European Journal of Cardiovascular Medicine

The term 'Siddha' originates from the Tamil word 'Siddhi', which denotes 'attainment' or 'flawlessness'. The Siddha medicine method not only addresses the treatment of the disease, but also considers the patient's behavior, environmental factors, age, habits, and physical condition [1]. Siddha is founded on the fundamental idea of studying the body (Dhegam), sensory organs (indriyam), intellect (Manam), and soul (Atma) as a collective unit [2]. The state of balance among these components is directly linked to one's overall health. Imbalances among these factors can lead to various problems in the human body, including cardiovascular diseases. Siddha proposes a comprehensive treatment for these ailments, which involves a combination of dietary adjustments, physical activity, meditation, and herbal remedies [3]. In Siddha, various botanical species and their preparations have proven to be advantageous in the management of cardiovascular ailments"[4]". Multiple pieces of data exist that demonstrate the efficacy of different Siddha medications in treating cardiovascular problems. The clinical trial indicates that marudham pattai is effective in treating congestive heart failure, chronic stable angina, and hypertension. The marudham pattai tree and its components, such as arjunolic acid, exhibit a cardioprotective effect in rats by virtue of their antioxidant activity [5]. The alcoholic extract derived from the bulb of Allium ascalonicum demonstrates a favourable impact on the proteolytic and hypocholesterolemic activity in rabbits [6]. The rhizome of Curcuma longa Linn, also known as turmeric, and its active compound curcumin, have demonstrated a hypolipidemic impact, antiatherosclerotic activity, and antithrombotic effect. Recent research have shown that natural components effectively inhibit, regulate, and impede key factors associated with cardiovascular disease, such as oxidative stress and inflammatory mediators [7]. Medicinal herbs have been beneficial in treating individuals with congestive heart failure, systolic hypertension, angina pectoris, atherosclerosis, cerebral insufficiency, and venous insufficiency "[8]" "[9]". To avoid cardiovascular illnesses, a herbal polypill can be created by including Siddha herbs like Kungiliyam, marudham pattai, Pushkarmoolam, poondu, nelli, and sadamaanjil. This polypill would help manage the risk factors associated with cardiovascular diseases [10]. In Siddha, the practice of Suryanamaskara is known to have a significant impact on the prevention of cardiac disorders [11]. According to a survey conducted by the global burden of disease study, it was discovered that cardiovascular disorders are responsible for the majority of deaths worldwide. The surveys were done in 2010. It is projected that by the year 2030, the number of deaths caused by cardiac arrest will increase to 24 million, accounting for a significant portion of the global population [12]. According to study conducted by the World Health Organisation (WHO), it was found that 80% of the global population relies on natural products and traditional forms of medicine for the treatment of various diseases. "[13]". Siddha medications commonly utilise extracts from widely recognised plants such as Ginkgo biloba, Ginseng, and Ganoderma lucidum to address various heart problems including myocardial ischemia, hypertension, and coronary heart disease [14]. Herbal extracts and their components play a significant role in managing hypertension and atherosclerosis, which are the primary causes of cardiovascular illnesses [15]. Herbal treatments possess multiple bioactive compounds, which contribute to their diverse cellular modes of action [16]. Herbal medicines possess antioxidant, vasorelaxant, anti-inflammatory, and diuretic properties. Herbal treatments additionally hinder the impairment of endothelial function, activation of platelets, oxidation of lipids, formation of reactive oxygen species (ROS), and the atherogenicity of macrophages. "[17]". Astragalus membranaceous includes Astragaloside, a prominent component utilised as an antioxidant and for safeguarding against cardiovascular ailments related with ischemia. A membranous extract regulates cardiac function by enhancing energy metabolism and suppressing the generation of free radicals in a rat model of myocardial ischemia and reperfusion [18]. Allium sativum, often known as garlic, is a prime illustration of a herbal remedy employed for the treatment and control of cardiovascular ailments. It offers several advantages in reducing the occurrence of cardiovascular diseases, including hypertension, oxidative stress, hyperlipidemia, and inflammation. Decreasing the cholesterol and the level of LDL reduces the content of lipids in the artery cells and owing to this reason it is effective in treatment of the atherosclerosis and hyperlipidemia "[19]".

