Therefore, reduction of lipoproteins oxidative change in the body by natural and synthetic antioxidants is an effective way to prevent cardiovascular disorders. Rapid advancements in understanding the molecular mechanisms of atherosclerosis have led to discover and suggest mechanisms to postpone the progress of coronary artery disease. Antioxidants such as vitamin E, selenium, beta-carotene and chemical compounds such as butyl hydroxytoluene and butyl hydroxyanisol can prevent cell membrane oxidation.
Therefore, studies on some natural compounds with antioxidant properties without toxic effects to inhibit lipid peroxidation and consequently to prevent related diseases seem necessary. Several studies have demonstrated that receiving a mixture of specific antioxidants as food supplements decrease the production of MDA and protein carbonyl, decrease erythrocyte hemolysis, and increase the total amount of antioxidants.
Medicinal herbs, as a source of different antioxidants, can be very effective in modulating oxidative stress derived cardiovascular or renal damages. Flavonoids are a group of phenolic compounds with low molecular weights. Their basic structure is similar and found in fruits and vegetables. The amount and type of flavonoids in different plants depend on the species, growth, and maturity of the plants.
More than phenolic structures are known which are composed of various molecules such as phenolic acids to fully polymerized compounds such as tannins. They are classified in flavonoid main groups comprising anthocyanins, flavonols, flavones, neoflavones, isoflavones, and dihydroflavones. Flavonoids are among potent antioxidants, free radical scavengers, metal excreters, ROS-family compounds collector, and lipid peroxidation inhibitors.
Studies show that flavonoids inhibit LDL oxidation in macrophage culture media and also reduce Ox-LDL absorption by macrophage sweeping receptors. Considering the therapeutic effect of flavonoids for cardiovascular diseases, using plants with such effects seems necessary.
Various studies with promising results have been done on plants with such properties. The most important medicinal herbs with documented antioxidant activity and hypolipidemic effects are as follows. Arachis hypogaea, Citrus limon, Linum usitatissimum, Aloe littoralis, Aloe vera, Ziziphus jujube, Zingiber officinale, Onopordon acanthium, Celosia cristata, Mukul comiphora. Atherosclerosis starts with fatty streaks formation and progresses with atheroma and atherosclerotic plaque formation.
Lipid oxidation, in the form of Ox-LDL, demonstrates the first step of atherosclerosis. MDA shows lipid peroxidation level and is a marker of increased oxidative stress. CRP is an indicative marker of body's response to inflammatory processes. It is one of the most important pathogenesis factors along with fibrinogen in atherogenic processes.
Nitric oxide is known as a vasodilator and endothelial survival factor which enhances the endothelial cell proliferation and migration. In special pathologic conditions such as severe hypercholesterolemia, peroxynitrate concentration increases, which leads to severe atherosclerotic damage.
Considering the role of oxidative stress and lipid oxidation in formation and progress of atherosclerosis and endothelial damage, using antioxidants, especially herbal types can be beneficial. Conflict of Interest: None declared.
National Center for Biotechnology Information , U. Int J Prev Med. Author information Article notes Copyright and License information Disclaimer. Correspondence to: Dr.
E-mail: moc. Received Jan 5; Accepted Mar 4. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. This article has been cited by other articles in PMC. Abstract Background: Atherosclerosis is the major cause of morbidities and mortalities worldwide.
Methods: The recently published papers about atherosclerosis pathogenesis and herbal medicines effective in the treatment and prevention of hyperlipidemia and atherosclerosis were searched. Results: Inflammation has a crucial role in pathogenesis of atherosclerosis.
Conclusions: The pathogenesis factors involved in atherosclerosis have recently been cleared and the discovery of these factors has brought about new hopes for better prevention and treatment of atherosclerosis. Keywords: Atherosclerosis, inflammation, lipids. METHODS The recently published papers about atherosclerosis pathogenesis and herbal medicines effective in the treatment and prevention of hyperlipidemia and atherosclerosis were searched in databases such as Web of Science, Medline, PubMed, Scopus, Embase, Cinhal and the Cochrane from to Fatty streaks formation Both animal and human studies show that the fatty streaks are the first sign of atherosclerosis.
Open in a separate window. Figure 1. The formation of fatty streaks has four steps Low density lipoprotein-cholesterol LDL-C trapping Activation of endothelial cells Leukocytes activation Formation of foam cells.
Low density lipoprotein-cholesterol trapping The first step in atherogenesis is trapping the lipoprotein in the lesion site. Activation of endothelial cells Cytokines and oxidized lipids play important roles in the activation of endothelial cells. Leukocytes activation During the initial steps of atherosclerosis, mononuclear leukocytes, monocytes, and T cells enter the intact endothelium through vascular walls.
