Cardiovascular disease is defined as medical conditions affecting the cardiovascular system, including heart, blood vessels(arteries and veins).
I. Coronary heart disease
Coronary heart disease is defined as a condition of narrowing coronary arteries that lead to blockage of the blood flow in the arteries as a result of hardening arterial wall, cholesterol building up in the arteries, chemicals, such as cadmium clog up arteries, etc. affecting the small blood vessels that supply blood and oxygen to the heart. Coronary heart disease (CHD) is the leading cause of death in the United States.
E.2. Treatments In Herbal medicine perspective
The aim of herbal medicines is to treat the underlining causes of Coronary heart disease. If the disease is caused by structure problem then convention medical surgery could be necessary
a. Anti Diabetes and hypoglycaemic effect
People who have high levels of blood cholesterol are proven to be in increased risk for coronary heart disease and other sequelae of atherosclerosisstroke. Artichoke leaf extract (ALE) has demonstrated the effects of lowing the blood cholesterol in some researches, according to the abstract of study of “Artichoke leaf extract for treating hypercholesterolaemia” by Wider B, Pittler MH, Thompson-Coon J, Ernst E., posted in PubMed(101)
Artichoke contains high levels of antioxidant Flavonoids which can enhance the immune system fightinf against the forming of free radicals and guarding our body against foreign invasion such as bacteria and virus, thus reducing the risk of free radicals and bacteria and virus causes of infection and inflammation, according to the article of “Artichoke” posted in Wikipedia(102) c. Blood vessel integrity protection
Artichoke has shown a property of protection of the the layer of epithelial cells that lines the interior surface of blood vessels, according to the study of “The effect of artichoke (Cynara scolymus L.) extract on ROS generation in HUVEC cells” by Juzyszyn Z, Czerny B, Pawlik A, Droździk M.(103), researchers filed the conslusion in abstract that artichoke extract were demonstrated by the reduction kinetics of cytochrome c in reference to ascorbate were also revealed. The results of the present study the warrant application of artichoke extracts as endothelium protecting agents.
In the determination of parsley (Petroselinum crispum, Apiaceae) used in In Morocco, used to treat cardiovascular diseases such as arterial hypertension, found that The oral administration of CAE (3g/kg) inhibited significantly (p<0.001) platelet aggregation ex vivo and prolonged bleeding time (p<0.001) without changes in the platelet amount. The prolongation of bleeding time by CAE may be attributed to the observed inhibition of platelet aggregation. These effects could be related in part to the polyphenolic compounds present in the extract. These results support the hypothesis that the dietary intake of parsley may be benefit in the normalization of platelet hyperactivation, in the nutritional prevention of cardiovascular diseases and are potentially interesting in the development of new prevention strategies, according to “Parsley extract inhibits in vitro and ex vivo platelet aggregation and prolongs bleeding time in rats” by Gadi D, Bnouham M, Aziz M, Ziyyat A, Legssyer A, Legrand C, Lafeve FF, Mekhfi H.(104) b. Spasmolytic effect
In the investigation of Traditional herbal medicines such as Petroselinum crispum (Parsley) used for treatment of intestinal disorders in Iran, found that adding extract before influence of KCl, cause reduced effect of KCl (n = 7, p < 0.001). In addition, the Tyrode solution without CaCl2 and high concentration of K+, various concentration of extract significantly (n = 7, p < 0.001) decreased the CaCl2-induced contraction. Therefore, it seems that the relaxation effect of extract alcoholic parsley seed on the contraction of ileum is performed by blocking of voltage-gated calcium channels, according to “Spasmolytic effect of Petroselinum crispum (Parsley) on rat’s ileum at different calcium chloride concentrations” by Moazedi AA, Mirzaie DN, Seyyednejad SM, Zadkarami MR, Amirzargar A.(105)
In a study of measurements of pH, water holding capacity, color, oxymyoglobin content, TBARS and oxidation-reduction potential in evaluating the effects of a dietary protein-xanthophylls (PX) concentrate of alfalfa to turkey diets conducted by University of Life Sciences in Lublin, Skromna 8, 20-704 Lublin, Poland.(106), researchers found that TBARS and oxidation-reduction potential values suggested that the inclusion of the concentrate to turkey diets acts as an antioxidant in the raw meat. b. Cholesterol
In a study to test the effect of Alfalfa used in traditional medicine to treat high blood cholesterol conducted by Malinow MR, McLaughlin P, Stafford C.(107), in 3 human volunteers during ingestion of diets containing alfalfa seeds (AS) for 3 weeks, researchers found that Plasma cholesterol concentrations were reduced and No signs of toxicity were detected through serum determinations of multiple parameters. The ingestion of AS in rats decreased the concentration of plasma cholesterol, reduced intestinal absorption of exogenous and endogenous cholesterol, and increased fecal biliary excretion.
