Holistic medicine to prevent heart disease

India today is facing the problem of non-communicable diseases (NCDs) such as diabetes, high blood pressure and heart disease. There is need to focus on the increasing importance of holistic medicine in preventing heart diseases.

High BP: non-pharmacological measures such as salt restriction, weight control, reduction in alcohol consumption, behavioural therapy including transcendental meditation are helpful in aiming for a reduction of diastolic pressure by an average of 10 mmHg.

Obesity and BP: it is a dangerous combination. The association of obesity with high BP is well documented. It has been shown that arterial pressure does not increase with age if the body weight does not increase. Non-obese children who gained weight in adult life have a high occurrence of hypertension.

Stress and hypertension: in some of the isolated sections of population, hypertension is pra­ctically absent and BP does not show a rise with age. These are societies living away from the st­ressful environment of modern urban life. This shows how stress can be the chief cause for hypertension, and hence should be avoided. Excess salt is being used in preserved and packaged food, as well as traditional foods such as pickles, and they must be given up in all cases of high BP.

Hypercholesterolemia: it is the low-density lipoprotein that promotes formation of cholesterol plaques in the coronary arteries, whereas high density lipoprotein (H-DLC) acts as a protective agent. It has been shown that every 1% rise in cholesterol ratio increases the incidence of heart disease by 2%. A balanced vegetarian diet with abundant fibre is going to be a good prescription for hypercholesterolemia before initiating anti-cholesterol measures.

Alcohol and hypertension: several epidemiological and clinical studies have demonstrated that alcohol consumption equivalent to or more than 30-60 g/day of ethanol has a vasopressor effect and is related to a higher prevalence of hypertension. Some 5-11% of hypertension in the society can be attributed to alcohol consumption.

DASH (Dietary Approach to Stop Hypertension): it shows that eating the right food works wonders to lower BP as much as taking a drug. The DASH diet also complements weight reduction, and exercise helps BP. A DASH stu­dy found that a diet that had less saturated fat and was rich in fruits, vegetables, whole grains and low fat dairy products lowered average BP both in normal and high normal BP cases.

The Greek food: the nutritional concept of the genesis of cardiac diseases points to the fact that the causal factors for coronary artery diseases (CAD) are of nutritional origin. Advocating the nutritio­nal pattern of low saturated fat, high complex carbohydrates, especially green, yellow vegetables which contain flavonoids are known to have protective action on the heart. Vegetables, fruits, fibre, animal protein like fish, limitation in salt contribute towards a better and healthier heart and blood vessels called Greek food.

Diabetes mellitus: diabetes is known to cause insulin resistance which has adverse effect on lipids and atherogenesis. It reduces HDL-C and increases total cholesterol and triglycerides. In general, the process of atherosclerosis is faster by 15 years compared to non-diabetics. The above mentioned factors help in controlling and preventing diabetes.

Smoking: smoking causes endothelial dysfunction and fatty deposition in coronary arteries and helps formation of atheromatous plaques. Nicotine present in tobacco stimulates excessive secretion of catecholamine and adrenaline which increase the heart rate and is responsible for the formation of carboxy–methemoglobin leading to less oxygen availability to the heart, gradually resulting in heart diseases.

Physical activity: today, physical exercise is considered a medicine worldwide. Regular physical activity and moderate aerobic exercise, especially brisk walking, jogging (exceeding 35 minutes) for at least five days a week, is considered a beneficial factor in reducing the incidence of heart disease.
Stress: modern competitive life exposes individuals to stress. Stress may cause sudden spasm of coronary artery and might help development of CAD in the presence of other risk factors.

Holistic approach, practiced traditionally, has been rather neglected in modern life. As a result, there is increased prevalence of NCDs with high mortality and mobility. Hence, focus should be on holistic approach.

(The writer is a diabetologist based in Mysuru)

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