PPT Slide

• Herbal therapies:

  • CHF: natural glycosides not recommended due to narrown therapeutic index. CoQ10 may have modest benefit. Hawthorn likely effective.
  • CAD: little evidence for any herbal therapy.
  • Cholesterol: Garlic shown to have minimal effects. Gugulipid widely used at 75 mg/d in India and shows chol reduction of 10-25%. Needs further study

• Vitamin supplements and Antioxidants:

  • Prospective randomized clinical trials have not shown cardiovascular benefit of vitamin E or betacarotene. Vitamin E potentiates anticoagulation effect of warfarin!
  • Homocysteine thought to have atherogenic and thrombotic effects. Some studies show elevated homocysteine levels in patients with CV disease. Increased homcysteine thought to result from vitaminB12 and folate depletion. Diets rich in fruit and vegetable
    Chelation Therapy
    Popular, expensive treatment for vascular disease with repeated chelator treatments in combination with vitamins and trace elements. Hypothesized to improve endothelial function by decreasing reactive oxygen species formation. Chelation is not recommen