Tuesday, October 19, 2010

botanical medicine: cardiovascular herbs

this lecture covered the herbs used to treat various cardiovascular conditions. allium sativa, or garlic, is one example; it affects the vascular system by several proposed mechanisms, including stimulating intracellular activity of nitric oxide synthase, which produces nitric oxide, a potent vasodilator. it also works to inhibit the cyclooxygenase enzyme, which produces inflammatory mediators from arachadonic acid- this effect is perhaps more pronounced with raw garlic. on the other hand, the oil produced from steaming garlic is high in sulphur compounds such as diallyl disulfide, which are thought to be antimicrobial and mucolytic. it might be helpful for diabetics by making more insulin available in circulation by competing for insulin binding sites in the liver. finally, garlic is thought to increase NK cells, thereby boosting innate immunity.

angelica sinensis, or dong quai as it is known in chinese medicine (as a blood mover / yin tonic) is another herb useful for cardiovascular conditions. it has vasodilating effects due to nicotinic acid and antispasmodic effects due to ferulic acid, which is thought to have calcium channel blocking effects. it is relaxing for uterine tissue and thus is indicated in some female hormonal conditions such as cramping and dysmenhorrea.

crataegus oxycantha, or hawthorne is an herb that is useful both in acute care as well as long term chronic management of cardiac cases. it has positive inotropic effects (increasing myocardial contractility), stabilizes capillaries via flavonoids, acts as a natural calcium channel blocker via procyanidins (which inhibits phosphodiesterase), and lowers blood pressure by inhibiting ACE and thus aldosterone.

gingko biloba is an herb commonly associated with increased mental clarity, which is thought to be due to increased cerebral artery perfusion. it also has beneficial effects on the vascular system, increasing coronary artery perfusion, enhancing peripheral vasodilation and also acting as an antioxidant via flavonoids and super oxide dismutase. because of its antioxidant effect it can be indicated in cases of hypoxic tissue damage.

one of the few herbs that is indicated specifically for hypotension rather than hypertension is selenicerues grandiflora, or cactus as it is commonly known. it is indicated in cases of weak heart muscle, as in CHF, mitral / aortic insufficiency, and even some arrhythmias. it is used more for functional, rather than organic disorders, and is especially indicated for a sensation of a heavy band in the chest.

a couple herbs with specific applications: leonurus cardiaca is a cardiotonic that is specific for the pelvic area and the vasculature, much like angelica (see above). thus it is used in cases of palpitations associated with pelvic pain, hormonal imbalances, or menstrual complaints. it might also have beta-blocking activity as well as improving blood viscosity. mentha piperita is an herb used specifically when angina occurs after a heavy meal, accompanied by digestive complaints such as gas and bloating. it is in fact part of the "glyconda formula", an eclectic formula used to treat cardiovascular complaints associated with gastrointestinal symptoms.

there are a number of herbs used to treat various pathologies of the peripheral vasculature. yarrow is an astringent that can be applied topically to wounds as well as internally; where it has vasodilatory effects in the peripheral vasculature and vasoconstrictive effects in the uterus. horse chestnuts aids in venous return and is therefore indicated in disorders such as varicose veins, and also has immune modulating effects via lectins. pineapple contains the sulfur-rich bromelain, which is thought to have thrombolytic effects, so much so that it might be used pre-surgery to reduce the risk of clots.

other peripheral vascular herbs: capsella (shepard's purse) is an herb used to stop chronic bleeding, especially uterine bleeding. stone root is a specific for constipation due to vascular engorgement of rectal mucosa and is also specific for congestion of oral, urinary, rectal mucosa. witch hazel is an astringent that can be applied topically or ingested, indicated for pale, engorged, congested tissues. hypericum is better known for its emotionally uplifting effects but also aids in venous stasis and varicosities due to the high flavonoid content. ruscus is in the lily family and contains rescogenins that have vasoconstrictive and anti-inflammatory effects. red clover is more commonly used to for female hormonal balance, but it also has circulatory actions, via the coumarins it contains, which improve blood lipids, reduce inflammation and reduce platelet aggregation. vaccinium, or bilberry contain anthocyanosides which have powerful antioxidant properties, and are stabilizing for capillaries as well. veratrum is an herb that can be used carefully in acute or severe cases of hypertension, indicated in a bounding pulse or flushed face. at higher doses, it acts as an emetic and thus must be used cautiously.

questions...
allium sativa...
1. what compounds does garlic contain that affect vascular endothelium?
2. how does garlic thin blood?
3. raw garlic has more of what effect?
4. which compounds are in garlic oil and result from steam processing?
5. how does garlic affect blood sugar?
6. garlic's effect on the immune system?
7. garlic's effect on inflammation?

angelica sinensis...
8. which family is angelica in? what compound is found in high quantities in this family?
9. antispasmodic effects due to which compound? what does this compound do?
10. vasodilating effects due to which compound?
11. used in chinese medicine for what purpose?

