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, Shrung-Bhasma 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
Triphala-Guggulu, Medohar-Guggulu, Arogya-
Vardhini, 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-Tinduk-Vati, 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,
single-dose 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.