In a study of Fifteen patients with hyperlipoproteinemia (HLP), types IIA (n = 8), IIB (n = 3) and IV (n = 4) were given 40 g of heat prepared alfalfa seeds 3 times daily at mealtimes for 8 weeks with otherwise unchanged diet, conducted by Mölgaard J, von Schenck H, Olsson AG.(108), found that patients with type II HLP alfalfa treatment caused after 8 weeks a maximal lowering of pretreatment median values of total plasma cholesterol from 9.58 to 8.00 mmol/l (P less than 0.001) and low density lipoprotein (LDL) cholesterol from 7.69 to 6.33 mmol/l (P less than 0.01), which corresponds to decreases of 17% and 18%, respectively. Maximal decrease was 26% in total cholesterol and 30% in LDL cholesterol. In two patients with hypercholesterolemia the LDL cholesterol decreased less than 5%. Apolipoprotein B decreased in the same period from 2.17 to 1.43 g/l (P less than 0.05) in type II HLP, corresponding to 34% decrease, whereas apolipoprotein A-I did not change. Body weight increased slightly during the first 4 weeks of alfalfa treatment (P less than 0.001) probably because of the caloric content in the alfalfa seeds. After cessation of treatment, all lipoprotein concentrations returned to pretreatment levels. We conclude that alfalfa seeds can be added to the diet to help normalize serum cholesterol concentrations in patients with type II HLP.
a. Hypotensive effects
In the investigation of Hawthorn (Crataegus laevigata) leaves, flowers and berries used by herbal practitioners in the UK to treat hypertension in conjunction with prescribed drugs indicated that this is the first randomised controlled trial to demonstrate a hypotensive effect of hawthorn in patients with diabetes takin, according to “Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial” by Walker AF, Marakis G, Simpson E, Hope JL, Robinson PA, Hassanein M, Simpson HC(109)
b. Cardiac effects
In the evaluation of the potential cardiac effects of two alcohol extracts of commercially available hawthorn found that the mechanism of cardiac activity of hawthorn is via the Na(+),K(+)-ATPase and intracellular calcium concentrations are influenced, according to “A comparison of the effects of commercially available hawthorn preparations on calcium transients of isolated cardiomyocytes” by Rodriguez ME, Poindexter BJ, Bick RJ, Dasgupta A.(110)
c. Cardiovascular disease
In the analyzing the effect of hawthorn in prevention and protection of cardiovascular disease indicated that these beneficial effects may in part be due to the presence of antioxidant flavonoid components. While a number of studies have been performed to evaluate the clinical efficacy of hawthorn, an international, multicenter, prospective clinical study including a large number of New York Heart Association (NYHA) class II/III heart failure patients is ongoing to test hawthorn‘s long-term therapeutic effects, according to “Hawthorn: potential roles in cardiovascular disease“by Chang WT, Dao J, Shao ZH.(111)
d. Chronic heart failure
In the assessment of Hawthorn extract usedas an oral treatment option for chronic heart failure, found that Ten trials including 855 patients with chronic heart failure (New York Heart Association classes I to III) provided data that were suitable for meta-analysis. For the physiologic outcome of maximal workload, treatment with hawthorn extract was more beneficial than placebo (WMD (Watt) 5.35, 95% CI 0.71 to 10.00, P < 0.02, n = 380). Exercise tolerance were significantly increased by hawthorn extract (WMD (Watt x min) 122.76, 95% CI 32.74 to 212.78, n = 98). The pressure-heart rate product, an index of cardiac oxygen consumption, also showed a beneficial decrease with hawthorn treatment (WMD (mmHg/min) -19.22, 95% CI -30.46 to -7.98, n = 264). Symptoms such as shortness of breath and fatigue improved significantly with hawthorn treatment as compared with placebo (WMD -5.47, 95% CI -8.68 to -2.26, n = 239), according to “Hawthorn extract for treating chronic heart failure” by Pittler MH, Guo R, Ernst E.(112)
in the determination of The Yishoujiangzhi (de-blood-lipid) tablets (composed of Radix Polygori Multiflori, Rhizoma Polygonati, Fructus Lycii, Crataegus Pinnatifida and Cassia Tora) and its effect on Hyperlipemia found that in the treatment of 130 cases of hyperlipemia, achieving an effective rate of 87.0% in lowering serum cholesterol and 80.8% in lowering triglyceride, according to ‘Yishou jiangzhi (de-blood-lipid) tablets in the treatment of hyperlipemia” by Guan Y, Zhao S.(113)
8. Gingko biloba
Ginkgo enhanced endothelium-dependent vasodilation and elevation of the endothelial intracellular Ca(2+) level in SHR, resulting in hypotension, according to the study of “Effects of Ginkgo biloba extract on blood pressure and vascular endothelial response by acetylcholine in spontaneously hypertensive rats” by Kubota Y, Tanaka N, Kagota S, Nakamura K, Kunitomo M, Umegaki K, Shinozuka K.(114)
b. Cardiovascular tissues
Ginkgo biloba extract (EGb) has shown the protection of the cardiovascular tissues against HgCl(2)-induced oxidative damage, according to the study of “Protective effects of Ginkgo biloba extract against mercury(II)-induced cardiovascular oxidative damage in rats” by Tunali-Akbay T, Sener G, Salvarli H, Sehirli O, Yarat A.(115)
Ginkgo biloba leaves (EGB) has demonstrated the activities of limitation of the absorption of cholesterol, inactivation of HMGCoA and favorable regulation of profiles of essential polyunsaturated fatty acid (EFA), according to the study of “Application of GC/MS-based metabonomic profiling in studying the lipid-regulating effects of Ginkgo biloba extract on diet-induced hyperlipidemia in rats” by Zhang Q, Wang GJ, A JY, Wu D, Zhu LL, Ma B,(116)
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