Online Marketing of Alternative Medicine for Heart Failure: An Assessment of Amazon.com

A wide array of products in the category of complementary or alternative medicine for cardiovascular disease and prevention are readily available on online retail platforms. However, a critical assessment of these products, including their therapeutic claims, has not been previously performed.

"Heart failure supplement" and similar terms were entered into the Amazon.com search engine, and all medication products including claims, content, and formulations were individually evaluated.

We identified 111 products, most of which lacked safety information. They included, on average, 8.2 ingredients. The median cost per order was $27.60. The majority were in capsule form (58.6%), and the most common ingredient was coenzyme Q10. All included a legal disclaimer. Physician testimonials were included in only 3 product listings.

Given the popularity of complementary and alternative medicine and their easy accessibility through online retailing, and the fact that prior studies suggest a minority of patients discuss use with their providers, further study is needed to evaluate the extent of and the potential for both undiagnosed drug-drug interactions and replacement of guideline-directed medical treatment for heart failure with unapproved products.