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Cited by 426Complementary and Alternative Medicine StudiesPhytochemistry Medicinal Plant ApplicationsNephrotoxicity and Medicinal Plants

Use of herbal products and potential interactions in patients with cardiovascular diseases

Open access
Tachjian, Ara, Maria, Viqar, Jahangir, Arshad·2010·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2009.07.074PMC PMC2831618
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Abstract

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.

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Registry

Crossref · 10.1016/j.jacc.2009.07.074

Cites

87 of 87 references verified0 citation errors · 0 not checkable

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  • Interactions between foods or dietary supplements and drugs are an underappreciated source of therapeutic variability and iatrogenic risk.

    “Interactions between foods or dietary supplements and drugs are an underappreciated source of therapeutic variability and iatrogenic risk [1,2].”

    From Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification-A Narrative Review (2026) · cites this paper as [1]

    The Introduction says dangerous herb–drug interactions may be missed, and the Conclusion says herbs can potentiate or reduce the effects of cardiovascular drugs. These passages support underappreciated risks and variable drug effects from herbal supplements, but the paper does not establish the claim for food–drug interactions generally. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Physicians rarely initiate discussion about supplement use, amplifying risk.

    “The failure of patient–clinician communication about supplement use amplifies this risk, as physicians rarely initiate the discussion [1,3].”

    From Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification-A Narrative Review (2026) · cites this paper as [1]

    The Introduction says physicians may not routinely ask about complementary and alternative medicine use and that dangerous herb–drug interactions may consequently be missed. This supports the communication-and-risk point, but the claim’s unqualified “rarely initiate” is stronger than the paper’s hedged wording. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Supplement-drug interactions are frequently omitted at history taking because of the perception that what is natural is harmless.

    “Unlike drug–drug interactions, those involving “natural” products are frequently omitted at history taking, because of the perception that what is natural is harmless [1,3].”

    From Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification-A Narrative Review (2026) · cites this paper as [1]

    The Introduction says patients often do not disclose complementary and alternative medicine use, physicians may not ask about it, and herb–drug interactions may therefore be missed. The Lack of Regulatory Oversight section separately describes a widespread belief that natural herbal products are safe. The paper does not establish that this belief causes omissions during history taking or compare those omissions with drug–drug interactions. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

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Cites

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1 of the 88 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [87]Institute of Medicine (U.S.) Complementary and alternative medicine in the United States, Committee on the Use of Complementary and Alternative Medicine by the American Public, Board on Health Promotion and Disease Prevention Washington (DC) National Academies Press c2005

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Authors
Tachjian, A., Maria, V., & Jahangir, A.
Affiliations
Mayo Clinic (US)
Corresponding author
Jahangir, Arshad
ORCID
Jahangir, Arshad
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2010-02
Volume
55
Issue
6
Pages
515-525
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2009.07.074
PMC
PMC2831618
OpenAlex
W2151268696
Cited by
426
References
88
Citations by year
2026: 7 · 2025: 12 · 2024: 26 · 2023: 19 · 2022: 35 · 2021: 23 · 2020: 38 · 2019: 25 · 2018: 30 · 2017: 28 · 2016: 34 · 2015: 39 · 2014: 23 · 2013: 30 · 2012: 25
FWCI
6.14
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Aging (R01AG021201, AG-21201)
  • National Heart, Lung, and Blood Institute (R01HL089542, HL089542)
Topics
  • Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
  • Life Sciences › Agricultural and Biological Sciences › Plant Science › Phytochemistry Medicinal Plant Applications
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Nephrotoxicity and Medicinal Plants
Keywords
herbal products, complementary and alternative medicine, herb-drug interactions, cardiovascular disease, cardiovascular drugs, elderly patients, polypharmacy, herbal medicine safety
MeSH terms
Cardiovascular Agents, Cardiovascular Diseases, Humans, Phytotherapy, Plants, Medicinal, Treatment Outcome, Herb-Drug Interactions

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