Diseases of the Cardiovascular System

Herbs For Diseases Of The Cardiovascular System Formulas For Cardiovascular Conditions Strategy Implement appropriate lifestyle changes and appropriate diet. Monitor patients regularly, particularly if herbs are used as the sole treatment for early cases or if the patients are on conventional medication. Doses can be adjusted upwards if changes of less than 20% have been observed per week. The doses of conventional medicines may need to be reviewed 1 to 2 weeks after beginning treatment with herbs. It is assumed that conventional medicines will be used for diagnosed cardiac disease, whenever good evidence exists for efficacy. In most cases these formulas provide adjunctive care. The formulas below can be made as per the recipe or adapted from other recipes according to patient needs. They are formulated to allow substitution. Hypertrophic cardiomyopathy Astragalus: Immune-enhancing, tonic, cardiotonic, nephroprotective, diuretic, hypotensive; 1 part. Bugleweed: Cardioactive, diuretic, reduced heart rate, sedative, thyroxine antagonist; 1 part. Motherwort: Sedative, antispasmodic, cardiac tonic; 1 part. Ginkgo: PAF inhibitor, antioxidant, circulatory stimulant, cognitive enhancer; 1 part. Dandelion Read more […]

Herb-Drug Interactions: Cat’s claw

Uncaria tomentosa DC, Uncaria guianensis J.F.Gmel. (Rubiaceae) Synonym(s) and related species Life-giving vine of Peru, Samento, Saventaro, Una de gato. Pharmacopoeias Cat’s Claw (US Ph 32); Powdered Cat’s Claw (US Ph 32); Powdered Cat’s Claw Extract (US Ph 32); Cat’s Claw Tablets (US Ph 32); Cat’s Claw Capsules (The United States Ph 32). Constituents The main constituents of both the closely related species of cat’s claw include the tetracyclic oxindole alkaloids, isorhynchophylline and rhynchophylline, and the indole alkaloids, dihydrocoryynantheine, hirsutine, and hirsuteine. Quinovic acid glycosides have also been isolated. Note that there are two chemotypes of Uncaria tomentosa, one primarily containing the tetracyclic oxindole alkaloids, isorhynochophylline and rhynchopylline, and one primarily containing the pentacychc oxindole alkaloids, (iso)pteropodine and (iso)mitraphylline. Use and indications Cat’s claw roots, bark and leaves have been used for gastric ulcers, arthritis, gonorrhoea, dysentry, herpes zoster, herpes simplex and HIV, and as a contraceptive. In various preclinical studies, antiviral, anti-inflammatory, antirheumatic, immunostimulating, antimutagenic, antitumour and hypotensive Read more […]

Herb-Drug Interactions: Cocoa

Theobroma cacao L. (Sterculiaceae) Synonym(s) and related species Cacao, Chocolate, Chocolate tree, Theobroma. Pharmacopoeias Chocolate (US Ph 32); Cocoa Butter (US Ph 32); Theobroma Oil (British Pharmacopoeia 2009). Constituents Cocoa seeds contain xanthine derivatives, principally theobromine (1% to 4%), with small amounts of caffeine (up to about 0.4%) and other alkaloids. They are also rich in flavonoids from the flavanol and procyanidin groups, mainly catechin and epicatechin and their polymers. The nibs (cotyledons) are a rich source of cocoa butter (theobroma oil), which contains oleic, stearic, palmitic and linoleic acids. Use and indications The seeds roasted and powdered are the source of cocoa, which is mainly used as a food (in chocolate). Medicinal uses include as a stimulant and as a diuretic; effects that can be attributed to the xanthine content. However, note that theobromine is a much weaker xanthine than caffeine. Cocoa butter is used as an emollient and pharmaceutical excipient. More recently, there has been interest in the possible beneficial effects of cocoa consumption on cardiovascular health, because of its high content of flavonoids. Pharmacokinetics The pharmacokinetics of caffeine Read more […]

