focuses on the "green" highlighted in his excel
Artichoke has evidence of helping what 2 conditions?
upset stomach and dyslipidemia
What lifestyle modifications can be made to help decrease HTN?
smoking cessation
exercise
weight loss
limit alcohol
What type of diets can help with HTN?
DASH DIET!!!!!!!!!
also Mediterranean / vegan diet
“DASH” diet stands for
dietary approaches to stop hypertension
In the dash diet you increase/decrease eating what?
increase- fruits, veggies, grains
decrease- fat
What supplements have potential hypotensive effects?
CoQ10
garlic
I-arginine
omega-3FA
psyllium
What supplements have potential hypertensive effects?
caffeine
licorice
green tea
Cannabis has significant ___ effects including ___________ BP.
Cannabis has significant CV effects including increased BP.
What are the nonpharmalogic options for pts with Heart Failure?
don’t drink or smoke
manage stress
acupuncture, therapy
eat well
anti-inflammatory or dash diet
exercise physically, mentally, and spirtually
avoid NSAIDs
get vaccines for lung diseases
To slow the progression of HF, what herbals and supplements can be used?
Foxglove
digoxin’s “natural cousin”
CoQ10
L-carnitine
iron, vit D, vit E
ginger, green tea, hawthorn
Ginger interacts with __________________ and at high doses may affect what?
interacts with anticoagulants
high doses may affect heart rate or rhythm
What type of lifestyle modifications helps coronary and peripheral artery disease?
nutrition- mediterranean diet
eat foods full of whole grains, fish, and nuts
exercise
smoking cessation
manage stress/anxiety
mind body therapy (yoga, mediation, etc.)
For arrhythmias what food/drinks can be triggers?
alcohol
caffeine
can be hidden
food allergies
high sugar foods
greasy foods
high sodium foods
large meals
ginkgo
can be hidden
What herbal supplement has evidence of bleeding/antiplatelet properties?
willow bark
like a natural aspirin
Patients on warfarin should be cautious with what vitamin?
vitamin K (phytonadione)
For patients using warfarin, they MUST be cautioned about ____________________.
multivitamins!!
each multivitamin has dif ingredients, they need to watch the vit K content
For dyslipidemia, what is the #1 lifestyle modification we should make?
weight management
What diet has been shown to be #1 best approach for reducing cholesterol in pts. with dyslipidemia?
“portfolio diet”
like a vegetarian version of the mediterranean diet
What herbals/supplements may lower cholesterol?
artichoke
berberine
fiber/psyllium
garlic
omega-3 FA/ fish oil
red yeast rice extract
tumeric/curcumin
What herbals/supplements may interact with statins?
black cohosh
cannabis
What are the evidence-based uses of berberine?
diabetes
dyslipidemia
What are the main interactions with black cohosh?
statins
cisplatin
Cannabis interactions with what medications?
anticoagulants/antiplatelets
warfarin
depressants
many CYP substrates!!
3A4, 2E1
anything to do with estrogen
hormones, contraceptives
Cannabis should be used in caution with what conditions?
CVD
compromised immune fxn
respiratory problems
seizure disorders
undergoing surgery
What are the evidence-based uses of caffeine?
migraine
mental alertness
weight loss
HYPOTENSION
What are the evidence-based uses of CoQ10?
myalgia
HTN
immune function
heart health
What are the interactions with Ephedra?
ALL HEART RATE AND HTN meds!
caffeine
all stimulants
What supplement is banned in the USA because of it’s cardiotoxicity?
Ephedra
What are the evidence based uses of garlic?
dyslipidemia
arthrosclerosis
common cold
HTN
Ginkgo, Ginger, Glucosamine, garlic, green tea AND Ginseng interact with what kind of drugs?
anticoagulant/antiplatelet drugs
especially WARFARIN
(For this module, EVERY HERBAL that starts with “G” interacts with anticoags)
also think: if interacts with anticoags every “G” herbal should be used in caution with anything to do with bleeding disorders!!
Ginkgo should be avoided or used in caution in patients that have what?
history of seizures!
pts. attempting to conceive
aka make a baby
diabetes
bleeding disorders
What are the side effects of green tea?
Think: due to the caffeine content!
HA
irritation
nervousness
anxiety
increased HR
What are the evidence-based uses of L-arginine?
angina
HTN
What are the side effects of licorice supplements?
N/V
angina
Licorice supplements interact with what drugs?
antihypertensives
caution in heart disease
Omega 3 fatty acids/fish oil have what evidence-based uses?
dyslipidemia
neuropathy
HTN
Policosanol has what evidence-based uses?
anticoagulation
leg cramps (intermittent claudication)
Probiotics have what evidence-based uses?
IBD
constipation
allergic rhinitis
Psyllium has what evidence-based uses?
dyslipidemia
CAD
HTN
IBD
Red Yeast/ Red Yeast Rice has what evidence-based use?
dyslipidemia
Soy has what evidence-based uses?
dyslipidemia
menopause
memory