INTEGRATIVE THERAPY IN CARDIOVASCULAR DISEASE: SAVIOR OR SHAM?
Saul Schaefer, M.D., University of California, Davis, CA, USA
While physicians generally treat cardiovascular disease and risk factors with conventional medications such as statins and beta blockers, patients often use complementary or integrative therapy such as fish oil, vitamins, enzymes, and chelation therapy. This $45 billion industry is based on the belief that non-allopathic therapies can lower cardiovascular risk in addition to, or in lieu of, conventional therapy. The NIH Center for Complementary and Alternative Medicine supports therapy "for which there is some high-quality scientific evidence of safety and effectiveness"; however, most integrative therapies do not meet this test. Prospective studies support a minor role for omega3 fatty acids, a Mediterranean diet, and possibly vitamin C supplementation to reduce cardiovascular risk in selected individuals. No evidence to data supports the routine use of multi-vitamins, coenzyme Q, vitamin D or chelation therapy. The critical role of addressing conventional risk factors should not be abridged by unproven integrative therapies.