Traditional Indian Therapeutic Herbal Agent for the Treatment of Ischemic Myocardial Disorders: Promises and Precautions

Cardiovascular disorders (CVD) like ischemic heart disease, hypertension, dysrhythmia and cerebrovascular complications account for maximum mortality in developed and developing world. According to World Bank health review, estimated deaths in all age groups due to CVD may mount up to 33% by 2015. In addition, ever increasing healthcare costs to the society are also becoming a huge social liability. Especially, ischemic heart diseases (IHD) are leading cause of mortalities and morbidities encountered by almost all CVD patients around the world. Till now there are a few approved therapeutic agents, one of them is tissue plasminogen activator (tPA), for the treatment of ischemic disorders. Moreover, use of thrombolytic agents and surgical interventions involve high interventional costs both economically and physiologically. Prevention of IHD can significantly add on to the quality of life of the vulnerable section of population than its therapeutic management. It has been established that injury and ensuing necrosis to cardiomyocytes can result from sudden reperfusion of the ischemic core which is pathognomonic of myocardial ischemic reperfusion injury. The underlying mechanisms viz. exacerbated generation of reactive oxygen species (ROS), inflammatory reactivity and uncontrollable necrosis are responsible for massive cellular injury during IHD. An ideal treatment should address most of these mechanisms without disturbing other vital physiological systems. Traditional herbal therapy has been shown to provide almost all of these benefits. The clinical evaluation of active constituents of many ayurvedic medicines like Terminalia arjuna greatly reinforces these centuries’ old beliefs. However, the increasing concomitant use of herbal therapeutic agents with modern medicines by patients with CVD poses a grave clinical challenge to physicians. In addition to this, less than 50% of the patients inform the use of alternative medicines to their physicians. Even if patients report it, many times physicians himself is unaware of the knowledge about the activity and the toxicity potentials of active constituents. Hence, a physician sometimes finds himself grossly unequipped to handle possible alterations in the actions of modern medicines used for the treatment of CVDs.

Keywords: Ayurveda, Adverse Effects, Cardiovascular Disorders, Herb-Drug Interactions.