Phytomedicines and Cardiovascular Health

Study Notes

Phytomedicines aid in treating mild heart failure, coronary insufficiency, atherosclerosis, and chronic venous insufficiency.
Key pharmacologic therapies for heart failure include cardiac glycosides (increase heart efficiency), diuretics (reduce preload), and vasodilators/ACE inhibitors (reduce afterload).
Cardiac glycosides may heighten the risk of cardiac arrhythmias due to their effect on the refractory period.

Foxglove (Digitalis purpurea) was introduced to medical practice by William Withering after an elderly woman in England shared its secret for treating cardiac diseases.
Active compounds from foxglove, Digoxin and Digitoxin, are widely prescribed for heart conditions.
Cardiac glycosides derived from Digitalis are specific chemical compounds with narrow therapeutic doses and are not considered traditional phytotherapeutic agents.

Hawthorn (Crataegus species) has roots in herbal medicine dating back to the 1st century, used for irregular heartbeat, high blood pressure, and heart failure.
Modern studies suggest hawthorn may be beneficial for mild-to-moderate heart failure, improving blood flow and lowering blood pressure.
Contains antioxidants like oligomeric procyanidins (OPCs) which combat free radicals that contribute to aging and heart disease.
Commonly used dosages range from 160-900 mg/day of extracts containing specific flavonoids and OPCs, continued for at least six weeks.

Potential side effects: headache, nausea, palpitations.
May enhance effects of medications such as digoxin and beta-blockers (e.g., Atenolol, Metoprolol).
In combination with nitrate medications, hawthorn could increase the risk of dizziness.

Garlic has been used since ancient times for health benefits, including preventing heart disease and atherosclerosis.
Evidence indicates garlic may mildly lower blood pressure (5%-8%) and act as a blood thinner to reduce heart attack and stroke risks.
A specific formulation (Kwai) has shown effectiveness in slowing atherosclerosis progression.

Horse chestnut (Aesculus hippocastanum) is used primarily for chronic venous insufficiency (CVI), favorably comparable to compression stockings in efficacy.
Works by thinning blood, preventing fluid leakage from veins, and promoting fluid loss through urine.
Typical dosage for CVI treatment is around 120 mg/day of standardized extract.

Horse chestnut may interact with anticoagulants (e.g., aspirin, ibuprofen) increasing bleeding risk.
Can affect the elimination of lithium, presenting risks for bipolar disorder patients.
May lower blood sugar, enhancing the effects of hypoglycemic medications in diabetics.