Cardiac Rehabilitation for patients of chronic heart failure (CHF)

Cardiac Rehabilitation for patients of chronic heart failure (CHF)

The main aim of the health care system in such patients is to reduce the symptoms of CHF and to provide a better prognosis, maximizing the function in everyday life with improved quality of life (QoL).  These CHF patients, mainly require a holistic approach to care, because of their comorbid factors, growing age, multiple medications, depression, fear, anxiety, deterioration in the patient’s morale, reduced coping skills, loneliness, etc. The standard cardiac therapy (SCT) is not enough to achieve these goals, though most of the standard recommendations include diet, exercise, psychotherapy, and medication including b-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), digoxin, anti-platelets, and diuretics, still, poor prognosis is found in some cases, though they are able to maintain and stabilize the patient’s limited functional abilities.  

In Ayurveda, several herbs  have been described to have evidence-based data associated with their antioxidant, anti-inflammatory, antiplatelet or hypolipidemic properties, but no clear evidence is available about their action in patients of CHF, towards improvement in QoL.

Here, in Ayurveda, besides, herbal medicine/ food supplements, change in diet, lifestyle, as per season and genetic constitution of the patient, and intervention through panchakarma (a conventional treatment approach consisting of 5-step procedures for internal purification of the body) are recommended. These can be used by modern cardiologists as “an add-on therapy”.

However, for its global acceptance, broad-based clinical studies are required. Recently, at Banaras Hindu University, Institute of Medical Sciences. Dr Suyash Tripathi of Dept of Cardiology and Vaidya Sushil K Dubey of dept of kriya Sharir have undertaken a clinical trial of “Hridya Maha kashya” a mixture of 10 medicinal plants, described in Charak Samhita. They are assessing the longevity of CHF patients, but some objective parameters like metabolic equivalents of tasks (METs), peak oxygen uptake (VO2peak), ejection fraction (EF), time to onset of ischemia (TOI), double pressure product (DPP), heart rate recovery (HRR) and quality of life (QoL) can be evaluated.

However, I would appreciate it if interventions of panchakarma and naturopathy may also be added to one arm of this study or if a separate similar study may be planned.  Dr Rohit sane of Madhav baug, Maharastra, India has published several papers on these lines, by using purva karma and medicated basti, and has reported significant benefits, but multicentric studies, with Hridya maha kashya, on better objective parameters, is the demand of time.

Yamini innovations wellness and nature cure centre, Sunderpur-karaudi, Varanasi (www.yamoniinnovationsllp.com)  have all these facilities, and it would be befitting to write some projects on these lines. The ICMR and Ministry of AYUSH may take lead to invite similar proposals, across the country to attract more talent. This would also support the national Mission of our Country for achieving wellness (health for all), under the subheading of “preventive cardiology through an integrative approach of treatment.  

 

(Prof Yamini Bhusan Tripathi)

PhD Biochemistry, Former Dean, Faculty of Ayurveda, IMS, BHU

CEO- Yamini Innovations LLP (Wellness and nature cure centre), Mahamana Nagar, Colony, Karaudi – Sunderpur, Varanasi

Mob. No. 8303248869

www.yaminiinnovationsllp.com, yaminiinnovationsllp@gmail.com