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| EDITORIAL |
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| Year : 2014 | Volume
: 35
| Issue : 2 | Page : 111-112 |
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Credential evidences of Ayurvedic cardio-vascular herbs
K Nishteswar
Executive Editor - AYU, I.P.G.T. and R.A., Gujarat Ayurved University, Jamnagar, Gujarat, India
| Date of Web Publication | 5-Dec-2014 |
Correspondence Address:
K Nishteswar
Executive Editor - AYU, I.P.G.T. and R.A., Gujarat Ayurved University, Jamnagar, Gujarat
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0974-8520.146194
How to cite this article:
Nishteswar K. Credential evidences of Ayurvedic cardio-vascular herbs. AYU 2014;35:111-2 |
The British scientist, Dr. N.J. Wald and Dr. M.R. Law of Wolfson Institute of Preventive Medicine at the University of London suggested a pill (six-in-one formulation) consisting of statin (hypocholestremic), three hypotensive drugs (thiazides, a beta blocker and an angiotensin-converting enzyme inhibitor), folic acid and aspirin for preventing heart attacks and stroke to be taken by everyone above the age of 55 years. This polypill can check four risk factors indicated for heart diseases, that is, (1) Abnormal levels of cholesterol and imbalance in the levels of proteins that transport it in the body, (2) abnormal blood pressure because of blockage of the tubes that carry it, (3) high levels of the harmful amino acid homocysteine, which damages blood vessels and (4) important functioning of the blood cells called platelets leading to blood clotting and vessel rupture - stroke. [1]
Though cardiovascular system was not envisaged by Ayurveda in the way in which it is being described presently in modern medicine, it appears that the various references pertaining to cardiovascular activities indicate that ancient Ayurvedists had a similar concept. References to the actual act of circulation are available in the Samhitas. The fluid that circulates in the body is spoken as Rasa because it is always going., th at is, ever circulating. The Rasa circulates round the body, like a rotating wheel. Sushruta states that the nutrient fluid circulates throughout the body with variable velocity, like the speed of light, sound and water. Bhela states that the nutrient fluid comes into circulation from the heart spreads all over the body through Siras. [2] The circulation described in Ayurvedic classics may be too sketchy as it does not describe portal circulation, renal circulation, etc. Alteration of the degree of circulation to the peripheral areas was described in Sushruta's description of blood not flowing out freely in Siravyadha (venesection). Charaka mentions that if the places where pulsations of vessel generally seen, if suddenly become free from pulsations it indicates a very bad prognosis. Dhamani Pratichaya described under Kaphaja Nanatmajavikara, is akin to atherosclerosis. Hypertension, which is the most important condition contributes for cardiovascular or cerebrovascular disorders was not described in Ayurveda and can be interpreted with different conditions like Raktavata, Raktagatavata, Siravata, Kaphavrita Vyana etc. [3]
Ayurvedic treatise documented drugs employed in Hridroga (Heart disease). Charaka introduced ten drugs under Hridya Mahakashaya group that comprises mostly like ascorbic acid of citrus fruits in it. It is proven that certain phytoconstituents present in these herbs help to maintain a healthy state of blood vessels including coronary arteries. Heart diseases are categorized according to Doshika dominance and Krimi. It appears to be very difficult to incorporate all the cardiovascular conditions described by modern medical science into these varieties. A critical analysis of the herbal lore utilized in the management of Hridroga (Heart disease) like Arjuna (Terminalia arjuna (Roxb.) Wight and Arn.), Pushkarmoola (Inula racemosa Hook. f.), Bala (Sida cordifolia Linn.), Nagabala (Sida humilis Linn.), Shunthi (Zingiber officinale Roscoe.), Pippali (Piper longum Linn.), Yashtimadhu (Glyccerrhiza glabra Linn.), Haritaki (Terminalia chebula Retz.) and Dashmoola, etc., clearly indicates that they are possessing hypotensive, hypocholestremic, anti-platelet and thrombolytic activities which play a crucial role in the management of cardio-vascular and cerebrovascular disorders.