Foam cell formation Mononuclear phagocytes differentiate to macrophage after insertion in the intima. Atheroma formation Severe damage to vascular tissue happens when adjacent SMC and endothelial cells secret small peptides such as cytokines and growth factors such as interleukin 1 IL-1 , and TNF which causes cell growth.
Figure 2. Atherosclerotic plaque formation Atherosclerotic plaques constituents are as follows: Vascular epithelium: Vascular epithelium reacts with macromolecules and blood components to increase the protein transfer in plasma Arterial smooth muscle: The maintenance of vascular repair and metabolism of blood products including lipids, and the secretion of various cytokines, is essential in the control of vascular wall tonus Lymphocytes: They may participate in the immune reactions.
Figure 3. Atherosclerosis risk factors and indicators The exact causes and risk factors of atherosclerosis are unknown; however, certain conditions, traits, or habits may raise the chance of developing atherosclerosis [ Table 1 ]. Cholesterol increase Cholesterol is a hydrophilic lipid that is progenitor of steroid hormones such as corticosteroids, sex hormones, bile acids, and vitamin D. Apolipoproteins and lipoproteins High concentrations of some plasma lipoproteins are related to atherogenesis.
Hypertension Hypertension is a risk factor in cardiovascular diseases and stroke. Defect in nitric oxide production or function Nitric oxide is produced from the conversion of L-arginine to L-citruline by enzymatic activity of NADH related to nitric oxide synthase NOS.
Figure 4. Roles of nitric oxide endothelial synthase in atherosclerosis. Immune and infection mediated atherosclerosis Mediators of acquired and innate immunity are involved in atherosclerosis, as might be anticipated for a chronic inflammatory process. Hemostatic factors Currently, fibrinogen and factor VII homeostatic factors are known as confounding risk factors in cardiovascular diseases. Figure 5. Stages of fibrinolyse, anticoagulation, and platelet inhibition. Homocysteine Although homocysteine does not seem to be a strong predictor of athrosclerosis, Cavalca et al.
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Reduction in incidence of coronary heart disease. If you have severe symptoms or a blockage, your doctor may recommend one of the following surgical procedures:. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Exercise most days of the week. Regular exercise improves blood flow, lowers blood pressure, and reduces your risk of conditions that increase the risk of atherosclerosis and heart disease.
Aim to exercise at least 30 minutes most days of the week. If you can't fit it all into one session, try breaking it up into minute intervals. You can take the stairs instead of the elevator, walk around the block during your lunch hour, or do some situps or pushups while watching television. Eat healthy foods.
A heart-healthy diet full of fruits, vegetables and whole grains — and low in refined carbohydrates, sugars, saturated fat and sodium — can help you control your weight, blood pressure, cholesterol and blood sugar. Try substituting whole-grain bread in place of white bread. Grab an apple, a banana or carrot sticks as a snack. Read nutrition labels as a guide to control the amount of salt and fat you eat. Use monounsaturated fats, such as olive oil, and reduce or eliminate sugar and sugar substitutes.
If you have high cholesterol, high blood pressure, diabetes or another chronic disease, work with your doctor to manage the condition and promote overall health. It's thought that some foods and herbal supplements can help reduce your high cholesterol level and high blood pressure, two major risk factors for developing atherosclerosis. With your doctor's OK, you might consider these supplements and products:.
Talk to your doctor before adding any of these or other supplements to your atherosclerosis treatment. Some supplements can interact with medications, causing harmful side effects. You can also practice relaxation techniques, such as yoga or deep breathing, to help you relax and reduce your stress level. These practices can temporarily reduce your blood pressure, reducing your risk of developing atherosclerosis.
If you think you may have atherosclerosis or are worried about having atherosclerosis because of a strong family history of heart disease, make an appointment with your doctor to have your cholesterol level checked.
Here's some information to help you get ready for your appointment and know what to expect from your doctor. Preparing a list of questions will help you make the most of your time with your doctor.
For atherosclerosis, some basic questions to ask your doctor include:. It's never too early to make healthy lifestyle changes, such as quitting smoking, eating healthy foods and getting more exercise. These are simple ways to protect yourself against atherosclerosis and its complications, including heart attack and stroke.
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This content does not have an English version. This content does not have an Arabic version. Diagnosis Your doctor will perform a physical exam and ask questions about your personal and family health history. Heart scan coronary calcium scan Open pop-up dialog box Close.
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