crataegus oxycantha, monogyna...
12. chemical consituents in crataegus?
13. describe the overall effect of hawthorne on the CV system.
14. flavonoids in hawthorne have what effect?
15. indicated for hyper or hypotension?
16. mechanism for lowering blood pressure?
17. mechanism for calcium channel blocking effects?
18. hawthorne berries are high in what compounds in the spring vs. the fall?
19. useful in CHF along with which other nutrient?

ginkgo biloba...
20. increases blood flow to...
21. main active constituent?
22. antioxidant actions via...
23. also used for what conditions due to cerebral perfusion?
24. why indicated for diabetics?

selenicereus grandiflorus...
25. indicated for hyper or hypotension?
26. indicated for functional or organic disorders?
27. specifically indicated for what chest sensation?

leonurus cardiaca...
28. what areas of the body is motherwort specific for?
29. leonurus injections were shown to improve...
30. 2 specific indications for leonurus.

mentha piperita...
31. most indicated for...
32. part of which formula?
33. contraindicated in which patients? why?

peripheral vasculature herbs...
34. yarrow's action in the peripheral vasculature?
35. yarrow's action on the uterus?
36. yarrow's topical effect?
37. horse chestnut's effect on vasculature?
38. [37] attributed to what compound?
39. horse chestnut immune effect via which compounds?
40. pineapple high in which compound?
41. pineapple used pre-surgery for...

more peripheral vasculature herbs...
42. shepard's purse used for...
43. capsella might be contraindicated in pregnancy because of...
44. capsella also contraindicated in people with...
45. stone root specific for which areas?
46. specific GI condition that might benefit from stone root?
47. witch hazel indicated in...
48. hypericum high in which compound?
49. cardiovascular indications of hypericum?
50. mechanism of action for hypericum?
51. what family is ruscus in?
52. active constituents of ruscus? actions?
53. indications for ruscus? affinity for which tissue?

54. active constituent in red clover?
55. effect of [54]?
56. active constituents in vaccinium?
57. effect of [56]?
58. why is bilberry particularly indicate for diabetics?
59. active constituents of veratrum viride?
60. effect of [59]?
61. veratrum effect at high doses?
62. black haw's effect is similar to what other herb?

answers
1. nitric oxide like compounds.
2. by inhibiting platelet aggregation.
3. it is more of a inhibitor.
4. diallyl disulfide and diallyl trisulfide.
5. competes with insulin binding sites on liver, allowing for more insulin to be in circulation, allowing for blood sugar stabilization.
6. increases NK cells.
7. COX inhibitor.

8. umble family, coumarins.
9. ferulic acid; ca-channel blocking effects.
10. nicotinic acid.
11. blood mover and blood builder.

12. flavonoids, tannins, organic acids, sterols, purines, triterpines.
13. normalize blood pressure, positive inotropic activity, diuresis.
14. stabilize capillaries to reduce permeability and fragility.
15. both.
16. inhibits ACE, which leads to a decrease in aldosterone and thus decreased water retention.
17. procyanidins inhibits phosphodiesterase, which breaks down cAMP, leaving higher calcium levels.
18. amines (spring) vs. bioflavonoids.
19. CoQ10.

20. cerebral arteries, carotid arteries.
21. flavonoids; ginkgo heterosides.
22. super oxide dismutase, flavonoids.
23. tinnitus or ear congestion.
24. to increase peripheral perfusion and prevent retinopathy, nephropathy, gangrene, etc.

25. hypotension.
26. functional.
27. band squeezing the chest.

28. pelvis and vasculature.
29. blood viscosity.
30. heart palpitations associated with pelvic pain or hormonal imbalance such as hyperthyroid.
e31. angina that occurs after eating accompanied by digestive symptoms.
32. glyconda.
33. patients with GERD, due to relaxing effects on LES.

34. peripheral vasodilator.
35. promotes constriction of uterine blood vessels.
36. astringent; aids in wound healing.
37. increases venous returns.
38. coumarins.
39. lectins have many immune modulating effects.
40. bromelain.
41. to reduce risk of clotting.

42. to stop chronic bleeding, especially from the uterus.
43. alkaloids.
44. high blood pressure.
45. oral, urinary, rectal mucosa.
46. constipation due to vascular engorgement of rectal mucosa.
47. pale, engorged, congested tissues.
48. hypericin, a bright red flavonoid.
49. venous stasis, varicosities.
50. hypericin and other flavonoids strengthen venous wall integrity, prevent free radical damage and enzymatic breakdown of collagen.
51. lily family.
52. ruscogenins: vasoconstrictive and anti-inflammatory effects.
53. peripheral vasculature, varicosities and hemorrhoids.

54. coumarin.
55. improve blood lipids, reduce inflammation and platelet aggregation.
56. flavonol glycosides-- anthocyanosides.
57. antioxidant and capillary stabilization.
58. because of its specificity for the eyes, fighting the effects of diabetic retinopathy.
59. veratrine.
60. potent hypotensive; circulatory depressant.
61. emesis.
62. cramp bark: uterine relaxant, relaxes peripheral blood vessels.

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