Essential Treatments in Cardiovascular Chinese Medicine. Hyperlipidemia

Essential Treatments in Cardiovascular Chinese Medicine 1: Hyperlipidemia
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Western scientists often reject Chinese medicine for specific reasons: the formula consists of dozens of ingredients with many chemical molecules, making it hard to clarify the therapeutic mechanism; the medications available in China do not undergo the same rigorous approval process as Western drugs to guarantee efficacy and safety; and most trials were conducted in China by traditional Chinese medicine physicians with medications largely unavailable in the United States.

In all, certain Chinese medications showed suggested benefits for each of the cardiovascular health conditions studied. For example, researchers looked at eight randomized controlled trials on traditional Chinese medicine and hypertension.

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Essential Treatments in Cardiovascular Chinese Medicine 1: Hyperlipidemia: Anika Niambi Al-Shura: The Book Depository UK. Essential Treatments in Cardiovascular Chinese Medicine 1: Hyperlipidemia by Anika Niambi Al-Shura, , available at Book Depository with free .

The evidence indicated that Tiankuijiangya, Zhongfujiangya, Qiqilian, Jiangya and Jiangyabao have antihypertensive effects and a good safety profile, making them a potential good alternative for patient intolerant of or who cannot afford Western medications. However, whether those benefits transferred into long-term positive cardiovascular outcomes would have to be determined by long-term trials. Thus, some medications might be used as a complementary and alternative approach for primary and secondary prevention of cardiovascular disease.

The American College of Cardiology is the professional home for the entire cardiovascular care team.

The mission of the College and its more than 52, members is to transform cardiovascular care and to improve heart health. The ACC leads in the formation of health policy, standards and guidelines. The College operates national registries to measure and improve care, offers cardiovascular accreditation to hospitals and institutions, provides professional medical education, disseminates cardiovascular research and bestows credentials upon cardiovascular specialists who meet stringent qualifications.

For more, visit acc. In addition, T-lymphocytes secrete cytokines that induce vascular smooth muscle cells to migrate from the media to the intima and proliferate shortly thereafter [ 1 ]. Over time, a growing lesion consisting of lipid and smooth muscle cells invade and narrow the lumen of the artery.

Red Yeast Rice: Benefits, Side Effects and Dosage

Other extracellular matrix ECM components such as collagen, elastin, glycoprotein, and proteoglycans give tensile strength and viscoelasticity to the arterial wall. Increasing the synthesis of ECM components such as matrix metalloproteinases MMPs contributes significantly to ECM destruction, which renders the plaque more prone to rupture [ 1 ]. Once a plaque ruptures, it can trigger an acute thrombosis or embolism by activating platelets.

It may finally lead to myocardial infarction, stroke, and even death. Atherosclerosis treatment usually begins with lifestyle changes such as a low cholesterol diet, regular exercise, and quitting smoking.

Chinese herbal medicine for dyslipidemia: protocol for a systematic review and meta-analysis.

Depending on the severity of the disease, a person may be prescribed oral medication such as antiplatelets, angiotensin-converting enzyme ACE inhibitors, or beta-blockers. In patients with advanced disease, certain medical procedures such as percutaneous transluminal coronary angioplasty or coronary artery bypass surgery may be necessary. Conventional medical costs paid by patients or by the Bureau of National Health Insurance Taipei, Taiwan are expensive.

In addition, conventional therapies for atherosclerosis-related diseases have some limitations such as statin-induced rhabdomyolysis or hepatitis, and antiplatelet agent-related gastrointestinal bleeding or peptic ulcer. Complementary and alternative therapy is another option for atherosclerosis medication. Traditional Chinese medicine is the primary complementary therapy used in the Chinese community.

The aim of this paper is to explore complementary therapy with traditional Chinese medication for treating atherosclerosis-related diseases. According to TCM theory, obstructed circulation of blood results in blood stasis syndrome Xue Yu , which is an important pattern of slowing or retardation of the blood circulation.


The main symptoms may include stabbing pain with a fixed position, tenderness, local purpura, lumps, dark-purple lips and finger nails, a blue-purple tongue, and a thready or hesitant pulse. Blood stasis syndrome in TCM corresponds to atherosclerosis in modern Western medicine. Both blood stasis syndrome and atherosclerosis are the predevelopment or initial stage of ischemic heart disease, myocardial infarction, or stroke Figure 1. With early treatment by medication, the progression of cardiovascular or cerebral vascular disease will not worsen. Table 1 shows atherosclerosis-related cardiovascular or cerebrovascular diseases.

Atherosclerosis can cause embolism, thrombosis, ischemia, infarction, stenosis, or occlusion of the arteries. Some Chinese herbs can promote blood circulation or remove blood stasis and may be useful for treating atherosclerosis-related diseases. Several strategies exist for the treatment of atherosclerosis and associated diseases such as risk factor modification, antioxidation, anti-inflammation, and antiplatelet accumulation.

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Hypercholesterolemia, a primary risk factor that leads to atherosclerosis, is associated with the development and progression of atherosclerosis. Hypercholesterolemia and endothelial injury lead to the infiltration of LDL particles into the subendothelial space. Lowering cholesterol can provide the initial blockade [ 2 ].

