MEDIA WATCH

Herbal preparations and heart patients

Last week, two American agencies — the National Institutes for Health and the Natural Standard Research Collaboration — warn that combining herbal preparations with orthodox medicine can harm those with heart conditions. SOLAADE AYO-ADERELE examines this issue in the context of Nigeria’s health sector

hey come in different names and brands. They can be in tablet, capsule or syrup form. They also come as dietary supplements. They are the organically manufactured drugs, otherwise known as alternative drugs or herbal preparations. While these preparations are there for the asking, relevant agencies have said it’s dangerous to use them alongside orthodox medicine.

In recent times, alternative therapy has become a thriving business globally, reporting billions of dollars in return from America to Zimbabwe, with Nigeria in-between.

In Third World countries like Nigeria, there is fear that the alternative drugs market is largely unregulated, with possible abuse of the processes of manufacturing, distribution, prescription and ingestion.

As experts agree, in Nigeria, herbal products have been with us since inception, but their popularity was reinforced with the ‘westernisation’ of the processes involved in their manufacture, as many of them now feature attractive packs, with some attempts at dosage prescription and expiration dating.

It goes without saying that millions of Nigerians take herbal remedies for all sorts of ailments, including high cholesterol, pile, sexual dysfunction/impotence; and for more complicated illness like heart condition. It’s not uncommon to see people combining both the orthodox treatment with herbal preparations, unmindful of possible dangers these may pose to their overall well-being.

As far as those who take these products are concerned, they are safe; but experts caution that they can cause serious (drug) interactions in people taking prescription drugs for heart problems especially.

A former Minister of Health, Prof. Babatunde Osotimehin, quoting the World Health Organisation, said heart diseases result in the death of 17 million people around the world yearly, including Nigeria. This being the case, he said, efforts must be geared towards increasing heart health.

Two American agencies — National Institutes for Health and the Natural Standard Research Collaboration — offer insight into certain herbal products that may not be used by heart patients accessing treatment by an orthodox medical practitioner.

One of such herbal products is garlic, a member of the onion family. Although it is used as food seasoning, it is also handy in lowering total and LDL (bad) cholesterol and blood pressure; while it also serves as a blood thinner and to combat atherosclerosis.

However, NIH warns that its blood-thinning properties can increase the risk of bleeding associated with warfarin — an anti-clotting drug commonly prescribed to people with heart-rhythm disorders, and to people who have had heart attacks or heart-valve replacements.

Another is ginkgo, whose leaf extract is also sold as capsules or tea. When taken in combination with orthodox medicine, NIH argues, it increases the risk of bleeding associated with aspirin and warfarin.

The leaves of the Camellia sinensis plant, otherwise known as the green tea, have become household name. And though it is usually steeped in water, it is also available as capsules or extract.

An examination of packs of the typical green tea claims that it helps in weight loss, improves mental alertness, lowers cholesterol, and prevents cancer. The risk, NSRC says, is that green tea contains vitamin K, which can counteract the effect of warfarin.

Ginger is a root that is used in cooking, though it is also processed and sold as capsules, and reputed to be handy in the treatment of various stomach ailments like nausea, diarrhoea, and stomach ache, among other herbal uses. It is however feared that it increases the risk of bleeding associated with warfarin.

However, two surprising ones are the grape fruit juice and aloe vera. Grapefruit juice competes for space on the shelf with the orange juice, and it is used to lose weight and to promote heart health. The risk, according to the duo of the NIH and NSRC is that grape fruit juice interferes with an enzyme that is essential for properly absorbing medications, including statins and calcium-channel blockers, which intensify the effect of those drugs.

“A single glass of grapefruit juice more than doubles the amount of calcium-channel blocker available to the body, research has shown,” they both claim.

The pulp of the aloe vera plant, in addition to its familiar use as a lotion and salve, is also taken orally to treat serious health conditions including arthritis, epilepsy, diabetes, and asthma.

Being an easily domesticated plant, it is not uncommon to see it as sitting-room plants in portable and fanciful pots. One of the most widely abused ‘drugs,’ people juice aloe vera and take it unceremoniously, sometimes before the first meal of the day, with all sorts of claims about its wonders in the human body.

The risk, according to the American agencies, is that aloe vera can cause a drop in the blood’s potassium level, which in turn can lead to heart-rhythm problems (arrhythmias), as well as complications in heart patients taking the drug Digoxin.

The licorice root is a regular sight in the stall of any herb seller, and it’s usually in dry form. These days, it also comes in capsule form and is reputed to be used in the treatment of ulcers and other stomach ailments, bronchitis and sore throat, and some viral infections.

The risk is that licorice root can raise blood pressure. And, like aloe vera, it can also cause a dangerous drop in blood potassium levels.

In response to these research findings, a Consultant Cardiologist with the Lagos State University Teaching Hospital, Dr. Folashade Daniel, said it was absolutely unadvisable for a heart patient to combine orthodox medicine with herbal preparations. She said she had patients who attempted it, with dire consequences.

“Many of these herbal preparations contain alcohol, which is not good for someone with heart condition,” she warned; “as they contain ingredients that are usually unstated beyond the fact that they are ‘blended with active medicinal plant extracts.’”

She said the effect of alcohol on health and heart disease is complex.

“For some people, even mild alcohol use carries major risks. But, until we know more about the pros and cons of alcohol consumption, doctors do not recommend drinking alcohol specifically for better heart health.

“Drinking alcohol can be harmful for some people. Those who have heart failure, cardiomyopathy (an enlarged heart), high blood pressure, diabetes, arrhythmia (irregular heart rhythm), a history of stroke, obesity, high triglycerides, or are taking medications should speak to their doctor before drinking alcohol,” Daniel counselled.

On the observation that some herbal preparations do enhance the libido, and whether it is safe for a heart patient to engage in sexual activity — an issue on which physicians differ — Daniel said when someone had heart disease, the last thing on his or her mind was sex.

“Albeit, it’s a matter of individual preference. While a study claims that men who have sex at least twice a week cut their chances of having a heart attack almost by half, for those who already have heart issue, it’s a different ball game. This is because sex exerts physical pressure on the heart. While having sex, the heart rate goes from 70 beats per minute to 150; and this may take its toll on someone who is suffering from heart condition.

“When you undertake a particularly strenuous bout of lovemaking, you might wonder whether the exertion is actually stressing, rather than strengthening, your heart. Anyone who is in doubt should ask his or her physician, who will be able to counsel them aright based on their medical history,” the cardiologist said.

In his response, a professor of chiropractor and President of the Federal College of Complementary & Alternative Medicine, Bishop Magnus Atilade, agreed with the views of Daniel that it is not advisable to combine both treatments, because one element might work against the other.

“Chemically-prepared drugs (orthodox medicine) must not be combined with organically-prepared ones (alternative medicine) because the elements may work against the other.

“Unlike orthodox medicines which are instant in the way they work, alternative medicines take time to work in the human system because the body needs time to adjust to it. We advise people against marrying the treatments.”

Reference:

punchng.com/Solaade Ayo-Aderele. 2012. Herbal remedy for erectile dysfunction passes clinical trial. [ONLINE] Available at: http://www.punchng.com/health/herbal-preparations-and-heart-patients/. [Accessed 28 January 12].

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