The effectiveness and safety of integrative medicine for chronic heart failure: An umbrella review
Background and purpose: Heart failure (HF) is associated with multi-organ dysfunction and significant morbidity and mortality. Despite advances in treatment, prognosis remains poor, highlighting the need to explore adjunctive therapies such as integrative medicine. This umbrella review synthesises t...
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| Format: | Article |
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Elsevier
2025-08-01
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| Series: | Complementary Therapies in Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0965229925000573 |
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| author | Wei J. Chua Jing Liu Kaitlyn Lam Alison Maunder Chhiti Pandey Adele E. Cave Allana O’Fee Guoyan Yang Aya Mousa Carolyn Ee |
| author_facet | Wei J. Chua Jing Liu Kaitlyn Lam Alison Maunder Chhiti Pandey Adele E. Cave Allana O’Fee Guoyan Yang Aya Mousa Carolyn Ee |
| author_sort | Wei J. Chua |
| collection | DOAJ |
| description | Background and purpose: Heart failure (HF) is associated with multi-organ dysfunction and significant morbidity and mortality. Despite advances in treatment, prognosis remains poor, highlighting the need to explore adjunctive therapies such as integrative medicine. This umbrella review synthesises top-tier evidence from systematic reviews and meta-analyses of randomised controlled trials (RCTs) assessing the safety and effectiveness of integrative medicine in patients with HF, in order to inform clinical decision-making. Methods: We searched MEDLINE, Cochrane, PsycINFO and EMBASE until April 2024. Primary outcomes included mortality, hospitalisation rates, and severity or prognostic indicators, including brain natriuretic peptide (BNP) and exercise capacity. A hierarchical evidence synthesis method was used whereby we included the most recent, highly ranked and comprehensive reviews for our research question. We assessed review quality using ‘A MeaSurement Tool to Assess systematic Reviews’ and, where possible, evidence certainty for our primary outcomes using the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Twenty-two reviews were included. Co-enzyme Q10 or Tai Chi may reduce mortality and hospitalisation rates (moderate certainty evidence), and acupuncture or intravenous Chinese herbal medicines may improve BNP (low to very low certainty evidence). The benefits of yoga and other nutrient supplements including L-carnitine remain unclear. Vitamin E may increase hospitalisation rates and should be avoided. Conclusion: The evidence for most integrative medicine modalities for adjunctive management of HF remains limited. Well-designed and rigorous RCTs are needed, particularly with long-term follow up and evaluation of clinically meaningful outcomes. |
| format | Article |
| id | doaj-art-d8d6e2131774405caf8073e2b44d3cdc |
| institution | OA Journals |
| issn | 0965-2299 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Complementary Therapies in Medicine |
| spelling | doaj-art-d8d6e2131774405caf8073e2b44d3cdc2025-08-20T02:37:41ZengElsevierComplementary Therapies in Medicine0965-22992025-08-019110318210.1016/j.ctim.2025.103182The effectiveness and safety of integrative medicine for chronic heart failure: An umbrella reviewWei J. Chua0Jing Liu1Kaitlyn Lam2Alison Maunder3Chhiti Pandey4Adele E. Cave5Allana O’Fee6Guoyan Yang7Aya Mousa8Carolyn Ee9School of Medicine, Western Sydney University, Penrith, NSW 2751, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, AustraliaWestern Australia Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, WA 6150, Australia; Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley, WA 6102, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, AustraliaMonash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3800, AustraliaNICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia; Correspondence to: NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, AustraliaBackground and purpose: Heart failure (HF) is associated with multi-organ dysfunction and significant morbidity and mortality. Despite advances in treatment, prognosis remains poor, highlighting the need to explore adjunctive therapies such as integrative medicine. This umbrella review synthesises top-tier evidence from systematic reviews and meta-analyses of randomised controlled trials (RCTs) assessing the safety and effectiveness of integrative medicine in patients with HF, in order to inform clinical decision-making. Methods: We searched MEDLINE, Cochrane, PsycINFO and EMBASE until April 2024. Primary outcomes included mortality, hospitalisation rates, and severity or prognostic indicators, including brain natriuretic peptide (BNP) and exercise capacity. A hierarchical evidence synthesis method was used whereby we included the most recent, highly ranked and comprehensive reviews for our research question. We assessed review quality using ‘A MeaSurement Tool to Assess systematic Reviews’ and, where possible, evidence certainty for our primary outcomes using the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Twenty-two reviews were included. Co-enzyme Q10 or Tai Chi may reduce mortality and hospitalisation rates (moderate certainty evidence), and acupuncture or intravenous Chinese herbal medicines may improve BNP (low to very low certainty evidence). The benefits of yoga and other nutrient supplements including L-carnitine remain unclear. Vitamin E may increase hospitalisation rates and should be avoided. Conclusion: The evidence for most integrative medicine modalities for adjunctive management of HF remains limited. Well-designed and rigorous RCTs are needed, particularly with long-term follow up and evaluation of clinically meaningful outcomes.http://www.sciencedirect.com/science/article/pii/S0965229925000573Heart failureComplementary therapiesDietary supplementsHerbal medicineMind body therapiesAcupuncture |
| spellingShingle | Wei J. Chua Jing Liu Kaitlyn Lam Alison Maunder Chhiti Pandey Adele E. Cave Allana O’Fee Guoyan Yang Aya Mousa Carolyn Ee The effectiveness and safety of integrative medicine for chronic heart failure: An umbrella review Complementary Therapies in Medicine Heart failure Complementary therapies Dietary supplements Herbal medicine Mind body therapies Acupuncture |
| title | The effectiveness and safety of integrative medicine for chronic heart failure: An umbrella review |
| title_full | The effectiveness and safety of integrative medicine for chronic heart failure: An umbrella review |
| title_fullStr | The effectiveness and safety of integrative medicine for chronic heart failure: An umbrella review |
| title_full_unstemmed | The effectiveness and safety of integrative medicine for chronic heart failure: An umbrella review |
| title_short | The effectiveness and safety of integrative medicine for chronic heart failure: An umbrella review |
| title_sort | effectiveness and safety of integrative medicine for chronic heart failure an umbrella review |
| topic | Heart failure Complementary therapies Dietary supplements Herbal medicine Mind body therapies Acupuncture |
| url | http://www.sciencedirect.com/science/article/pii/S0965229925000573 |
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