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Title: Nutraceuticals in heart failure patients: A systematic review.
Austin Authors: Hopper, Ingrid;Connell, Cia;Briffa, Tom;Depasquale, Carmine G;Driscoll, Andrea ;Kistler, Peter M;Macdonald, Peter S;Sindone, Andrew;Thomas, Liza;Atherton, John J
Affiliation: National Heart Foundation of Australia, Melbourne, Australia
Heart Centre, The Alfred Hospital, Melbourne, Australia
Department of Medicine, University of Melbourne, Melbourne, Australia
Centre for Health Services Research and Cardiovascular Research Group, School of Population Health, University of Western Australia, Perth, Australia
Department of Cardiovascular Medicine, Flinders Medical Centre & Flinders University, Adelaide, Australia
St Vincent's Hospital, Victor Chang Cardiac Research Institute, University of New South Wales, Sydney, Australia
Department of Cardiology, Westmead Hospital, Department of Medicine, University of Sydney, Department of Medicine, University of New South Wales
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia
Heart Failure Unit and Department of Cardiac Rehabilitation, Concord Hospital, Sydney, Australia
University of Sydney, Sydney, Australia
Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, Australia
Faculty of Medicine, University of Queensland, Brisbane, Australia
Faculty of Science, Health, Education and Engineering, University of Sunshine Coast, Australia
Faculty of Health, Queensland University of Technology, Brisbane, Australia
Heart Centre, The Alfred Hospital, Melbourne, Australia
Issue Date: Feb-2020 2019-11-05
Publication information: Journal of cardiac failure 2020; 26(2): 166-179
Abstract: Nutraceuticals are pharmacologically active substances extracted from vegetable or animal food and administered to produce health benefits. We recently reviewed the current evidence for nutraceuticals in patients diagnosed with heart failure as part of the writing of the Australian Guidelines for the prevention, diagnosis and management of heart failure. A systematic search for studies that compared nutraceuticals to standard care in adult patients with heart failure was performed. Studies were included if > 50 patients were enrolled, with ≥ 6 months follow up. If no studies met criteria then studies < 50 patients and < 6 months follow up were included. The primary outcomes included mortality/survival, hospitalisation, quality of life, and/or exercise tolerance. Iron was not included in this review as its role in HF is already well established. Forty studies met the inclusion criteria. The strongest evidence came from studies of polyunsaturated fatty acids, which modestly decreased mortality and cardiovascular hospitalisations in patients with mostly New York Heart Association (NYHA) II and III heart failure across a range of left ventricular ejection fraction. Co-enzyme Q10 may decrease mortality and hospitalisation, but definite conclusions cannot be drawn. Studies that examined nitrate rich beetroot juice, micronutrient supplementation, hawthorn extract, magnesium, thiamine, vitamin E, vitamin D, L-arginine, L-carnosine and L-carnitine were too small or underpowered to properly appraise clinical outcomes. Only one nutraceutical, omega-3 PUFA, received a positive recommendation in the Australian heart failure guidelines. Although occasionally showing some promise, all other nutraceuticals are inadequately studied to allow any conclusion on efficacy. Clinicians should favour other treatments that have been clearly shown to decrease mortality.
DOI: 10.1016/j.cardfail.2019.10.014
PubMed URL: 31704198
Type: Journal Article
Appears in Collections:Journal articles

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