LECTURE 5 Herbal treatment for vascular disease

Angina Pectoris - Ayurvedic Herbal Treatment

Angina pectoris, typically chest pain, is a common presenting symptom among patients with coronary artery disease, caused by an imbalance between myocardial blood supply and oxygen demand. Myocardial ischemia can result from a reduction of coronary blood flow, abnormal construction of coronary vessels or a reduced oxygen carrying

capacity of the blood. Causes of angina pectoris include atherosclerosis, coronary spasm and inflammatory vascular disease. A family history of the disease, cigarette smoking, diabetes mellitus, high cholesterol levels, obesity and systemic hypertension are known risk factors for this disease. The Ayurvedic treatment of angina pectoris is aimed at relieving the symptoms, slowing the progression of the disease and reducing the possibility of future events like myocardial infarction and premature death. Medicines like Laxmi-Vilas-Ras, ShrungBhasma and Bruhat-Vat-Chintamani are used to relieve the pain. In order to slow down the progress of the disease, atherosclerosis and hyperlipidemia have to be controlled. Medicines like TriphalaGuggulu, Medohar-Guggulu, ArogyaVardhini, Amalaki (Emblica officinalis), Haritaki (Terminalia chebula), Behada (Terminalia bellerica), Vishwa (Zinziber officinalis), Marich (Piper nigrum), Pippali (Piper longum), Guggulu (Commiphora mukul), Chitrak (Plumbago

zeylanica), Psyllium (Plantago ovata), Lashuna (Allium sativum) and Kutki (Picrorrhiza kurroa) are used for this purpose. Medicines like Sarpagandha (Rauwolfia serpentina), Jyotishmati (Celastrus panniculatus), Arjun (Terminalia Arjuna), Brahmi (Bacopa monnieri), Punarnava (Boerhaavia diffusa), Apamarga (Achyranthus aspera), Shilajit (Purified bitumen), Tankan (Purified borax) and Khurasani Ova (Hyoscymus niger) are used to strengthen the heart muscle and control hyper tension. Medicines like Tapyadi-Loh, Ekang-Veer-Ras, Mahamanjishthadi Qadha, Chandraprabha-Vati, Saarivasav, Chandanasav, Manjishtha (Rubia cordifolia, Saariva (Hemidesmus indicus), Yashtimadhuk (Glycerrhiza glabra), Chandan (Santalum album) and Usheer (Vetiveria zizanioidis) are used to reduce inflammation in the coronary arteries. To reduce or prevent spasm in the coronary vessels, medicines like Trayodashang-Guggulu, Vish-TindukVati, Kuchla (Strychnos nuxvomica),

Vishwa, Dashmool (Ten roots), Nirgundi (Vitex negundo), Ashwagandha (Withania somnifera) and Shatavari (Asparagus racemosus) are used. Smoking cessation is a very important factor which can result in a significant reduction of acute adverse effects on the heart. Patients should be educated to adopt a healthy life style, stop smoking and alcohol consumption, adopt a healthy and balanced diet and increase regular physical activity. Exercise training results in improvement of symptoms, increase in the threshold of ischemia and improvement of patients' sense of well being. Yogic asanas and pranayam also help in reducing symptoms and increasing physical and mental fitness. It is important to reduce stress. Since complications of angina pectoris include unstable angina, myocardial infarction and death, it is important that all people suffering from angina pectoris be under the regular care and supervision of a Cardiologist.

Phytotherapy Teas or tinctures can be taken internally three to four times a day to help heal varicose veins from the inside. The actions of the medicinal plants listed here can increase vein elasticity, reduce blood-vessel fragility, stimulate circulation and reduce water retention. Horse chestnut (Aesculus hippocastanum) strengthens blood vessels and is an effective astringent that tones and tightens tissues.2 The herb reduces capillary fragility and swelling by regulating capillary permeability, and it helps strengthen and repair blood vessels that have lost their elasticity.3 The shiny brown fruits of this ornamental shade tree have a long history of treating varicose veins. As is the case with many herbs, horse chestnut's historical uses are being affirmed by modern research, and

now some animal, clinical and in vitro studies give evidence of the herb's benefit.4 At least two classes of compounds in horse chestnut, aesculin and aescin, may affect circulation. Both are coumarin glycosides; coumarins slow the onset of blood coagulation and are found in more than 150 species of medicinal plants. Aesculin thins blood and improves blood viscosity, so is thought to be endowed with vascular-protective properties.5 Aescin is a complex mixture of saponins, which are soaplike agents found in plants such as potatoes and beans that foam when cooked. Saponin compounds reduce the surface tension of liquids, and aescin itself increases the permeability of the inner vascular walls, making it easier for tissue fluids to drain into

capillaries. Aescin, present at up to 13 percent in horse chestnut, is reported to have anti-inflammatory, anti-swelling and anti-exudative (oozing of fluids) properties.5 Rutin, the key flavonoid in buckwheat, and other flavonoids have long been used to treat weak capillaries and veins—and aescin is 300 times more potent than rutin.6 Commercial extracts of aescin from horse chestnut seeds also have been shown to reduce excessive clotting. Researchers at Bastyr University in Kenmore, Wash., conducted a double-blind, randomized, singledose trial on 71 healthy individuals to assess the effects of a topical 2 percent aescin gel on experimentally induced bruises (broken blood vessels). The aescin gel reduced inflammation and tenderness in all cases over the recorded 10-hour period.

Other astringent herbs include white oak (Quercus alba) bark and witch hazel (Hamamelis virginiana). The healing and anti-inflammatory actions of calendula (Calendula officinalis) are also well suited for treating varicose veins. These herbs can be taken as teas and used in sitz baths or used as compresses with a few drops of the essential oils added for their synergistic effects. A salve can be made of any of these herbs for treating hemorrhoids. Other herbs stimulate peripheral circulation, thereby aiding blood flow in the legs. These include ginkgo (Ginkgo biloba), ginger (Zingiber officinalis), cayenne (Capsicum frutescens), and prickly ash (Zanthoxylum americanum). Garlic (Allium sativum), either fresh cloves or odorless standardized capsules, and bromelain from pineapple both

contain enzymes that improve circulation by dissolving blood vessel fibrin that forms lumpy deposits around the veins.10-11 If water retention causes ankle or leg swelling, a diuretic such as dandelion (Taraxacum officinale) or yarrow (Achillea millefolium) is also helpful. Hawthorn (Crataegus spp.) is said to improve circulation by safely toning the heart muscle. Hawthorn also contains proanthocyanidins and anthocyanidins, which increase capillary strength and tone veins.12-14 Liver tonic and cleansing herbs such as Oregon grape (Berberis aquifolium), milk thistle (Silybum marianum), dandelion and burdock (Arctium lappa) are important for varicose vein treatment. A popular remedy is yellow dock (Rumex crispus); though not for varicose veins specifically, it is a helpful liver

tonic and cleanser, and is a safe, mild laxative. Finally, nonherbal methods can also ease the discomfort of varicose veins. Sitz baths (for hemorrhoids) or hot and cold compresses (for varicose veins in the legs) often provide the greatest immediate pain relief. Hot and cold water added to a bath in one- to three-minute intervals improves circulation and helps decongest the veins. Compression stockings also relieve the pain of varicose veins, but the stockings themselves can be a nuisance. Also, using a slantboard to raise the legs above the level of the head for 10-minute intervals several times a day can bring relief. Even though chronic venous insufficiency is one of the more common health conditions of the adult population, it's nice to know

nature offers effective remedies for its treatment.