
Cardiovascular Diseases and its
Prevention in Unani System of Medicine
·
Aliya Parveen,
·
Mohammad Saqlain,
·
Zarnigar
Department of
Community medicine NIUM Bangalore.
Scholar, Department
of Kulliyat, A.M.U. Aligarh
ABSTRACT
Cardiovascular diseases (CVDs) are
the world’s largest killer claiming 17.3 million lives a year.
Over 80% of the world's deaths from
CVDs occur in low and middle income countries. India contributes to this as 306.3 deaths
per one lac of population. It not only affects the individual but also affects the economic output of
a country due to the inabilities and disabilities caused by it.
Risk factor modifications are the
best approach till date to combat with this world’s leading death causing problem. As Hippocrates
stated “Take care of your health before you lose it”.
Thus, following the tadabeer(regimens) mentioned by Unani physicians, one can be saved from being affected by the gross complications of CVDs. This article tried to highlight all the possible preventive & therapeutic approaches of Unani medicine that could be valuable for the management & control of CVDs as well as could be a source of further researches.
INTRODUCTION
Cardiovascular
diseases are a group of disorders of heart and blood vessels, including coronary heart diseases, congenital heart diseases, cerebrovascular diseases, rheumatic
heart diseases, deep
vein thrombosis and pulmonary embolism3. More or less atherosclerosis becomes
the reason for majority of CVD’s. Atherosclerosis is a disease in which plaque builds up
inside the arteries.
Plaque is a sticky substance made up of fat, cholesterol, calcium, and other
substances found in the blood. Over time, plaque hardens and narrows arteries that limit the flow of
oxygen-rich blood to
the body. However, too much pressure in arteries can make the walls thick and
stiff, sometimes restricting blood flow to organs and tissues. This process is called
arteriosclerosis, or hardening of
the arteries. These plaques can also burst, triggering a blood clot.
Atherosclerosis is often considered a heart problem, but it can affect arteries anywhere in the body. It
is a preventable and
treatable condition that develops gradually. Sometimes a blood clot completely
blocks blood flow or even breaks apart and can trigger a heart attack or stroke5. At a
mechanistic level, it is the
oxidative stress that promotes atherosclerosis. Oxidative stress arises as a
result of an imbalance between free radical production and antioxidants defenses, associated with
damage to a wide range
of molecules like lipids, protein and nucleic acid6. Normally mitochondria in
human body during oxidative phosphorylation produces reactive oxygen species (ROS) like
superoxide anions, alkoxyl
and peroxyl radical , hydroxyl radical, nitric oxide and nitrogen dioxide. The
ROS thus produced helps the immune system to remove the dead tissues and foreign bodies. But when
this normal
concentration of ROS changed to abnormal concentration (increased production),
it leads to a number of problems like cancer and atherosclerosis etc. The production of ROS
is believed to
induce endothelial dysfunction- an initial step to atherosclerosis. Oxidative
stress leads to the oxidation of LDL (low density lipoprotein) whose uptake becomes easier for
macrophages. The
macrophages get accumulated in the smooth muscles of blood vessels and release
inflammatory factors like nuclear factor (NF-ÎB) and activator protein 1 (AP-1) and other
cytokines. Thus, it
seems that atherosclerosis is an inflammatory process strongly affected by
oxidative stress. Furthermore, increased production of ROS reduces the production and
consequently the
bioavailability of NO (nitric oxide- released naturally from endothelium),
leading to vasoconstriction, platelet aggregation and adhesion of neutrophils to the
endothelium. All these
the phenomenon leads to the formation of what we called is atherosclerotic plaque.
Unani physicians also mentioned this vascular alteration under the heading of Amraze mufrada-sue
tarkeeb-khilqatmajari.
They defined atherosclerosis as a marz of majari (disease of vessels) in
which sharain(arteries) becomes narrow and obstructed. The obstruction is caused
either by akhlate
ghaleeza/viscid humours or akhlate luzuja/sticky humours. It implies that there
are some changes in the dynamic profile leading to akhlat to get accumulated in the blood
vessels (oxidative stress)
and thus causing narrowness and obstructions. The mechanism so described in
Unani literature not only involve heart (sue mijaz sada or maddi) but also the factors which
produces raddi khoon
(unhealthy diet, obesity, physical inactivity etc.). Ultimately abnormal khilt
is produced by liver (hazme doem) which proceeds to next digestive process- hazme saani (inside
urooq/vessels). The
abnormal sauda(black bile) and phlegm thus produce diseases in their place of
digestion i.e. blood vessels, hence leads to the formation of atheroma, that affects other organs
also like brain, liver,
lungs etc.8,9 It has been proved by numerous of epidemiological and
experimental studies that the use of antioxidants interfere in the LDL oxidation and reduce the level of
atherosclerotic lesions at
the clinical level. Vitamins C and E (antioxidants) stimulates the increase of
BH4 (tetrahydrobiopterin which acts as cofactor and is used as a substrate for L-arginine leads to NO
formation) levels
and the activity of NO synthase and its bioavailability and improves
endothelial dysfunction. Co-administration of vitamin C and E seems to improve endothelial function in hyperlipidemic
patients. But the risk factors so involved for the development of CVDs plays
equally important role. It includes tobacco use, smoking, unhealthy diet, obesity, physical
inactivity, raised blood
pressure, diabetes and raised lipids.10 Unani physicians mentioned various
principles for life style modifications thousands of years ago, which if adopted properly can combat with
the prevailing
problem of CVDs. The tadabeer mentioned in Unani literature focused on the
change in the temperament of heart and then whole body to bring it to normal or close to
normal. This can be
achieved through-
Ghiza
Tadbeer
Dawa
Ghiza/ Dietotherapy
Recommended
diet in Unani medicine for the people under risk of CVD, consist of a diet
which is
lateef and kaseerut taghzia i.e;
1.
Having the property of jila that will produce lateef khoon e.g. honey, fig,
pistachio etc. This
type of diet helps in thinning of blood.
2.
Which are hareef and muqatta balgham e.g. mustard seeds, soya, cumin, garlic,
etc. This type of food stuff usually makes thick viscous phlegm thin and then helps to
excrete them
out of the body by changing it into marrah safra.
Which are
maleh e.g. small fish, maul jaban, maul laham etc. These food items reduce
blood viscosity and increase blood circulation thus,
preventing heart and other organs from ischemia.
Which are
haamiz e.g. vinegar, all citric fruits (Vit C) etc. These dietary stuffs break
the
viscid and thick humours into pieces so that
obstruction will be released.
The above
mentioned diet not only helps in preventing CVDs but also act as an adjuvant in
the treatment of CVDs, as they not only prevents
thrombus formation but also breaks it, helps
in releasing obstruction and preventing the ultimate outcomes-MI and Stroke.
Avoid constipating and flatulence producing food stuffs like Brinjal, potatoes, beef, cabbage etc, as they produces ghaleez khilt and bukharat that affects heart.
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