Scientific evidence is available on the usefulness of several Ayurvedic drugs in cardiovascular diseases. Clinical studies have shown the efficacy of the bark of T. arjuna in congestive cardiac failure, [4] chronic stable angina [5] and hypertension. [6] T. arjuna and its constituent, Arjunolic acid have shown cardioprotective effects due to antioxidant activity in rats. [7],[8] Alcoholic extract of the bulb of Allium ascalonicum (single clove garlic) showed significant anticoagulant, fibronoloytic and hypocholesterolaemic activity in rabbits. [9] Crude extract of Andrographis paniculata (Burm.f.) Wall. Nees and its active ingredient andrographaloide have shown hypotensive activity in rats. [10] Studies reveal that it inhibits human platelet aggregation and could be useful in the prevention of myocardial ischemia. [11] The plant also helps in preventing re-stenosis of artery after coronary angioplasty. [12] Rhizome of Curcuma longa Linn. (turmeric) and its constituent, curcumin possess hypolipidemic effect, anti-atherosclerotic action [13] and antithrombotic effects. [14] In animal (rats, cats, dogs) studies, essential oil of rhizome of Nardostachys jatamansi DC. as well as Jatamansone displayed significant and prolonged hypotensive effect. Jatamansone was also shown to posses antiarrhythmic activity in certain animal models, besides its sedative and tranquillizing activities. Clinical support for these activities has also been obtained. [15] Pushkarguggulu (prepared form Pushkarmoola and Guggulu) has shown anti anginal and hypolipidemic activities in coronary heart disease. [16] Dr. Dean Ornish, the modern scientist, developed a program to reverse heart diseases with regular Suryanamaskar exercises and certain lifestyle modifications. [17]
A careful review of modern pharmacology indicates that cardiovascular drugs were developed initially from certain medicinal plants. Williams Withering (1776) reported that Digitalis (foxglove) had shown miraculous effect in few cases of dropsy. In 1911, Sir James Mackenzie demonstrated that, Digitalis blocks the atrio-ventricular condition. [18] This invention unearthed the potentialities of medicinal plants for the management of cardiac failure and paved the way for the search of cardiovascular drugs from natural resources. Quinidine, an isomer of the anti-malarial drug quinidine, is one of the natural alkaloids occurring in the Cinchona bark was introduced as an anti-arrhythmic drug. [19] Reserpine, an alkaloid from the root of Rauwolfia serpentina (L.) Benth. ex Kurz. is by far the most potent of all hypotensive alkaloids, whereas ajmaline had quinidine like properties. [20] Dihydrogenated ergot alkaloid (hydergine) is indicated in anti-hypertensive therapy. [21] Aspirin, initially developed from natural resources (English Willow-Salix alba var. cearulea tree) has been demonstrated to reduce the incidence of myocardial infarction in patients with chronic stable and unstable angina. [22]
Experimental research has produced vivid evidence about medicinal plants of Ayurvedic Materia Medica for their cardio protective, hypolipidemic, antianginal, fibrinolytic, thrombolytic, antiplatelet and antihypertensive activities. Unfortunately, none of these drugs are subjected to different phases of clinical trials for demonstrating their therapeutic utility. At the same time no attempts have been made so far to demonstrate the efficacy of Ayurvedic herbs in different varieties of Hridroga viz., Vataja, Pittaja, Kaphaja, Tridoshaja and Krimija varieties from Ayurvedic perspectives. Certain herbs appear to have a role in the prevention of heart diseases. The need of the hour is to produce credential clinical evidence for their role in the management of cardiovascular diseases.
For the prevention of heart diseases and cerebrovascular diseases, a herbal polypill can be developed by incorporating Ayurvedic herbs with known and proven value like - Guggulu, Arjuna, Pushkarmoola, Lasuna, Amalaki and Jatamansi for managing risk factors of cardiovascular conditions. Adaptation of performing Suryanamaskara (Sun salutation) may have added value in the programme of prevention of cardiovascular diseases. In this issue a review articles on natural medicaments in dentistry and some basic aspects of statistics in health sciences; eight clinical research articles; one case study on wound healing; two articles of pharmaceutical standardization and five articles of pharmacological study are included. The issue ends with a book review, on the work entitled 'Rasashastra' written by Andrew Mason.
