Difference between revisions of "Cardiac diseases"

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Updates on management of cardiac diseases through Ayurveda
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'''Updates on management of cardiac diseases through Ayurveda'''
  
 
(This article is based on lecture delivered by Dr. Rohit Sane in Prof.M.S.Baghel Memorial Lecture Series on June 09, 2021.)
 
(This article is based on lecture delivered by Dr. Rohit Sane in Prof.M.S.Baghel Memorial Lecture Series on June 09, 2021.)
  
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The major chronic diseases prevailing in India are cardiovascular disorders (CVD), diabetes, hypertension, obesity and dyslipidemia. Mortality due to cardiovascular disease is increasing substantially. In the year 1990, the mortality rate due to CVD  in India was 15.2, which increased to 28.1 in 2016.  Despite the advancements in modern medicine, especially in treating CVD like angioplasty, bypass surgery, etc., the disease burden is increasing. Ayurveda can play a significant role in treating CVD as a lifestyle disorder and a non-communicable disorder.
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The major chronic diseases prevailing in India are cardiovascular disorders (CVD), diabetes, hypertension, obesity and dyslipidemia. Mortality due to cardiovascular disease is increasing substantially. In the year 1990, the mortality rate due to CVD  in India was 15.2, which increased to 28.1 in 2016.<ref>India State-Level Disease Burden Initiative CVD Collaborators. The changing patterns of cardiovascular diseases and their risk factors in the states of India: the Global Burden of Disease Study 1990–2016.Lancet Glob Health 2018; 6: e1339–51 Available from https://www.thelancet.com/action/showPdf?pii=S2214-109X%2818%2930407-8 cited on 23/06/2021 </ref> Despite the advancements in modern medicine, especially in treating CVD like angioplasty, bypass surgery, etc., the disease burden is increasing. [[Ayurveda]] can play a significant role in treating CVD as a lifestyle disorder and a non-communicable disorder.
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The risk factors of CVD are diabetes, hypertension, and obesity. The burden of these lifestyle disorders is also high on the rise.  As per the data available, 9.7% of the adult population in India has Diabetes.<ref>Akhtar SN, Dhillon P. Prevalence of diagnosed diabetes and associated risk factors: Evidence from the large-scale surveys in India. J Soc Health Diabetes [serial online] 2017 [cited 2017 Oct 15 ];5:28-36</ref>  Hypertension is present in 25% of urban and 10% of rural subjects in India. Stage I hypertension carries significant cardiovascular risk. Therefore, it is essential to treat these comorbid conditions while treating CVD.
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==Importance of animal trials==
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In Ayurvedic classical texts, different treatment techniques and different drugs are mentioned for the treatment of heart disorders. This must be reproved per the current knowledge. Animal trials are necessary to understand the mode of action of the drug along with re-establishing its efficacy.
 +
 
 +
==Antihypertensive herbs==
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Common Ayurvedic herbs used in the treatment of hypertension and their mechanism of action is shown in Table 1 below.
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{| class="wikitable"
 +
|+ Table 1: Herbs used in the management of hypertension
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|-
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! Herb  !! Latin Name !! Mechanism of action
 +
|-
 +
!  Bramhi !! Bacopa monnieri !! Calcium channel antagonist
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|-
 +
!  Shunthi !! Zingiber officinale !! Calcium channel antagonist
 +
|-
 +
! Vacha  !! Acorus calamus !! ACE inhibitor
 +
|-
 +
!  Bibhitaki !! Terminalia bellirica !! ACE inhibitor
 +
|-
 +
! Pippali  !! Piper longum !! ACE inhibitor
 +
|-
 +
!  Kalaajaji !! Nigella sativa !! Diuretic
 +
|-
 +
!  Punarnava !! Boerhaviadiffusa !! Diuretic
 +
|-
 +
|}
 +
 
 +
Since Bramhi and Shunthi are calcium channel antagonists they can be used for patients with systolic hypertension. Vacha, Bibhitaki and Pippali can be used in diastolic hypertension as they are ACE inhibitors. Kalaajaji and Punarnava are excellent diuretics to be used very effectively in the early phase of hypertension.
 +
 
 +
==Anti-diabeti cherbs==
 +
 
 +
Some of the Ayurvedic herbs used in diabetes management and their mechanism of action are shown in Table 2.
 +
 
 +
{| class="wikitable"
 +
|+ Table 2: Herbs used in the management of diabetes
 +
|-
 +
! Herb  !! Latin Name !! Mechanism of action
 +
|-
 +
!  Daruharidra !! Berberis aristata !! Hypolipidemic, insulin resistance
 +
|-
 +
! Amalaki !! Phyllanthus emblica !! Beta cell-protective & beta cell regenerative
 +
|-
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!  Haridra !! Curcuma longa !! Hypolipidemic & Beta cell protective
 +
|-
 +
! Vishanika /Gudmar*  !! Gymnema sylvestre !! Insulin secretogogues
 +
|-
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! Banaba/ Jarul  !! Lagerstroemia speciosa !! Insulin secretogogues
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|-
 +
|}
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*Gudmar also has the capacity to produce a coat over the intestine so that the carbohydrate absorption through the gut gets reduced.