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These adhesion molecules recruit circulating macrophages and T-lymphocytes into the subintima; this action is mediated by macrophage chemoattractant protein-1 MCP-1 [ 17 ]. Among them, Salvia miltiorrhiza [ 3 ], Panax notoginseng [ 4 ], and Coptis chinensis [ 18 ] can downregulate the expression of MCP Signaling interactions between CD and CD40L-expressing cells result in the formation of matrix metalloproteinases MMPs , which degrade collagens and the thin fibrous cap and lead to the formation of vulnerable plaques and rupture [ 20 ].

Table 3 summarizes the target activities of these herbal extracts or compounds in atherosclerosis. Salvia miltiorrhiza has been widely used in the Chinese population for treating cardiovascular and cerebrovascular diseases. Its specific clinical use is for angina pectoris, hyperlipidemia, and acute ischemic stroke [ 27 ], which are all closely associated with atherosclerosis.

According to TCM theory, Salvia miltiorrhiza promotes blood circulation, removes blood stasis, and relieves pain. Several compounds derived from Salvia miltiorrhiza have been well studied in the treatment of atherosclerosis. Protocatechuic aldehyde derived from Salvia miltiorrhiza inhibits lipopolysaccharide-induced human umbilical vein EC apoptosis via the regulation of caspase-3, the migration and proliferation of VSMC, and intravascular thrombosis [ 28 , 29 ]. Cryptotanshinone derived from Salvia miltiorrhiza suppresses the increase in endothelial permeability, which is likely because of the restoration of NO bioavailability in EC.

Cryptotanshinone also can attenuate monocyte adhesion to EC through inhibiting the expression of adhesion molecules. Salvianolic acid B, a water-soluble antioxidant obtained from Salvia miltiorrhiza , can reduce oxidative stress, inhibit LDL oxidation, and reduce oxidized LDL-induced cytotoxicity [ 31 ]. Tanshinone IIA, another compound derived from Salvia miltiorrhiza , markedly inhibits the elevation of ROS evoked by hydrogen peroxide.

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Tanshinone IIA significantly decreases the hydrogen peroxide-induced expression of proapoptotic proteins Bax and caspase-3 and significantly increases the expression of antiapoptotic protein Bcl-2 in EA. Hung et al. In addition to herbal medicine, acupuncture has been used for a long time in the treatment of cardiovascular disease in Asia. Acupuncture is applied in the treatment of hypertension and hyperlipidemia, which are risk factors leading to atherosclerosis. Kim et al. Tian et al. Another study by Xiao et al. Li et al. Tai chi chuan tai chi is a Chinese traditional mind—body exercise with low to moderate exercise intensity.

Previous studies have shown that it offers benefits for aerobic capacity, muscular strength, balance, and cardiovascular risk factors such as hypertension, diabetes mellitus, and dyslipidemia. Furthermore, tai chi appears to be safe and effective for patients with acute myocardial infarction, coronary artery bypass grafting surgery, congestive heart failure, and stroke [ 55 ]. A study conducted in India shows that regular yogic practices can significantly reduce blood pressure, heart rate, body fat, total cholesterol, triglycerides, and LDL.

These reactions are beneficial for cardiac and hypertensive patients [ 56 ]. Certain mental disorders and stress are conducive to atherosclerosis. Kroenke et al. Everson-Rose et al. Stillman et al. Meditation is an alternative medicine practice for mental and physical health. It has salutary effects on patients with anxiety [ 61 , 62 ], depression [ 61 , 63 ], and stress [ 64 , 65 ].

Some articles report that meditation can calm the emotions and produce beneficial effects on the cardiovascular system, particularly with regard to vascular aspects [ 66 - 68 ]. Walton et al. The mechanism and neurobiological effects of mindfulness meditation involve 1 deactivation of the default mode network, which generates spontaneous thoughts, contributes to the maintenance of the autobiographical self, and is associated with anxiety and depression; 2 the anterior cingulate cortex, which underpins attention functions; 3 the anterior insula, which is associated with the perception of visceral sensation, the detection of the heartbeat and respiratory rate, and the affective response to pain; 4 the posterior cingulate cortex, which helps one to understand the context from which a stimulus emerges; 5 the temporoparietal junction, which assumes a central role in empathy and compassion; and 6 the amygdala, which is implicated in fear responses [ 69 ].

There are few studies on formulas or single herbal drugs interaction in the treatment of atherosclerosis. Atherosclerosis-related diseases are the primary causes of death. In addition to standard treatment, complementary therapy needs to be face up. Traditional Chinese medicine is a popular complementary and alternative medicine CAM in East Asia and throughout the world.

Traditional Chinese Medicine May Benefit Some Heart Disease Patients

There is increasing scientific evidence demonstrating that TCM has potential for treating atherosclerosis and its associated conditions. Acupuncture, tai chi , and meditation have beneficial effects for atherosclerosis-related cardiovascular diseases. Extracts or compounds of single herbs of some Chinese herbs such as Salvia miltiorrhiza, Panax notoginseng, Ginkgo biloba, Curcuma longa, Crataegus pinnatifida, Paeonia lactiflora, Prunella vulgaris, Polygonum multiflorum, Coptis chinensis , and red yeast rice through their endothelial protective, antioxidative, anti-inflammatory, and lipid-lowering effects may act on multiple mechanisms involved in the pathogenesis of atherosclerosis.

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