On the q.t. no more: Exposing the arrhythmic risks of dietary supplements

Abstract

The limitless pursuit of “natural” remedies capable of warding off cardiovascular disease has existed for centuries. In fact, the origins of many lifesaving cardiovascular drugs stem from discoveries made in nature, including acetylsalicylic acid, quinidine, and digoxin from plants, statins from fungi, alteplase from human uterine tissue, and angiotensin-converting enzyme inhibitors from snake venom. These remarkable early innovations were translated into pharmaceutical grade drugs that continue to be subjected to rigorous surveillance and safety standards. While agents classified as nutraceuticals and dietary supplements may also result in modest improvements in blood pressure and cholesterol levels, the benefits observed are inferior to pharmaceutical medications, and the risks associated with high doses and long-term usage are unestablished. 1 Laffin Luke J. Bruemmer D. Garcia M. et al. Comparative effects of low-dose rosuvastatin, placebo, and dietary supplements on lipids and inflammatory biomarkers. J Am Coll Cardiol. 2023; 81: 1-12 Crossref PubMed Scopus (2) Google Scholar ,2 Borghi C. Cicero A.F. Nutraceuticals with a clinically detectable blood pressure-lowering effect: a review of available randomized clinical trials and their meta-analyses. Br J Clin Pharmacol. 2017; 83: 163-171 Crossref PubMed Scopus (73) Google Scholar Nevertheless, many Americans continue to enthusiastically fund this ever-growing multibillion dollar per year industry, which remains minimally regulated compared with the pharmaceutical drug market. The latter fact is particularly worrisome when studies, like the one published in this issue of Heart Rhythm Journal by Martinez et al, 3 Martinez K. Smith A. Ye D. Zhou W. Tester D.J. Ackerman M.J. Curcumin, a dietary natural supplement, prolongs the action potential duration of KCNE1-D85N–induced pluripotent stem cell–derived cardiomyocytes. Heart Rhythm. 2023; (in press) Google Scholar point toward the potentially proarrhythmic properties of a widely used natural dietary supplement derived from the turmeric plant, called curcumin. Curcumin, a dietary natural supplement, prolongs the action potential duration of KCNE1-D85N–induced pluripotent stem cell–derived cardiomyocytesHeart RhythmPreviewCurcumin, a polyphenolic dietary natural compound and active ingredient in turmeric, exerts antioxidant, anti-inflammatory, antidiabetic, anticancer, and antiarrhythmic properties. KCNE1-D85N, present in ∼1% of white, is a common, potentially proarrhythmic variant that predisposes individuals to drug-induced QT prolongation under certain conditions. Full-Text PDF