A patient asks: What alternative therapies with regard to vascular and heart disease appear worth considering?

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The doctor answers: Massage and acupuncture are safe, but don’t forsake science-backed cures for hopeful nostrums.

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My reading of the literature is that these treatments are not yet convincingly proven, at least regarding heart disease. I have no objection to patients utilizing massage therapy. Whether they will live longer, or be less likely to have a stroke or heart attack, I don’t know.

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What I do know is that chronic stress is not good for your heart. Blood pressure isn’t the only thing that rises along with stress levels — aggravation can also result in increased cholesterol. In fact, research suggests those under the most stress are 13 times more likely to have cholesterol high enough to increase the future risk of heart disease.

British researchers monitored cholesterol levels of nearly 200 middle-aged men and women taking computerized tests specifically designed to confuse and frustrate subjects. As stress levels mounted, so did cholesterol — especially LDL “bad” cholesterol.  

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As I have written previously, I advise patients to make lifestyle changes to try to improve their cholesterol levels — before I prescribe statins. While diet and exercise top the list, massage and other stress-management interventions that may fall under the rubric of alternative treatment, such as acupuncture and meditation, are certainly worth a try.

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Indeed, prayer might be categorized as an “alternative therapy” strictly speaking, and yet it’s certainly part of my own personal heart-healthy, soul-healthy regimen, each and every day.

I don’t want to discourage physicians from exploring these avenues, since many conditions — refractory atrial fibrillation, stroke, advanced heart failure — require better therapies.

My approach generally is to try things that have been shown to work, and to use alternative medicine if that is the patient’s preference.

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At the University of California, San Francisco Osher Center for Integrative Medicine (initially for alternative therapies) was established 15 years ago, in an effort to meet the need for a new model of care and daily living that promotes healing and well-being of the whole person — mind, body and spirit.

They provide acupuncture and traditional Chinese medicine, Ayurveda, biofeedback, guided imagery, manual medicine and spinal manipulation, massage therapy, and several other forms of treatment.

Heart disease may be aggravated by other conditions — insomnia, anxiety, hormonal imbalance, and others — that many of these other treatments may benefit.

Bottom Line: The jury is still out on most forms of alternative therapies, but many are safe and worth a try if traditional medicine is not working for you.