Complementary and Alternative

Therapies for Coronary Heart

DiseaseDr. P.Naina Mohamed PhD

Pharmacologist

Introduction The therapies which could be combined with

conventional medicine is termed “Complementary Medicine”.

“Alternative Medicine” includes therapies that are used in place of conventional medicine.

“Complementary and Alternative Medicine” (CAM) refers to a wide range of clinical therapies outside the conventional medicine.

“Conventional Medicine” is a type of medicine practiced by medical doctors and by allied health professionals, such as physical therapists, psychologists, and registered nurses. It is also called Western or Allopathic medicine.

“Integrative Medicine” represents a combination of conventional medicine, CAM, and evidence-based medicine.

CAM Use An US study reported that the Complementary and

Alternative Medicine (CAM) use is high and continues to increase.

The most important reason cited by patients for the supplemental CAM use is the perception that CAM is harmless.

CAM use is highest in patients include Female Nonsmokers Physically active Having normal body mass index (BMI) Eating low-fat diets with a high fruit and vegetable content Individuals aged 35 to 54 years with a high level of education.

Types of CAM Practices

Mind-Body and Manipulative Practices

Traditional Medical Systems

"Modern" Medical Systems

Mind and BodyPractices

  Acupuncture and Acupressure Yoga Hypnosis Massage Meditation Reflexology Alexander technique Tai chi Spinal manipulation Therapeutic touch Guided imagery Rolfing/structural integration

Traditional Medical Systems

  •Ayurvedic medicine •Siddha medicine •Unani medicine •Native American medicine •Tibetan medicine •Traditional Chinese medicine •Curanderismo

"Modern" Medical Systems

  •Homeopathy •Naturopathy •Osteopathy •Chiropractic •Anthroposophic medicine

Coronary Heart Disease (CHD)

Coronary Heart Disease (CHD) is actually a result of Coronary Artery Disease (CAD).

Atherosclerosis (Buildup of plaque) in the coronary arteries (Heart’s arteries) that could lead to heart attack is known as Coronary Heart Disease.

The traditional risk factors for CHD include… High LDL cholesterol, Low HDL cholesterol, High blood pressure,

Family history, Obesity, Diabetes, Smoking, Menopause and Age (Above 45 yrs)

Typical warning signs of Coronary Heart Disease (CHD) include… Chest pain, Shortness of breath, Palpitations and Fatigue.

CAM used for CHD Dietary supplements

Omega 3 fatty acids Vitamin C Vitamin E Fiber Coenzyme Q10

Alternative therapies Chelation therapy Meditation Acupuncture Reflexology Tai chi

Omega-3 Fatty Acids

Omega-3 fatty acids (EPA and DHA) are derived from fatty fish such as salmon, herring, mackerel, etc.

Omega-3 fatty acids (ALA) can also be found in flax and flaxseed oil, walnuts, canola oil, soybeans, and soybean oil.

High doses of omega-3s can increase the risk of bleeding problems, especially if taken with blood-thinning medications.

It is recommended to eat two servings per week of fatty fish for primary and secondary prevention of CHD.

http://eurheartj.oxfordjournals.org/content/early/2011/09/19/eurheartj.ehr362

Vitamin C

It is recommended to consume a diet containing five to seven servings of fruits and vegetables per day.

Patients with known CHD should probably take vitamin C in a dosage of 500 to 1,000 mg per day.

http://circ.ahajournals.org/content/99/4/591.full

Vitamin E

The American Heart Association recommends the consumption of foods abundant in antioxidant vitamins and other nutrients.

It is recommended to consume a diet containing five to seven servings of fruits and vegetables per day.

Consumption of foods rich in vitamin E has been associated with lower risk of coronary heart disease in middle-aged to older men and women.

Patients with known CHD should probably take vitamin E in a dosage of 400 IU per day.

http://www.ncbi.nlm.nih.gov/pubmed/19451807

Fiber

Diets high in fiber are significantly associated with lower risk of CHD and CVD.

http://www.bmj.com/content/347/bmj.f6879

Coenzyme Q10

CoQ10 (Ubiquinone) convert sugars and fat into energy in conjunction with enzymes.

CoQ10 is also an antioxidant within the body. Daily consumption of 300mg of Coenzyme Q10 can significantly increase

antioxidant enzymes activities and reduce the levels of inflammatory markers (TNF-α and IL-6) in CAD patients during statins therapy.

https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-12-142

Chelation for Coronary Heart Disease

Chelation therapy is a controversial complementary health approach.

Chelation therapy benefitted only the patients with diabetes. The use of disodium EDTA for heart disease has not been

approved by the U.S. Food and Drug Administration. Patients should discuss with their cardiologist or other health

care provider before using chelation therapy. https://nccih.nih.gov/health/chelation

Meditation

Meditation should be an adjunct to prescribed medications, healthy eating and regular physical activity.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295748/

Acupuncture

Acupuncture can significantly improve symptoms of angina pectoris.

Acupuncture is not suitable for emergency treatment of myocardial infarction.

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/3771-coronary-heart-disease.html

Reflexology

Reflexology may be used as an efficient adjunct to the therapeutic regimen in CAD patients.

http://www.ncbi.nlm.nih.gov/pubmed/22314629

Tai chi

Tai Chi exercise is a good option for heart patients with very limited exercise tolerance and can be an adjunct to rehabilitation programs for patients with CHD or CHF.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3855938/

References Textbook of Complementary and Alternative

Medicine Chun-Su Yuan, Eric J. Bieber

Evidence Based Guide to Complementary and Alternative Medicine Bradly P. Jacobs, Katherine Gundling

Hurst's The Heart, 13eValentin Fuster, Richard A. Walsh, Robert A. Harrington

Harrison's OnlineFeaturing the complete contents of Harrison's Principles ofInternal Medicine, 18e Dan L. Longo, Anthony S. Fauci, Dennis L. Kasper, Stephen L. Hauser, J. Larry Jameson, Joseph Loscalzo, Eds.