Traditional Indian Therapeutic Herbal Agent for the Treatment of Ischemic Myocardial Disorders: Promises and Precautions
Pp. 178-212 (35)
Vipin Dhote, Aman Upaganlawar and Aditya Ganeshpurkar
Cardiovascular disorders (CVD) like ischemic heart disease, hypertension,
dysrhythmia and cerebrovascular complications account for maximum mortality in
developed and developing world. According to World Bank health review, estimated
deaths in all age groups due to CVD may mount up to 33% by 2015. In addition, ever
increasing healthcare costs to the society are also becoming a huge social liability.
Especially, ischemic heart diseases (IHD) are leading cause of mortalities and
morbidities encountered by almost all CVD patients around the world. Till now there
are a few approved therapeutic agents, one of them is tissue plasminogen activator
(tPA), for the treatment of ischemic disorders. Moreover, use of thrombolytic agents
and surgical interventions involve high interventional costs both economically and
physiologically. Prevention of IHD can significantly add on to the quality of life of the
vulnerable section of population than its therapeutic management. It has been
established that injury and ensuing necrosis to cardiomyocytes can result from sudden
reperfusion of the ischemic core which is pathognomonic of myocardial ischemic
reperfusion injury. The underlying mechanisms viz. exacerbated generation of reactive
oxygen species (ROS), inflammatory reactivity and uncontrollable necrosis are
responsible for massive cellular injury during IHD. An ideal treatment should address
most of these mechanisms without disturbing other vital physiological systems.
Traditional herbal therapy has been shown to provide almost all of these benefits. The
clinical evaluation of active constituents of many ayurvedic medicines like Terminalia
arjuna greatly reinforces these centuries’ old beliefs. However, the increasing
concomitant use of herbal therapeutic agents with modern medicines by patients with
CVD poses a grave clinical challenge to physicians. In addition to this, less than 50%
of the patients inform the use of alternative medicines to their physicians. Even if
patients report it, many times physicians himself is unaware of the knowledge about the
activity and the toxicity potentials of active constituents. Hence, a physician sometimes
finds himself grossly unequipped to handle possible alterations in the actions of
modern medicines used for the treatment of CVDs.
To highlight the advances in traditional herbal medicines, their potential therapeutic
effects, possible drug-herb interactions and precautions to be taken are discussed in this
chapter. Patients commonly use These scientifically validated herbs as an alternative
therapy for the prevention and management of cardiovascular disorders.
Ayurveda, Adverse Effects, Cardiovascular Disorders, Herb-Drug
Shriman Sureshdada Jain College of Pharmacy, Chandwad, Maharashtra, India.