 References | |  |
| 1. | Rodgers A. A cure for cardiovascular disease? Combination treatment has enormous potential, especially in developing countries. BMJ 2003;326:1407-8.  [ PUBMED] |
| 2. | Bhela, Bhela Samhita, Sutra Sthana, Urdhwadashamahamuliya Adhyaya, 20/3. In: Shukla G, editor. Reprint edition. Varanasi: Chaukhambha Bharati Academy; 2006. p. 32. |
| 3. | Nishteswar K. Ayurvedic Treatment for Hypertension (High Blood Pressure). Varanasi: Chowkhamba Krishnadas Academy; 2009. p. 3, 19. |
| 4. | Kumar DS, Prabhakar YS. On the ethnomedical significance of the Arjun tree, Terminalia arjuna (Roxb.) Wight and Arnot. J Ethnopharmacol 1987;20:173-90. |
| 5. | Bharani A, Ganguli A, Mathur LK, Jamra Y, Raman PG. Efficacy of Terminalia arjuna in chronic stable angina: A double-blind, placebo-controlled, crossover study comparing Terminalia arjuna with isosorbide mononitrate. Indian Heart J 2002;54:170-5. |
| 6. | Colabawalla HM. An evaluation of cardiotonic and other properties of Terminalia arjuna. Indian Heart J 1951;3:205-30. |
| 7. | Sumitra M, Manikandan P, Kumar DA, Arutselvan N, Balakrishna K, Manohar BM, et al. Experimental myocardial necrosis in rats: Role of arjunolic acid on platelet aggregation, coagulation and antioxidant status. Mol Cell Biochem 2001;224:135-42. |
| 8. | Karthikeyan K, Bai BR, Gauthaman K, Sathish KS, Devaraj SN. Cardioprotective effect of the alcoholic extract of Terminalia arjuna bark in an in vivo model of myocardial ischemic reperfusion injury. Life Sci 2003;73:2727-39. |
| 9. | Khare CP. Indian Medicinal Plants - An Illustrated Dictionary. 2 nd Indian Reprint. New Delhi: Springer (India) Pvt. Ltd.; 2007. p. 33. |
| 10. | Zhang C, Kuroyangi M, Tan BK. Cardiovascular activity of 14-deoxy-11,12-didehydroandrographolide in the anaesthetised rat and isolated right atria. Pharmacol Res 1998;38:413-7. |
| 11. | Amroyan E, Gabrielian E, Panossian A, Wikman G, Wagner H. Inhibitory effect of andrographolide from Andrographis paniculata on PAF-induced platelet aggregation. Phytomedicine 1999;6:27-31. |
| 12. | Wang DW, Zhao HY. Prevention of atherosclerotic arterial stenosis and restenosis after angioplasty with Andrographis paniculata nees and fish oil. Experimental studies of effects and mechanisms. Chin Med J (Engl) 1994;107:464-70. |
| 13. | Ramírez-Tortosa MC, Mesa MD, Aguilera MC, Quiles JL, Baró L, Ramirez-Tortosa CL, et al. Oral administration of a turmeric extract inhibits LDL oxidation and has hypocholesterolemic effects in rabbits with experimental atherosclerosis. Atherosclerosis 1999;147:371-8. |
| 14. | Olajide OA. Investigation of the effects of selected medicinal plants on experimental thrombosis. Phytother Res 1999;13:231-2. [ PUBMED] |
| 15. | Dev S. A Selection of Prime Ayurvedic Plant Drugs: Ancient - Modern Concordance. New Delhi: Anamaya Publishers, 2006. p. 313. |
| 16. | Singh R, Singh RP, Batiwala PG, Upadhyay BN, Tripathi SN. Puskara-Guggulu an antianginal and hypolipiemic agent in coronary heart disease (CHD). J Res Ayurveda Siddha 1991;12:1-18. |
| 17. | Ornish D. Dr. Dean Ornish′s Programme for Reversing Heart Disease. New York: Ivy Books; 1996. |
| 18. | Satoskar RS, Bhandarkar SD, Ainapure SS. Pharmacology and Pharmacotherapeutics. Chapter - 24, Digitalis and Pharmacotherapy of Cardiac Failure. 16 th ed. Mumbai: Popular Prakashan; 1999. p. 349. |
| 19. | Satoskar RS, Bhandarkar SD, Ainapure SS. Pharmacology and Pharmacotherapeutics. Chapter - 25, Pharmacotherapy of Cardiac Arrhythmias, 16 th ed. Mumbai: Popular Prakashan; 1999. p. 373. |
| 20. | Satoskar RS, Bhandarkar SD, Ainapure SS. Pharmacology and Pharmacotherapeutics. Chapter - 26, Pharmacotherapy of Hypertension, 16 th ed. Mumbai: Popular Prakashan; 1999. p. 394. |
| 21. | Satoskar RS, Bhandarkar SD, Ainapure SS. Pharmacology and Pharmacotherapeutics. Chapter - 26, Pharmacotherapy of Hypertension, 16 th ed. Mumbai: Popular Prakashan; 1999. p. 397. |
| 22. | Satoskar RS, Bhandarkar SD, Ainapure SS. Pharmacology and Pharmacotherapeutics. Chapter - 27, Vasodilator Drugs and Pharmacotherapy of Angina Pectoris, 16 th ed. Mumbai: Popular Prakashan; 1999. p. 428. |
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