On Coronary Heart Disease and Chinese herbal formulas and/or specific herbs to help and/or prevent - Research Paper Example

Coronary Heart Disease and Chinese Herbal Formulas Introduction Coronary heart disease has become one of the major causes of morbidity and mortality in the United States. With the increased rates of obesity and intake of processed and high cholesterol foods, this issue will likely continue to prevail in US society. In fact, coronary heart disease (CHD) or coronary artery disease (CAD) is said to affect about 14 million people in the United States alone (WebMD, p. 1). According to the Centers for Disease Control (CDC) CHD is the most common type of heart disease in the US with about 445,000 individuals in 2006 alone dying from the disease. There are different suggested interventions for CHD, these interventions range from the field of traditional medicine to that of complementary and alternative medicine. In the traditional medicine field, conventional treatments like heart medications and surgery are being implemented. Interest in the field of complementary and alternative medicine has also been raised. In this regard, Chinese herbs and Chinese herbal formulas have been considered in the management and treatment of coronary heart disease. These herbs have been known to help in the stabilization and/or prevention of CHD and its associated symptoms. This paper shall discuss how these Chinese herbs and herbal formulas can help with the management of CHD with particular attention to how they assist in the stabilization of this disease. Discussion The heart, like any other organ in our body, is supplied with blood. The coronary arteries supply the heart with the blood it needs in order to power the heart muscles or the myocardium which the much needed energy to pump blood. Coronary heart disease manifests when combined fatty material, calcium, and scar tissue builds up in the walls of the arteries which supply blood to the heart (WebMD, p. 1). The plaque narrows the arteries, making it difficult for the heart to pump blood; and the slowed blood flow then causes chest pain. In some instances, the plaque completely obstructs the blood flow and causes a heart attack or a disruption in the rhythm of the heart which may lead to cardiac arrest (WebMD, p. 1). There are different possible causes of CHD and these causes include: high levels of cholesterol, tobacco use, obesity, high blood pressure, diabetes, lack of exercise, emotional stress, and genetics (WebMD, p. 2). In order to manage its symptoms, medical practitioners advocate for a healthy lifestyle. Healthy lifestyle is based on a healthy diet (low in fat, with fruits and vegetables); on exercise; on moderate alcohol; and a no smoking lifestyle. Medical treatment for this disease involves the administration of aspirin for the reduction of risks of clot; beta-blockers which decreases the heart rate and blood pressure; nitroglycerin which reduces chest pain and decreases the heart’s oxygen requirement by dilating arteries; calcium channel blockers which dilate coronary arteries; ACE inhibitors which dilate blood vessels; statins which reduce lipids in the blood (WebMD, p. 4). Medical procedures include cardiac catheterization for blocked arteries; coronary angioplasty; stenting; atherectomy, and bracytherapy (WebMD, p. 6). These remedies can however still be insufficient in relieving the symptoms and managing the disease. The Chinese herbal options shall now be discussed. Based on a variety of studies, Chinese herbs and herbal formulas can help in the management of CHD. Chinese herbal medicines have various uses and a combination of herbs have been considered in the treatment of this disease. Chi shao yao or red peony root is said to eliminate heart stasis and invigorate the blood; dan shen (red sage) is considered a tonic for the blood and helps improve its movement through the heart; dang gui (angelica) invigorates the blood and strengthens it; nui xi (Achyranthes root) removes blood stasis and revives the blood; and zhi ke (bitter orange) improves the flow of qi through the heart (AltMD). A combination of herbs is used in order to achieve the various benefits which can potentially be gained from these herbs. In the traditional preparation of the Xue Fu Zhu Yu Tang treatment, 11 herbs are used to manage coronary heart disease and angina. Based on a small study comparing the use of traditional medicine to this combination herbal treatment, the Chinese herbal combination treatment slightly outperformed the traditional pharmaceutical drug intervention (AltMD). When given by an expert practitioner, this Chinese herbal preparation is said to be highly effective. These herbs can however interact with prescription medicines; therefore, users have been advised to consult with expert practitioners before using these