Plants Used in Traditional Chinese Medicine

The practice of TCM has been documented for thousands of years, and the medicinal preparations used include various substances of animal, fungal and plant origin. TCM has also influenced the traditional medicine practiced in neighbouring regions, such as Japan, Korea and Vietnam. Evodia rutaecarpa (Juss.) Benth. The plant described in the Pharmacopoeia of the People’s Republic of China (2005) as Evodia rutaecarpa (Juss.) Benth. (Rutaceae) is used in TCM for its reputed cardiotonic, restorative and analgesic effects. Extracts and alkaloids isolated from this plant have been investigated for activities that might help to explain the reputed restorative effects. An ethanol extract of this plant and four compounds present, dehydroevodiamine, evodiamine, rutaecarpine and synephrine, have been shown to be anti-inflammatory in vitro, an action that has been implicated as potential therapy in some cognitive disorders. The alkaloid rutaecarpine is also reported to inhibit COX-2 activity in vitro and to be anti-inflammatory in vivo, although another study showed evodiamine to inhibit COX-2 induction and NF-kB activation, whilst rutaecarpine did not show these effects. Evodiamine has also been shown to inhibit both constitutive Read more […]

Ginkgo biloba

In Europe, leaf preparations of Ginkgo biloba L. (Ginkgoaceae) were used for the treatment of circulatory disorders in the 1960s, and they are now a popular herbal remedy with a reputation for alleviating memory problems. In Iran, Ginkgo biloba has been used traditionally to improve memory associated with blood circulation abnormalities. The use of Ginkgo biloba in TCM dates back for centuries, and the Pharmacopoeia of the People’s Republic of China (2005) includes G biloba seeds as a remedy for cough and asthma and to reduce leukorrhoea and urination. There has been extensive research to determine any pharmacological basis which might explain the reputed effects of Ginkgo biloba on memory, and a number of clinical studies have also been conducted. Much of this research has used a standardised extract of Ginkgo biloba known as EGb 761, which contains flavonoid glycosides and terpenoid lactones amongst various other constituents. This extract has shown a variety of activities relevant to improving cognitive function, particularly neurodegenerative-related disorders such as Alzheimer’s disease, thus indicating that the extract may have a number of different modes of action. EGb 761 has shown favourable effects on Read more […]

CYCLOOXYGENASE INHIBITORS

CYCLOOXYGENASE INHIBITORS bind reversibly or irreversibly to the enzyme cyclooxygenase (originally referred to as the prostaglandin synthase system or ‘prostaglandin H2 synthase'; (PGHS)-l and (PGHS)-2). Members of the prostaglandin family have a number of proinflammatory or hyperalgesic actions, and consequently many cyclooxygenase inhibitors are used as anthnflammatories and ANALGESICS. Prostanoids are members of the eicosanoid family of phospholipid mediators, and are comprised of the thromboxanes and the prostaglandins, both of which are formed by the complex cyclooxygenase system. They share common precursors in the form of a series of unstable cyclic endoperoxides. The first stage of the transformation of arachidonic acid has the enzyme endoperoxide synthase oxygenate arachidonate, followed by cyclization to give a cyclic endoperoxide called PGG2. These reactions are inhibited by cyclooxygenase inhibitors. Subsequently, PGG2 is converted by a peroxidase action to PGH2. This is a common precursor for a number of different pathways, forming prostacyclin (by prostacyclin synthase), the various prostaglandins or thromboxanes (by thromboxane synthase). See THROMBOXANE SYNTHASE INHIBITORS. The conversion depends Read more […]