Revision as of 08:31, 28 June 2021

Contributors
Section/Chapter/topic Concepts and Contemporary Practices -Nidana Chikitsa / Vyadhi / Cardiac diseases
Author Dr. Sane Rohit 1
Reviewer Basisht G.2
Editors Deole Y.S.2, Aneesh E.G.2, Basisht G. 2
Affiliations

1 M.D. & C.E.O. at Madhavbaug, Vaidya Sane Ayurvedic Labs Pvt. Ltd. Thane, Maharashtra, India

2Charak Samhita Research, Training and Development Centre, I.T.& R.A., Jamnagar, Gujarat, India
Correspondence email: carakasamhita@gmail.com
Date of first publication: June 26, 2021
DOI Under process

Updates on management of cardiac diseases through Ayurveda

(This article is based on lecture delivered by Dr. Rohit Sane in Prof.M.S.Baghel Memorial Lecture Series on June 09, 2021.)

The major chronic diseases prevailing in India are cardiovascular disorders (CVD), diabetes, hypertension, obesity and dyslipidemia. Mortality due to cardiovascular disease is increasing substantially. In the year 1990, the mortality rate due to CVD in India was 15.2, which increased to 28.1 in 2016.[1] Despite the advancements in modern medicine, especially in treating CVD like angioplasty, bypass surgery, etc., the disease burden is increasing. Ayurveda can play a significant role in treating CVD as a lifestyle disorder and a non-communicable disorder.

The risk factors of CVD are diabetes, hypertension, and obesity. The burden of these lifestyle disorders is also high on the rise. As per the data available, 9.7% of the adult population in India has Diabetes.[2] Hypertension is present in 25% of urban and 10% of rural subjects in India. Stage I hypertension carries significant cardiovascular risk. Therefore, it is essential to treat these comorbid conditions while treating CVD.

Importance of animal trials

In Ayurvedic classical texts, different treatment techniques and different drugs are mentioned for the treatment of heart disorders. This must be reproved per the current knowledge. Animal trials are necessary to understand the mode of action of the drug along with re-establishing its efficacy.

Antihypertensive herbs

Common Ayurvedic herbs used in the treatment of hypertension and their mechanism of action is shown in Table 1 below.

Table 1: Herbs used in the management of hypertension
Herb Latin Name Mechanism of action
Bramhi Bacopa monnieri Calcium channel antagonist
Shunthi Zingiber officinale Calcium channel antagonist
Vacha Acorus calamus ACE inhibitor
Bibhitaki Terminalia bellirica ACE inhibitor
Pippali Piper longum ACE inhibitor
Kalaajaji Nigella sativa Diuretic
Punarnava Boerhaviadiffusa Diuretic

Since Bramhi and Shunthi are calcium channel antagonists they can be used for patients with systolic hypertension. Vacha, Bibhitaki and Pippali can be used in diastolic hypertension as they are ACE inhibitors. Kalaajaji and Punarnava are excellent diuretics to be used very effectively in the early phase of hypertension.

Anti-diabeti cherbs

Some of the Ayurvedic herbs used in diabetes management and their mechanism of action are shown in Table 2.

Table 2: Herbs used in the management of diabetes
Herb Latin Name Mechanism of action
Daruharidra Berberis aristata Hypolipidemic, insulin resistance
Amalaki Phyllanthus emblica Beta cell-protective & beta cell regenerative
Haridra Curcuma longa Hypolipidemic & Beta cell protective
Vishanika /Gudmar* Gymnema sylvestre Insulin secretogogues
Banaba/ Jarul Lagerstroemia speciosa Insulin secretogogues 
*Gudmar also has the capacity to produce a coat over the intestine so that the carbohydrate absorption through the gut gets reduced.
  1. ↑ India State-Level Disease Burden Initiative CVD Collaborators. The changing patterns of cardiovascular diseases and their risk factors in the states of India: the Global Burden of Disease Study 1990–2016.Lancet Glob Health 2018; 6: e1339–51 Available from https://www.thelancet.com/action/showPdf?pii=S2214-109X%2818%2930407-8 cited on 23/06/2021
  2. ↑ Akhtar SN, Dhillon P. Prevalence of diagnosed diabetes and associated risk factors: Evidence from the large-scale surveys in India. J Soc Health Diabetes [serial online] 2017 [cited 2017 Oct 15 ];5:28-36
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