Chinese herbs. Foods have also been recommended by alternative Chinese practitioners. Foods such as corn have been known to strengthen the heart; dates are said to control palpitations and improve blood flow; the Hawthorne fruit has been known to prevent the formation of phlegm which can lead to blood clots; honey has also been recommended in the prevention of heart disease; and tea has been recommended for reducing swellings which often accompany coronary heart disease (AltMD). With these benefits, the practice of Chinese alternative medicine has been recommended for the management of CHD. A plant-based diet has been largely the basis for the management of coronary heart disease by the Chinese. The use of psyllium is also being advocated for the management of CHD. This plant is a rich source of soluble fiber. In a study Sprecher, et.al., (1993) they discovered that when 5 g of psyllium was administered two times a day for 4 months to patients who had high blood cholesterol, their cholesterol levels dropped an average of 0.26-0.39 mmol/L. The levels fell even greater for patients with even higher cholesterol levels (Sprecher, et.al., 1993). Chinese herbal medication also includes the concentrated extract of the leaves of the Ginkgo tree which improves cerebral blood flow. Claims seem to indicate that ginkgo biloba extract is relatively effective, most particularly among geriatric patients, especially under conditions of memory loss, dizziness, and confusion (Craig, p. 4915). These ailments seem to respond well to the relief of vasodilation and improved blood flow which is given by the Ginkgo. The active ingredient in the Gingko which is flavones glycosides and diterpenoids is said to contribute greatly in inhibiting the platelet activating factor, eventually assisting in the management of blood flow (Craig, p. 4915). As was previously mentioned, the Hawthorne is also an herb used by the Chinese in order to manage coronary heart disease. More specifically, it is used to improve blood flow. The leaves, fruit, and the flowers of the hawthorne are used in some areas of Europe because of its ability to improve the pumping of the heart and in the treatment of angina (Craig, p. 4915). It is also said to provide flavonoids. All in all, hawthorne increases the dilation of the smooth muscles of the coronary blood vessels and therefore it also increases the blood flow through the vessels (Tyler). The proanthocyanidins have also been discovered as elements of this herb and this element is said to prevent the biosynthesis of thromboxane A (Craig, p. 4915). In a study by Schmidt, et.al., (p. 17) the authors were able to establish that giving 600 mg/d of hawthorne extract with chronic heart disease effectively assisted in decreasing their blood pressure and heart rates; they also had lesser incidents of shortness of breath during exercise as compared with subjects not receiving hawthorne. All in all, this study indicated strong support for the use of this herb in the treatment and improved management of coronary heart disease. One of the qualities seen among the identified Chinese herbs is the presence of about 4000 flavonoids in these herbs. These flavonoids are universal plant pigments which give plants’ flowers and leaves colors (Craig, p. 4917). They have different favorable qualities, primarily in the promotion of health and prevention of diseases. They improve the action on Vitamin C; they act as antioxidants; they prevent the oxidation of LDL cholesterol; and they prevent the aggregation of platelets (Craig, p. 4917). In a study in the Netherlands elderly men took in fruits, vegetables and tea rich in flavonoids in an attempt to review the impact of this pigment in the management of heart diseases. The study revealed that elderly patients with a diet rich in flavonoids had lesser associated risks with heart disease mortality and heart attack morbidity over a 5-year period (Hertog, p. 1007). An important process in the management of coronary artery disease is that of oxidative modification of LDL cholesterol. The Chinese herbs, which were previously mentioned, are said to be effective antioxidants and they can prevent the oxidation of LDL cholesterol (Craig, p. 4917). Licorice extract and isoflan glabridin found in licorice have exhibited the ability to reduce LDL oxidation. In a study by Fuhrman, et.al. (p. 267), the authors found out that LDL cholesterol which was isolated from subjects with normal lipids who consumed about 100 mg licorice extract for 2 weeks was more resistant to oxidation than the LDL cholesterol drawn from subjects who did not consume licorice extract. In effect, such a study presented the benefits of licorice in the management of cholesterol and atherosclerosis, and eventually, in the management of coronary artery disease. The use of Chinese herbs has also been