The Resource Dietary supplements in adults taking cardiovascular drugs, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by University of Ottawa Evidence-based Practice Center ; investigators, Dugald Seely [and others], (electronic resource)

Dietary supplements in adults taking cardiovascular drugs, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by University of Ottawa Evidence-based Practice Center ; investigators, Dugald Seely [and others], (electronic resource)

Label
Dietary supplements in adults taking cardiovascular drugs
Title
Dietary supplements in adults taking cardiovascular drugs
Statement of responsibility
prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by University of Ottawa Evidence-based Practice Center ; investigators, Dugald Seely [and others]
Contributor
Subject
Genre
Language
eng
Summary
BACKGROUND: A substantial proportion of patients with cardiovascular diseases use dietary supplements in anticipation of benefit. This also poses risks of adverse events from supplement-drug interactions and nonadherence associated with polypharmacy. OBJECTIVES: For supplements commonly used by patients with cardiovascular disease, we examined benefits, harms, and effects on cardiovascular drug pharmacokinetics of coadministration of dietary supplements with cardiovascular drugs. We also sought evidence regarding variability among subgroups, and of statistical interactions between supplements and drugs. DATA SOURCES: We searched MEDLINE(r), Embase, the Cochrane Library, International Bibliographic Information on Dietary Supplements (IBIDS), and Allied and Complementary Medicine Database (AMED), as well as gray literature, from inception to September 2011. STUDY SELECTION: Following a predefined protocol, two reviewers included experimental and observational studies comparing a supplement plus cardiovascular drug versus drug alone published in English or German; other languages were excluded due to concerns with study quality and applicability. DATA EXTRACTION: One reviewer extracted data into a standardized electronic form, assessed study risk of bias, graded the strength of the body of evidence, and reported its applicability. Study risk of bias and strength of evidence regarding gradable outcomes were independently verified, as was a random 10 percent subset of all data. DATA SYNTHESIS: Sixty-seven randomized controlled trials, two controlled clinical trials, and one observational study contributed evidence of limited validity in highly selected populations. Evidence was insufficient for all gradable clinical efficacy and harms outcomes (e.g., mortality, thrombotic events, serious adverse events) because there were few, small studies per supplement. One pragmatic trial in women showed no benefit from coadministering vitamin E with aspirin on a composite cardiovascular outcome. Evidence for most intermediate outcomes of efficacy was insufficient or of low strength and suggested no effect. Notable findings were incremental improvement of triglyceridemia with omega-3 fatty acid supplementation, stabilization of international normalized ratio with vitamin K added to warfarin therapy, and improved high-density lipoprotein cholesterol (HDL-C) with added garlic. Clinically nonsignificant or otherwise inconclusive changes were noted for pharmacokinetic outcomes. LIMITATIONS: The evidence base principally consisted of underpowered short-term studies in selected populations, generally with moderate risk of bias. CONCLUSIONS: Limitations of the evidence base precluded meaningful conclusions across most supplement-drug combinations. Low-strength evidence indicates benefits of omega-3 fatty acids, vitamin K, and garlic coadministration on specific intermediate outcomes. Evidence regarding harms was inconclusive. Care providers and researchers should query supplement use to improve care and to facilitate research regarding drug-supplement interactions
Member of
Cataloging source
NLM
Funding information
Prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by University of Ottawa Evidence-based Practice Center
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
NLM call number
QV 150
http://library.link/vocab/relatedWorkOrContributorName
  • Seely, Dugald
  • United States
  • Effective Health Care Program (U.S.)
  • University of Ottawa Evidence-based Practice Center
  • Effective Health Care Program (U.S.)
Series statement
  • Comparative effectiveness review
  • AHRQ publication
Series volume
  • no. 51
  • no. 12-EHC021-EF
http://library.link/vocab/subjectName
  • Cardiovascular Agents
  • Dietary Supplements
  • Cardiovascular Diseases
  • United States
  • United States
http://bibfra.me/vocab/relation/supportingbody
RzTDSdffmEM
Label
Dietary supplements in adults taking cardiovascular drugs, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by University of Ottawa Evidence-based Practice Center ; investigators, Dugald Seely [and others], (electronic resource)
Instantiates
Publication
Note
"April 2012."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
811318047
Extent
1 online resource (797 pages)
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations
Specific material designation
remote
System control number
(OCoLC)811318047
Label
Dietary supplements in adults taking cardiovascular drugs, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by University of Ottawa Evidence-based Practice Center ; investigators, Dugald Seely [and others], (electronic resource)
Publication
Note
"April 2012."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
811318047
Extent
1 online resource (797 pages)
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations
Specific material designation
remote
System control number
(OCoLC)811318047

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