there is also some evidence that supplementing with magnesium may be helpful for individuals taking both digoxin and diuretics; diuretics can deplete the body of magnesium, which may increase risk of digoxin side effects.
Finally, it is important to pay attention to all the general considerations that bring health to the heart, such as those described in the article on atherosclerosis.
Vitamin E has been proposed as a treatment for congestive heart failure, but a small, double-blind study did not find it effective.
CHF is too serious a condition for self-treatment. The supervision of a qualified health-care professional is essential. However, given medical supervision, some of the following treatments may be quite useful. The herb hawthorn appears to be effective for mild CHF, and may be helpful for more severe CHF, as well. However, while standard drugs have been shown to help reduce hospitalizations and mortality associated with CHF, there is no similar evidence for hawthorn.
Also, adding the supplement coenzyme Q10 to standard treatment may improve results. Finally, the supplement vitamin B1 (thiamin) may be helpful for individuals who take loop diuretics (such as furosemide) for CHF.
Hawthorn
At least 9 double-blind, placebo-controlled trials, involving a total of about 500 participants have found hawthorn effective for the treatment of mild to moderate congestive heart failure; in addition, one study of more than 200 individuals found hawthorn helpful in more severe CHF as well.
In the most recent of these studies, 209 individuals with relatively advanced congestive heart failure (technically, New York Heart Association [NYHA] class III) were given either 1800 mg or 900 mg of standardized hawthorn extract or matching placebo. The results after 16 weeks of therapy showed significant improvements in the hawthorn groups as compared to the placebo groups. Benefits in the high-dose hawthorn group included a reduction in subjective symptoms, as well as an increase in exercise capacity. Subjective symptoms improved to about the same extent in the lower-dose hawthorn group, but there was no improvement in exercise capacity.
A comparative study suggests that hawthorn extract (900 mg) is about as effective as a low dose of the conventional drug captopril. However, while captopril and other standard drugs in the same family have been shown to help reduce hospitalizations and mortality associated with CHF, there is no similar evidence for hawthorn.
Like other treatments used for CHF, hawthorn improves the hearts pumping ability. However, it may offer some important advantages over certain conventional drugs used for this condition.
Digoxin, as well as other medications that increase the power of the heart, also make the heart more susceptible to dangerous irregularities of rhythm. In contrast, preliminary evidence indicates that hawthorn may have the unusual property of both strengthening the heart and stabilizing it against arrhythmias. It is thought to do so by lengthening what is called the refractory period. This term refers to the short period following a heartbeat during which the heart cannot beat again. Many irregularities of heart rhythm begin with an early beat. Digoxin shortens the refractory period, making such a premature beat more likely, while hawthorn protects against such potentially dangerous breaks in the hearts even rhythm.
Another advantage of hawthorn involves toxicity. With digoxin, the difference between the proper dosage and the toxic dosage is dangerously small. Hawthorn has an enormous range of safe dosing.
However, keep in mind that digoxin is itself an outdated drug. There are many newer drugs for CHF (such as ACE inhibitors) that are much more effective and have been proven to save lives. Hawthorn has not been shown to provide the same benefit. And it is not clear whether one can safely combine hawthorn with other drugs that affect the heart.
For more information, including dosage and safety issues, see the full hawthorn article.
Coenzyme Q10 (CoQ10)
People with CHF have significantly lower levels of CoQ10 in heart muscle cells than healthy people. This fact alone does not prove that CoQ10 supplements will help CHF; however, it prompted medical researchers to try using CoQ10 as a treatment for heart failure.
In the largest study, 641 individuals with moderate to severe congestive heart failure were monitored for one year. Half were given 2 mg/kg of body weight of CoQ10 daily; the rest were given placebo. Standard therapy was continued in both groups. The participants treated with CoQ10 experienced a significant reduction in the severity of their symptoms. No such improvement was seen in the placebo group. The people who took CoQ10 also had significantly fewer hospitalizations for heart failure.
Similarly positive results were also seen in other double-blind studies involving a total of over 250 participants.
However, two recent and very well-designed double-blind studies enrolling a total of about 85 individuals with congestive heart failure failed to find any evidence of benefit. The reason for this discrepancy is not clear.
For more information, including dosage and safety issues, see the full CoQ10 article.
Vitamin B1
Evidence suggests that the strong diuretics (technically, loop diuretics such as furosemide) commonly used to treat CHF may interfere with the body’s metabolism of vitamin B1 (thiamin).
Since the heart depends on vitamin B1 for proper function, this finding suggests that taking a supplement may be advisable; and, in fact, preliminary evidence suggests that thiamin supplementation may indeed improve heart function in individuals with CHF.
Other Proposed Treatments for Congestive Heart Failure:
Several studies (primarily by one research group) suggest that the amino acid taurine may be useful in CHF and may be more effective than CoQ10.
Another treatment for CHF that has some evidence is the expensive supplement L-carnitine, especially when given in the special form called propionyl-L-carnitine. Carnitine is frequently combined with CoQ10.
Three small, double-blind studies enrolling a total of about 70 individuals with congestive heart failure found that the supplement arginine significantly improves symptoms of CHF, as well as objective measurements of heart function.
Evidence suggests that the sports supplement creatine may offer some help for the sensation of fatigue that often accompanies CHF.
Combination therapy with several of the supplements mentioned above may also be helpful. A double-blind trial of 41 individuals found that use of a supplement containing taurine, CoQ10, creatine, and carnitine, as well as other nutrients, improved objective measures of heart function.
Additionally, there is also some evidence that supplementing with magnesium may be helpful for individuals taking both digoxin and diuretics; diuretics can deplete the body of magnesium, which may increase risk of digoxin side effects.
Finally, it is important to pay attention to all the general considerations that bring health to the heart, such as those described in the article on atherosclerosis.
Vitamin E has been proposed as a treatment for congestive heart failure, but a small, double-blind study did not find it effective.