seen in the intake of green or black tea. Green or black tea has been found to be beneficial in reducing blood cholesterol concentrations, eventually assisting in the reduction of risk of cardiovascular diseases (Craig, p. 4917). In a study of rats fed green tea polyphenols, blood cholesterol levels were lowered in these rats with high cholesterol levels; blood pressures were also reduced in rats with high blood pressure (Dreosti, et.al., p. 51). The effects of green tea has been based on its ability to decrease the absorption of cholesterol in the intestines, its ability to decrease the coagulability of blood, and its ability to decrease the spread of human aortic smooth muscle cells (Dreosti, et.al., p. 51). Studies have established that LDL-cholesterol oxidation was reduced through the intake of tea, more specifically, the catechins from green tea leaves or the flavins from black tea leaves. Some phenolic elements are also found in fruits and herbs. Such compounds impact on the stability of foods by acting as flavorants and antioxidants (Craig, p. 4917). They also reduce anti-carcinogenic properties and reduce the risk for atherosclerosis. In the University of Texas Health Science Center in Houston, researchers sought to evaluate how Chinese herbs benefited the heart. They noted how these herbs seem to have qualities of widening the arteries and improving the flow of blood to the heart muscles (Blanchard). The researchers were able to establish that these herbs contain about three to twenty herbs which are relatively safe for the human body. They were also able to establish that herbs deliver nitric oxide to the blood vessels which are able to decrease blood pressure and assist in the improved circulation of blood to the heart (Blanchard). The researchers were also able to establish that the herbs helped in decreasing plaques and in preventing the formation of blood clots which may lead to heart attacks. One of the main authors of the study, Nathan Bryan, revealed that Chinese herbs have nitric oxide bioactivity, by assisting in the action of nitric oxide in the inner walls of blood vessels and by increasing the ability of the nitrite to convert nitrate into nitric oxide (Blanchard). The researchers also cite and commend the use of Traditional Chinese Medicine (TCM), including acupuncture, in the management of cancer, cardiovascular diseases, diabetes, and similar chronic diseases (Blanchard). With these results, stronger support has been built for the use of Chinese herbs in the management of coronary heart disease. In a paper by Dharmananda, the author pointed out that, in the application of Chinese herbs, for medicinal purposes, there is a tendency to repeatedly refer to certain herbs which contain a limited range of active elements. Most of these herbs are considered qi tonics, and the most commonly relied upon qi tonics are ginseng and astragalus. Chinese doctors traditionally focused on managing heart diseases by clearing orifices which were blocked by phlegm (Dharmananda). This method has been replaced through the application of blood revitalizing herbs, more specifically salvia. Medical practitioners have since favored herbal methods because they found out that the opening of orifices can sometimes be toxic (Dharmananda). Flavonoids and triterpenes are the two groups of non-toxic elements found in herbs which are used for heart diseases. Both substances can be taken in several hundred milligrams a day and they are safe for long-term use (Dharmananda). Flavonoids have already been discussed above. Triterpenes are the primary elements in ginseng and is now being promoted in the treatment of cardiovascular diseases. It was originally used to relieve indigestion. Triterpenes has been identified as one of the main components in new herbs from China, gynostemma and rhodiola, and ganoderma (Dharmananda). These three herbs have been known to significantly assist in reducing cardiovascular risks. Ginseng saponins are the main components in Shengmai San and they have traditionally been used in China for assisting patients in recovering from heart attacks (Dharmananda). This triterpenes decrease blood cholesterol and increase the utilization of oxygen; it also has heart protective impacts and has been known to decrease free radical damage. Various combinations of Chinese herbs have been used for the management of cardiovascular diseases. Base herbs used in clinical trials have included the combination of qi tonics astralagus, ginseng, and atractylodes as supported by blood vitalizers salvia, leonurur, red peony curcuma, and notginseng (Dharmananda). Combinations have also included Zhen Wu Tang which is that of atractylodes and aconite; Shengmai San (ginseng and ophiopogon); and Shen Fu Tang (ginseng and aconite) (Dharmananda). In order to manage myocardial infarction, a mixture