Herb-Drug Interactions: Yarrow

Achillea millefolium L. (Asteraceae) Synonym(s) and related species Achillea, Milfoil, Nosebleed. Achillea collina Becker and Achillea lanulosa Nutt. are closely related and are also frequently used. Pharmacopoeias Yarrow (British Ph 2009, European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4). Constituents Yarrow contains a volatile oil composed of various monoterpenes (including limonene and alpha-thujone), and sesquiterpene lactones (including achillicin, achillin, millefin and millefolide). Azulene is the major component in the closely related Achillea collina and Achillea lanulosa but it is reported to be absent in Achillea millefolium. Yarrow also contains pyrrolidine and pyridine alkaloids, flavonoids (including apigenin, quercetin and rutin), tannins and sugars. Use and indications Yarrow has been used in the treatment of bruises, swellings and strains, and for fevers and colds. It has also been used for essential hypertension, amenorrhoea, dysentery, diarrhea and specifically for thrombotic conditions. There is little, if any, clinical evidence to support these uses, but extracts and many of the constituents have reported anti-inflammatory and antiplatelet activity. Pharmacokinetics An Read more […]

Herb-Drug Interactions: Willow

Salix species (Salicaceae) Synonym(s) and related species European willow, Salix, White willow. Salix alba L., Salix cinerea L., Salix daphnoides, Salix fragilis L., Salix pentandra L., Salix purpurea L. Pharmacopoeias Willow Bark (British Ph 2009, European Ph 2008); Willow Bark Dry Extract (British Ph 2009, European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4). Constituents The bark of willow contains the phenolic glycosides salicin (up to 10%), acetylsalicin, salicortin, salireposide, picein, triandrin. Esters of salicylic acid and salicyl alcohol, and flavonoids and tannins are also present. Extracts are sometimes standardised to a minimum of 1.5% of total salicylic derivatives, expressed as salicin (British Ph 2009, European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4). Use and indications The bark of willow is reported to have analgesic, anti-inflammatory, antipyretic and astringent properties. It has long been used for treating all kinds of fevers, headache, influenza, rheumatism, gout and arthritis. Pharmacokinetics In a pharmacokinetic study, 10 healthy subjects were given two oral doses of Salix purpurea bark extract, each standardised to contain 120 mg of salicin, 3 Read more […]

Herb-Drug Interactions: Tea

Camellia sinensis (L.) Kuntze (Theaceae) Synonym(s) and related species Camellia thea Link, Thea sinensis L. Note that Green tea (predominantly produced in China and Japan) is produced from steam-treated tea leaves. Black tea or Red tea (predominantly produced in India, Sri Lanka and Kenya) is processed by fermentation and heating, whereas Oolong tea is partially fermented. Pharmacopoeias Powdered Decaffeinated Green Tea Extract (The United States Ph 32). Constituents Tea contains caffeine (around 1 to 5%), with minor amounts of other xanthines such as theophylline and theobromine. Tea also contains flavonoids, the content of which varies between green (unfermented) and black (fermented) tea. Green tea appears to contain greater quantities of the flavonol-type flavonoids than black tea. Black tea also contains theaflavins, which are produced during the fermentation process. Other flavonols present include quercetin and kaempferol. Oolong tea contains some unique flavones known as oolonghomobisflavins. Tea also contains up to 24% tannins. Use and indications The leaf buds and very young leaves of tea are used as a stimulant and diuretic, actions that can be attributed to the caffeine content. They are Read more […]

Herb-Drug Interactions: Resveratrol

Types, sources and related compounds Resveratrol is a polyphenol present in most grape and wine products and is the compound largely credited with providing the health benefits of red wine. However, the concentration is very variable between foods and supplements, so it is difficult to evaluate the clinical relevance of the available information. Use and indications Resveratrol is used for its reputed anti-ageing effects. It is said to have antioxidant properties and antiplatelet effects, and is therefore promoted as having benefits in a variety of cardiovascular diseases, including atherosclerosis. It also has some oestrogenic and anti-inflammatory activity, and is under investigation in the prevention and treatment of cancer, because it appears to reduce cell proliferation. Pharmacokinetics An in vitro study reported that resveratrol inhibited the cytochrome P450 isoenzyme CYP3A4, but was much less potent than erythromycin, a known, clinically relevant, moderate CYP3A4 inhibitor. Similar results were found in other studies. Interestingly, red wine also inhibited CYP3A4, but this effect did not correlate with the resveratrol content. In other studies resveratrol had only very weak inhibitory effects on CYP1A2, Read more […]