T h e r a p e u t i c I n d e x 13 5. Anticoagulant action: Withania somnifera has anticoagulant activity. 6. Myocardial/Cardioprotective action: Terminalia arjuna, Acorus calamus, Withania somnifera, Terminalia chebula, Nardostachys jatamansi, and Ocimum sanctum minimize ischemic injury to the myocardium. Aglycones in Terminalia arjuna are responsible for positive inotropic effect that improves cardiac pumping and myocardial performance. 7. Coronary vasodilatory (antianginal) action: Terminalia arjuna has coronary vasodilatory (antianginal) action. 8. Antioxidant action: Terminalia arjuna, Withania somnifera, Tinospora cordifolia, Terminalia chebula, Glycyrrhiza glabra, Asparagus racemosus, Commiphora wightii, Centella asiatica, Ocimum sanctum, Nardostachys jatamansi, Piper longum, Zingiber officinale, Acorus calamus, Syzygium aromaticum, and Foeniculum vulgare are antioxidants that prevent oxidative damage (which leads to endothelial dysfunction) in CVDs. Emblica officinalis, the richest natural source of vitamin C and a powerful antioxidant, acts as a natural cardioprotective by reducing oxidative stress in the heart. 9. Inhibition of proinflammatory mediators: Punica granatum acts as nuclear factor kappa B (NF-kB) inhibitor in vascular endothelial cells and thereby inhibits plaque formation. 10. Adaptogenic action: Stress plays a major role in the development and exacerbation of CVDs, and adaptogens are the drugs of choice for the management of stress-related disorders. They increase the resistance against multiple stressors (physical, chemical, and biological), and have a normalizing influence without disturbing the normal physiological functions. Reduction of stressors results in normalization of cardiac activities, thus producing a cardioprotective effect. Withania somnifera has anti-stress and adaptogenic activities. Asparagus racemosus, Terminalia chebula, Emblica officinalis, Piper longum, and Ocimum sanctum have potent adaptogenic actions. 11. Anxiolytic action: Anxiety is an important stress-inducer and a known risk factor for CVDs. Centella asiatica is a well-known tranquilizer and nervine tonic. Glycyrrhiza glabra has remarkable anxiolytic action. Convolvulus pluricaulis has tranquilizing and anxiolytic effects. Nardostachys jatamansi has anxiolytic and tranquilizing properties, and is beneficial in patients with nervousness and palpitation. 12. Diuretic action: Withania somnifera, Boerhaavia diffusa, and Terminalia chebula have diuretic actions that reduce cardiac load, normalize the blood pressure, and prevent CVDs. Abana® (tablet)
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