of qi tonics astragalus, codonopsis, polygonatum and blood vitalizers salvia, red peony, and curcuma have been used. Other herbs have also included adjunctive agents like alisma (manage edema) and aconite in the management of coldness and to improve heart contractions (Dharmananda). The Shen Mai injection is a combination of ginseng and ophiopogon and is used to manage congestive heart failure; Sheng Fu injection is used to manage heart damage caused by viral endocarditis. Combining ginseng, astragalus, and tang-kuei in what is known as the Yiqi Huoxue infection has been utilized in the management of coronary heart disease (Dharmananda). Ganoderma has similar effects as ginsenosides and has been used to manage CHD. In a research by Zhu Boqing, et.al., (p. 75) the authors set out to explain the reason for the reliance on qi tonics. The authors treated patients with CHD with the combined herbal therapy of astragalus and codonopsis. Such a combination was expected to relieve patients with a qi deficiency and blood stasis. The authors set forth that setting the qi in motion can be managed through tonics because blood circulation will be able to proceed normally (Boqing, et.al., p. 75). They supported the use of salvia in increasing blood circulation, but prioritized the use of tonics for the therapy of patients. In their follow up study, the authors were able to establish that salvia can improve myocardial ischemia and addressing abnormal hemorrheological elements in patients with CHD (Boqing, et.al., p. 75). They established that astragalus helps in increasing cardiac systolic functioning among patients with heart problems. It also can have a favorable iontropic impact by improving heart contractions. Astragalus and salvia manifest synergistic impact in securing symptoms and cardiac function among patients with heart failure (Boqing, et.al., p. 75). Aconite has been known to improve sinus node function and cardiac functions. It has also been used in combination with salvia in treating heart failure, along with the combination of Zhen Wu Tang (salvia and carthamus); astragalus and salvia has also been used in managing heart failure (Boqing, et.al., p. 75). The combination of Chinese herbal medications have been based on the principles of Ying-Yang, the five elements, the five organs and six viscera, the seven feelings, and six orexises theory (Shi, et.al., p. 1581). The concept of Ying-Yang is said to be the foundation of traditional Chinese medicine and any imbalance in it can lead to illness. In order to manage any imbalance, there is a need to identify where the deficiency lies and to identify the herbs which can restore the balance (Shi, et.al., p. 1581). In instances of strokes which are complicated by coma, herbs are often used. Based on theories, compromised consciousness is based on a break in the link between the heart and brain. The herbal medicines are said to open the aperture and improve alertness (Shi, et.al., p. 1581). In ischemic strokes among alert patients, combinations of herbal medications such as Bu Yang Huan Wu Tang can be utilized in order to help support vital functions and reenergize the circulation and reduce stasis. In a study by Qian (p. 491) Dang Shen Tong is a combination of herbs which has been known to improve fibrinogenolysis, decrease platelet aggregation, and reduce the viscosity of blood. Chi Shao has been known to antagonize arachidonic acid and then decrease platelet aggregation (Qian, p. 491). Stroke patients can opt for TCM doctors or may be referred to them by modern doctors. Massages, acupuncture, and injection of acupoints with herbs have been used in the management of heart disorders. Conclusion Based on the above discussion, Chinese herbs and Chinese herbal preparations and combinations have significant benefits in the management of coronary heart disease. The Chinese herb formulas and combinations have exhibited various actions which collectively assist in improving cardiac function and in dilating the blood vessels of the heart. Some of these herbs have been known to reduce bad cholesterol and decrease the appearance of plaque in the arteries. Improved blood flow is important in preventing myocardial infarction and the delivery of much needed oxygen to the heart muscles. One of the more specific components of these herbs – flavonoids – has exhibited actions in preventing the oxidation of LDL cholesterol. In the end, these qualities assist the heart in maintaining its functions and in managing efficient blood flow. Traditional Chinese Medicine has been based on the principle of creating a balance in the human body. In detecting the imbalance, the Chinese practitioners have established efficient means in using the right herbs to eventually create the much needed balance for the body. 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