Arjuna Terminalia arjuna arjuna myrobalan
Source: Bazaar of India
HEART disease is a leading cause of death and disability the world over. Heart disease, if let unmanaged, can result in heart attack and death. It is also a major cause of stroke and disability.
Heart disease is due to the narrowing of the coronary arteries that feed the heart. When the coronary arteries become narrowed or clogged by cholesterol and fat deposits – a process called atherosclerosis – and cannot supply enough blood to the heart, the result is coronary heart disease (CHD) or ischaemic heart disease.
If not enough oxygen-carrying blood reaches the heart, you may experience chest pain, and this is called angina. If the blood supply to a portion of the heart is completely cut off by total blockage of a coronary artery, the result is a heart attack. This is usually due to a sudden closure from a blood clot forming on top of a previous narrowing.
Excess cholesterol has been shown to increase the risk of heart disease by forming deposits in the coronary arteries.
In Ayurveda, Arjun is described as an important cardiotonic herb. Other risk factors that contribute to the increased prevalence of heart disease include increasing incidence of diabetes, obesity and other risk factors such as stress, a sedentary lifestyle and poor eating habits such as consumption of foods rich in saturated fats, smoking, and alcohol. Gender, age and heredity also have a role to play in determining who is at risk of developing heart disease.
While early diagnosis and the right medications are important, comprehensive lifestyle changes such as opting for a low-fat, vegetarian diet, stopping smoking, stress management training, and moderate exercise have been shown to bring about regression of even severe atherosclerosis1.
Ayurvedic perspective of heart disease
In Ayurveda, ischemic heart disease (IHD) is known as Hridroga. There are five clinical descriptions of IHD according to Ayurveda based on vitiated doshas and other causes. If the pain is acute and has a shifting nature, it is known as vata heart disease. If it is associated with a burning sensation, it is called pitta heart disease. If the pain is mild and is associated with heaviness, nausea, and cough, it is called kapha heart disease. If all the representative symptoms are present, then it is identified as tridosha heart disease.
In Ayurveda, kapha (hardening of arteries) is the major underlying mechanism of heart diseases.
Various herbs are used in the Ayurvedic system of medicine for their heart protective actions. These are Arjun (Terminalia arjuna), Ashwagandha (Withania somnifera), Lasuna (Allium sativum) and Turmeric (Curcuma longa).
Arjuna (Terminalia arjuna)
Arjun is an important cardiotonic plant described in Ayurveda2. It is a large, evergreen tree that grows to heights of 60-90 feet throughout India. It has a spreading crown and drooping branches. The bark is very thick, grey or pinkish green, smooth, exfoliating in large, thin, irregular sheets.
The bark is useful as an anti-ischaemic and cardioprotective agent in hypertension and ischaemic heart disease, especially in disturbed cardiac rhythm, angina or myocardial infarction. Terminalia arjuna has been shown to be beneficial for coronary artery disease, heart failure, and possibly for high cholesterol levels. It has also been found to be antibacterial and antimutagenic3 (protection against cancer).
Various studies have demonstrated the heart protective action of Arjun. The effect of Terminalia arjun on angina pectoris (chest pain) and congestive heart failure (where the heart cannot pump enough blood to various organs) was studied in 10 patients with ischaemic heart disease and/or myocardial infarction. Administration of Terminalia arjun improved the left ventricular ejection fraction (which determines the heart’s efficiency) in patients4.
In another randomised, double-blind study, 58 males with chronic stable angina (NYHA class II-III) received either Terminalia arjun or isosorbide mononitrate or a matching placebo. There was improvement in clinical and treadmill exercise parameters in both groups compared to placebo therapy. These benefits were similar to those observed with isosorbide mononitrate therapy and the extract of Arjun was well tolerated5.
The heart protective actions of Terminalia arjuna are due to its potent antioxidant and cholesterol- reducing activity.
In a study on 105 patients, it was found that patients on Arjun had a significant reduction in the total and low-density lipoprotein (bad) cholesterol, along with enzymes responsible for initiating oxidative stress.
Studies indicate that Withania somnifera possesses anti-inflammatory, antistress, antioxidative and rejuvenating properties.
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2. Kumar DS, Prabhakar YS. On the ethnomedical significance of the Arjun tree, Terminalia Terminalia arjuna. (Roxb.) Wight & Arnot. J Ethnopharmacol. 1987 Jul;20(2):173-90.
3. Terminalia arjuna. Altern Med Rev. 1999 Dec;4 (6):436-7.
4. Dwivedi S, Jauhari R. Beneficial effects of Terminalia Terminalia arjunain coronary artery disease. Indian Heart J. 1997 Sep-Oct;49(5):507-10.
5. Bharani A, Ganguli A, Mathur LK, Jamra Y, Raman PG. Efficacy of Terminalia Terminalia arjunain chronic stable angina: a double-blind, placebo-controlled, crossover study comparing Terminalia Terminalia arjunawith isosorbide mononitrate. Indian Heart J. 2002 Mar-Apr;54(2):170-5.
6. Gupta R, Singhal S, Goyle A, Sharma VN. Antioxidant and hypocholesterolaemic effects of Terminalia Terminalia arjunatree-bark powder: a randomised placebo-controlled trial. J Assoc Physicians India. 2001 Feb;49:231-5.
7. Mohanty I, Arya DS, Dinda A, Talwar KK, Joshi S, Gupta SK. Mechanisms of cardioprotective effect of Withania somnifera in experimentally induced myocardial infarction. Basic Clin Pharmacol Toxicol. 2004 Apr;94(4):184-90.