Corrections



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Am Fam Physician. 2001 Jul 1;64(1):36-38.

The article “Alternative Therapies: Part II. Congestive Heart Failure and Hypercholesterolemia” (September 15, 2000, page 1325) contained an error in the second sentence of the first full paragraph in the right-hand column on page 1328. The correct sentence reads as follows: “This ‘red rice yeast product’ has been used for centuries in China and contains starch, protein, fiber and at least eight statin compounds, which function as 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors.” The abbreviation was also incorrectly expanded in Table 1. The corrected table is reprinted above.

TABLE 1

Summary of Natural Products Used in the Management of Cardiac Disorders

Product Other names Efficacy Mechanism of action Formulation Dosage/interval Side effects Drug interactions

Congestive heart failure (CHF)

Q10

Ubiquinone

Modest, at best

Antioxidant; positive ionotrope

Liquid, capsules

100 to 200 mg per day

None recorded

None recorded

Hawthorn

Crataegus species, haw, may, whitethorn

Incomplete, but highly promising data; approved for use in Germany and Asia for mild cases of CHF

Vasodilatory effects; increased coronary flow; decreased peripheral resistance; ACE–inhibitor-like effect

Dry extracts or liquid

Average daily dosage: 5 g or 160 to 900 mg extract for a minimum a minimum of 6 weeks

None recorded

May interfere with digoxin or digoxin monitoring

Hypercholesterolemia

Garlic

Allium sativum, poor man's treacle

Not efficacious

None

Fresh, oil, aqueous, fermented or dried

Large quantities can cause stomach stomach complaints

None recorded

Soy

Glycine soja

Proved efficacy; will decrease total cholesterol 5 to 9%, LDL 13%

Estrogen-like properties; alters hepatic cholesterol metabolism

Extract

Average daily dosage: 25 g soy protein

Possible occasional stomach pain loose stool and diarrhea

None recorded

Cholestin

Went yeast, Monascus purpureus, fermented on rice

As efficacious as commercial Statins

HMG CoA reductase inhibitor

Capsules

1,200 mg twice daily

Possible liver enzyme elevation and myositis; none, however, recorded

Same as commercially available statins

Gugulipid/guggal gum

Commiphora molmol, Arabian myrrh, Somalian myrrh

Preliminary data promising; needs larger controlled studies; widely used in India

Increased hepatic LDL binding sites*

Extract powdered resin; concentrated tablets

75 mg per day

None recorded†

None recorded


ACE = angiotensin-converting enzyme; LDL = low-density lipoprotein; HMG CoA = 3-hydroxy-3-methylglutaryl coenzyme A.

*Information from Singh V, Kaul S, Chander R, Kapoor NK. Stimulation of low-density lipoprotein receptor activity in liver membrane of guggulsterone-treated rats. Pharmacol Res 1990;22:37–44.

†—Information from Lawrence Review of Natural Products. Guggul. St. Louis, Mo.: Facts and Comparisons, 1995.

TABLE 1   Summary of Natural Products Used in the Management of Cardiac Disorders

View Table

TABLE 1

Summary of Natural Products Used in the Management of Cardiac Disorders

Product Other names Efficacy Mechanism of action Formulation Dosage/interval Side effects Drug interactions

Congestive heart failure (CHF)

Q10

Ubiquinone

Modest, at best

Antioxidant; positive ionotrope

Liquid, capsules

100 to 200 mg per day

None recorded

None recorded

Hawthorn

Crataegus species, haw, may, whitethorn

Incomplete, but highly promising data; approved for use in Germany and Asia for mild cases of CHF

Vasodilatory effects; increased coronary flow; decreased peripheral resistance; ACE–inhibitor-like effect

Dry extracts or liquid

Average daily dosage: 5 g or 160 to 900 mg extract for a minimum a minimum of 6 weeks

None recorded

May interfere with digoxin or digoxin monitoring

Hypercholesterolemia

Garlic

Allium sativum, poor man's treacle

Not efficacious

None

Fresh, oil, aqueous, fermented or dried

Large quantities can cause stomach stomach complaints

None recorded

Soy

Glycine soja

Proved efficacy; will decrease total cholesterol 5 to 9%, LDL 13%

Estrogen-like properties; alters hepatic cholesterol metabolism

Extract

Average daily dosage: 25 g soy protein

Possible occasional stomach pain loose stool and diarrhea

None recorded

Cholestin

Went yeast, Monascus purpureus, fermented on rice

As efficacious as commercial Statins

HMG CoA reductase inhibitor

Capsules

1,200 mg twice daily

Possible liver enzyme elevation and myositis; none, however, recorded

Same as commercially available statins

Gugulipid/guggal gum

Commiphora molmol, Arabian myrrh, Somalian myrrh

Preliminary data promising; needs larger controlled studies; widely used in India

Increased hepatic LDL binding sites*

Extract powdered resin; concentrated tablets

75 mg per day

None recorded†

None recorded


ACE = angiotensin-converting enzyme; LDL = low-density lipoprotein; HMG CoA = 3-hydroxy-3-methylglutaryl coenzyme A.

*Information from Singh V, Kaul S, Chander R, Kapoor NK. Stimulation of low-density lipoprotein receptor activity in liver membrane of guggulsterone-treated rats. Pharmacol Res 1990;22:37–44.

†—Information from Lawrence Review of Natural Products. Guggul. St. Louis, Mo.: Facts and Comparisons, 1995.


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