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

Background: A wide array of products in the category of complementary or alternative medicine products 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.

Methods: "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.

Results: We identified 111 products, most of which lack safety information; include on average 8.2 ingredients; and cost $27.60 per order (median). Most were in capsule form (58.6%) and the most common ingredient was Co-Enzyme Q10. All included a legal disclaimer; physician testimonials were included in only 3 product listings.

Conclusions: Given the popularity of and easy accessibility to online retailing of complementary and alternative medicine 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 use and the potential for both undiagnosed drug-drug interactions and/or replacement of guideline-directed medical treatment for heart failure with unapproved products.