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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.