CHF
1) Herbs containing cardiotonic glycosides |
2) Hawthorn leaves, flowers (berries) |
Dgitalis sps. Strophanthis sp. Squill bulbs |
AI: flavonoids (anthocyanidins, proanthocyanidins) |
MOA: Increase Ca in heart muscle--> Increased contractions-->positive inotropic effect |
MOA: AMP phosphodiesterase inhibitor--> decrease in cyclic AMP--> increase in contractions.
Antioxidant//vasodilatory to coronary and peripheral BV. |
Due to low therapeutic index, they are monitored under medical supervision (part of conventional therapy) |
Low arrythmia risk (unlike digoxin), so DOC in CHF. |
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Effective on:
-Chronic heart disease (reduces angina chance)
-CHF class II |
Atherosclerosis
1) Garlic bulb |
2) Green tea extract |
3) Grape seed extract |
AI: (odorless, inactive) Aliin--alliinase--> (active, odor) Allicin---> ajoene, alkyl disulfides.
S-allyl-cysteine |
AI: polyphenols (procyanidins, catechins) |
AI: procyanidins |
MOA: Antithrombotic(ajoenes)/ Antihyperlipidemic (S-allyl cysteine)/Vasodilatory |
MOA: antioxidant activity to inhibit LDL-C oxidation;
chemoprevention & for CVD by scavenging free radicals. |
MOA: potent antioxidant. |
SE/caution: GIT upsets, garlic breath, bleeding risk (caution with anticoagulants & NSAIDS) |
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Has same MOA of green tea extract with added use for circulatory disorders like venous insufficiency. |
Adjunct & preventative in HTN |
Phytotherapy as preventative measure.
Angina
1) Hawthorn |
2) Ginseng |
3) Danshen (red sage) |
MOA: dilates coronary BV |
AI: ginsenosides, saponins, sesquiterpenes. |
MOA: Free radical scavenging/ Coronary BV dilation/ inhibits platelet aggregation (root decoction) |
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MOA: Ca2+ channel antagonist--coronary artery dilation/inhibits atherogenesis/fibrinolytic
Releases vasodilator NO |
Caution: bleeding risk with warfarin or anticoagulants. |
HTN
1) Garlic bulb "Allium sativa" |
2) Black seed "Nigella sativa" |
3) Snakeroot "rauwolfia |
4) Hibiscus |
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AI: VO (thymoquinone, carvacol, P-cymene)
Fixed oils |
AI: reserpine alkaloid |
AI: Organic acids/Polyphenols (anthocyanidins)/Pectin, mucilage, minerals |
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MOA: Releases NO/Ca2+ channel antagonist/Ace-inhibitory like effects--> VD
/Antioxidant/Antihyperlipidemic |
MOA: reserpine destroys biologic amines vesicle--> the released amines are broken down by MAO--> antihyoertensive + CNS depressant effect |
MOA: Antioxidant |
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Uses: mild, uncomplicated HTN |
Uses: mild-moderate HTN & combination therapy to avoid excessive CNS depression |
Uses: cooling drink, antihypertensive |
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Caution: with other antiHTN or diuretics for additive hypotensive effect |
Chronic venous insufficiency (CVI)
1) Horse chestnut "Aesculus hippocastanum" |
2) Butchers broom "Ruscus aculeatus" |
3) Bilberry "Vaccinum myrtillus" |
AI: Coumarins (aesculetin), flavonoids, saponins, tannins |
AI: Steroidal saponins (ruscogenin, neoruscogenin) |
AI: Anthocyanins, tannins, flavonoids |
MOA: inhibits lysosomal enzyme--> reduce capillary permeability--> less water & proteins release
Relieves edema/increases venous tone |
MOA: VC of veins only, which reduces blood stasis in veins |
MOA: stimulate capillary repair
- Antiplatelet activity |
Uses: (by approval of GCE) for symptomatic ttt of CVI |
Uses: for symptoms of CVI |
AE: some GIT complaints |
AE: GIT effects, nausea |
Caution: HCE should not be injected due to hemolysis risk (due to saponins, Aescin) |
Most common manifestation is Varicose veins.
Horse chestnut & Butcher's broom topical creams are approved by GCE for hemorrhoids & CVI ttt.
Hemorrhoids
1) Witch hazel |
AI: mix of tannins (gallotanins, hamamelitanins & procyanidins) |
AE: contact dermatitis |
Enlarged, inflamed venous plexus of rectum/anus. Pain, bleeding, itchiness may occur.
- Aggravated by constipation or straining.
-Common in pregnancy
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