Traditional treatments for stress in cardiovascular diseases

Stress is one of the significant risk factors (RF) for the development of cardiovascular diseases (CVD), therefore stress correction methods are very important.

Effect of stress on cardiovascular disease (CVD) factors. Stress can cause the development of hypertension as a result of repeated rises in blood pressure and an increase in the concentrations of vasoconstrictor hormones. The stress factors that increase the risk of developing hypertension include increased workload, social environment, emotional stress, a visit to the doctor (“white coat hypertension”), and the ethnic identity of influenivaum plays a certain role.

The Framingham Study showed that hypertension accounts for 80% of all tornadoes for her from cardiovascular diseases (CVD). In addition, the risk of death associated with hypertension is 2 times higher than the risk of death associated with smoking or increasing the level of cholesterol. Currently, an increase in blood pressure was recorded in 50 million Americans.

Stress correction methods:
1. Pets. Caring for pets reduces psycho-emotional stress by creating a goal in life and reducing the feeling of loneliness. The study showed that in patients with CVD, pet care can lead to increased heart rate variability.
2. Correction of stress through internal concentration. Correction of stress based on methods of internal concentration includes methods of internal meditation, yoga and coordinated deep breathing, aimed at reducing pain and reducing anxiety. In a meta-analysis, it was shown that the methods of inner concentration contribute to the reduction of stress and suffering associated with various diseases.
3. The method of controlled imagination. This therapeutic method allows the patient to use their own imagination to connect the body and mind in order to achieve the desired results, for example, to reduce the perception of pain or reduce anxiety. The method of controlled imagination in studies involving patients before and after surgery. In a study involving patients who underwent surgery on the heart, it was found that the method of controlled imagination can reliably reduce both pain and anxiety. In a continuing study at Scripps Clinic, it is noted that the use of guided imagination and healing touch before surgery on the heart and after the intervention is accompanied by a 50% reduction in pain and anxiety.
4. Transcendental meditation. Transcendental meditation is a unique method of meditation and relaxation, which is the most studied method of DAM. Studies of transcendental meditation began in the 1970s. Studies have shown that transcendental meditation lowers blood pressure and such a component of MS, as IL, and also improves the tone of the autonomic nervous system (VIS).
5. Biofeedback method. The biofeedback method is a way to change a person’s habitual reactions to stress. In patients with CHD, using this method increases heart rate variability.

6. Food additives and natural products. Eating certain components of the diet leads to a reduction in the risk of cardiovascular diseases (CVD). These components include plant sterols and stanols, soluble fibers, omega-3 PUFAs, garlic, soy, tea, and small amounts of alcohol. The 1994 Dietary Supplement Health and Education Act (DSHEA) amended the pre-existing dietary supplement definition given by the Federal Food, Drug and Cosmetic Act.

According to the new definition, dietary supplements are any product (with the exception of tobacco) that contains vitamins, minerals, herbs, or other plant components or amino acids and is taken as a supplement to the diet. Currently, food supplements in the USA can be labeled as dietary supplements. Accordingly, these products are not intended to diagnose, treat, cure or prevent diseases (the requirement for traditional drugs), nor are they traditional foods. According to U.S. Food and Drug Administration (FDA), in 2000 there were> 29 thousand dietary supplements in the US market, and every year there are 1,000 new ones.

In some countries (for example, in Germany, France, Sweden, Canada and Australia), licensing strategies for herbal preparations, including testing before entering the market, have been introduced. In the US, licensing of these drugs is not required.

Currently, a number of herbal substances with proven effect are widely used, for example, digoxin, atropine, reserpine and amiodarone. However, only with respect to a small number of commercial herbal remedies sold in the United States, studies of their effectiveness in cardiovascular diseases (CVD) have been conducted. Hawthorn (heart and coronary insufficiency), garlic (atherosclerosis), ginkgo biloba (artery occlusion) and horse chestnut (chronic venous insufficiency) were studied.

Rigid formalization and standardization necessary for conducting clinical trials are possible only for a few supplements. Herbal supplements, unlike most traditional drugs, are a complex mixture of biologically active substances, each of which may or may not have a therapeutic effect. Very often, the active ingredient is unknown, a complete description of the chemical composition is missing. Like many traditional medicines, herbal remedies can have a therapeutic effect in one dose and toxic in another.

Concomitant use of herbs can mask, enhance, or level the effects of other drugs. In cardiology, the problem of unrecognized interactions of herbs and traditional cardiovascular drugs, many of which have a narrow therapeutic dosing range, is very important. The table below lists the sources of detailed information on nutritional supplements and herbal preparations.

The herb-drug interaction can be described as pharmacodynamic or pharmacokinetic. Pharmacodynamic interaction develops when the components of the herbal preparation have a synergistic or antagonistic effect on the traditional drug, thereby affecting the effects of the drug at the receptor level. Pharmacokinetic interaction is a violation of the absorption, distribution, metabolism or elimination of a traditional drug under the influence of herbal remedies or food supplements.

Herbal remedies contain several components that are metabolized in phases 1 and 2 of drug metabolism, especially with the participation of cytochrome P450 (CYP3A4), and also are substrates of certain transporter proteins and P-glycoprotein. In vivo and in vitro studies have shown that P-glycoprotein-mediated elimination and / or CYP metabolism is the most likely interaction of a drug with a herbal remedy, which can reduce the effectiveness of the drug and increase its toxicity.

The clinical significance of this interaction depends on a variety of factors: the dose, frequency and time of administration of the herbal remedies, the dosage regimen and the route of intake of the drug and its therapeutic range. In addition, the use of herbal remedies can lead to a significant change in the results of laboratory tests. Deviations of laboratory tests from the norm may indicate the need for careful collection of anamnesis about the patient’s intake of herbal remedies and nutritional supplements.

Herbal remedies can affect the results of laboratory tests due to the direct impact on the studied parameters, most often immunological, due to physiological effects due to toxicity and induction of enzymes, or due to the presence of pollutants.

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