Cardiovascular illnesses Cardiovascular diseases encompass a variety of health disorders that impact the circulatory system, specifically the heart and capillaries. Cardiovascular disorders encompass a broad range of conditions affecting the heart and blood arteries. Blood flow through the heart is diminished due to the presence of blood clots (thrombosis) and hyperlipidemia. Consequently, the artery becomes constricted, leading to the development of atherosclerosis."[20]". Hypertension is a medical condition characterised by high blood pressure. According to Siddha, hypertension is typically associated with the pitta dosham. due to inadequate circulation of blood. The individual exhibits characteristics of the Vata dosham, and the presence of Kapha dosham is observed due to congestion, resulting in reduced blood flow to the heart caused by phlegm blockage. In a conventional perspective, hypertension is a persistent medical problem that occurs when the blood pressure is elevated. Hypertension is a persistent medical illness that occurs when blood pressure is unusually elevated, namely exceeding 140 mm Hg systolic and 90 mm Hg diastolic. Hypertension is a condition characterised by the narrowing of the body's smaller blood vessels, known as arterioles. This narrowing leads to increased pressure exerted by the blood on the walls of the vessels, which in turn requires the heart to expend more effort to maintain the pressure. While the heart and blood arteries can endure elevated blood pressure for extended periods, over time the heart may undergo hypertrophy, leading to a weaker state that can ultimately result in failure.

Conventional Siddha treatments for hypertension

 The identification and management of the underlying causes are the primary focus in treating hypertension. Siddha prioritises disease prevention as its primary goal. Ayurveda emphasises nonpharmacological approaches, such as adopting a suitable dietary regimen and making lifestyle modifications, in numerous chapters dedicated to managing hypertension. Classical texts such as thiru mandhiram, pararasasegaram, etc. Focus on promoting a healthy lifestyle, reducing body weight, quitting smoking, maintaining a nutritious diet, and engaging in regular exercise [21].

Unavu (Diet) A suitable diet is prescribed to patients with mild hypertension to prevent the development of moderate hypertension. In accordance with the teachings of thirumoolar the primary cause of hypertension is the long-term ingestion of excessive amounts of salt. Excessive intake of sodium chloride causes harm to many tissues and arteries. An optimal diet consists of including fresh fruits and whole grains, while minimising the consumption of high-fat foods, fast food, and excessive sugar. Additionally, it is crucial to abstain from alcohol consumption.

Life style Reducing stress is a crucial element in the control of hypertension. Engaging in consistent meditation and other exercises leads to a decrease in stress levels. Engaging in pattini(fasting), practicing pranayama, and performing Surya namaskar are also beneficial for managing hypertension. Shavasanam, Sukhasanam, Dhanurasanam, Makarasanam, and Vajrasaanam are important in reducing blood pressure in those with hypertension and in those without the condition.

Siddha Management

Combine equal amounts of Uppu parpam and Inji rasam (Ginger Juice) with honey, a heart tonic for Ruthra vayu [22].

Elathi mathirai treats disordered pitha symptoms as palpitations, giddiness, and syncope [23].

Kaariya parpam and Vasambu kudineer (Acorus calamus decoction) are used as a cardiac tonic for various heart disorders [24].

Siddha has provided innovative solutions for the treatment, prevention, and control of cardiovascular problems. Various herbs are utilised in the management of cardiovascular disease. Herbs like arjuna, garlic, and cinnamon, along with their specific composition, have a substantial impact on the treatment of cardiovascular illnesses. Kungiliyam is efficacious in treating atherosclerosis and also beneficial in managing hyperlipidemia. An in-depth examination of herbs and their bioactive components, with regards to their pharmacological impact, would facilitate the creation of sophisticated molecules for the treatment of cardiovascular disorders. Herbs have a substantial impact on the management of illnesses, leading to their increased popularity. Herbs exhibit a greater number of adverse effects in comparison to modern medicine. Further clinical investigations are necessary to assess the phytochemicals, effectiveness, safety, and toxicity of medicinal plants.

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