Clinical Considerations
➤ General comments
– Hypotension is defined as a chronic reduction in the systolic blood pressure to < 100 mmHg.
– Primary hypotension is common, but clinically significant only if the symptomsare severe. The causes of hypotension are unknown. Fatiguability and orthostasis are typical symptoms.
– Secondary hypotension is rare. It can occur secondary to cardiac or adrenal insufficiency, or as the result of liver disease or cancer. When possible, the causes of the disease should be treated. No clinical data on herbal treatment of hypotension are currently available.
➤ Clinical value of herbal medicine
– Primary hypotension can usually be managed by nonpharmaceutical measures, such as exercise and physical therapy. It does not appear wise to prescribe medications unless the patient is recovering from illness of surgery or is under great physical and mental stress.
– Herbal remedies for primary hypotension are low-side-effect alternatives to synthetic drugs and chemical remedies, which often fail to provide satisfactory results, especially in long-term treatment. The herbal remedies are safe to use for self-treatment. Clinical studies are not available.
Recommended Herbal Remedies (Overview)
External Remedies
➤ Rosemary leaf (Rosmarini folium).
– Action: The essential oil in rosemary leaves stimulates the blood flow and has central analeptic effects attributed to the constituents camphor and cineol.
A circulatory tonic effect of the herbal remedy has been empirically demonstrated.
– Contraindications: Heart failure. (See Herbal Hydrotherapy.
– Dosage and administration: Steep 50 g of rosemary leaf in 1 liter of boiled water for 30 minutes, then strain and add to full bath or hip bath. Bathe for 10 minutes at 34–36 °C after getting up in the morning and rest for 1 hour afterward.
Note: Rosemary baths are stimulating, they should not be taken before retiring at night.
Internal Remedies
➤ Rosemary leaf (Rosmarini folium, see p. 112).
– Action: See above.
– Dosage and administration: Take 5 drops of rosemary tincture (1: 5) in a little warm water, 15 minutes before meals, 3 times a day.
Clinical Considerations
➤ General comments
– The incidence of peripheral and/or cerebral circulatory disturbances is growing since the average age of the population is increasing in many states.
– Peripheral vascular disease (PVD) is characterized by the development of arteriosclerotic vessel changes, especially in the extremities. Low-density lipoprotein (LDL), elevated cholesterol levels, the coagulatory system, and platelet function play a decisive role in these changes. Their interactions are responsible for the deposition of arteriosclerotic plaques on blood vessel walls. This ultimately leads to narrowing and occlusion of the blood vessels. Since this is related to an oxygen deficiency, larger quantities of free radicals develop and damage the vessel walls by way of oxidized LDL.
➤ General treatment measures
– It is essential to eliminate the risk factors (e. g., smoking and lack of exercise) and to ensure optimal management of diabetes, elevated serum lipid levels, and arterial hypertension.
– Regular physical therapy and physical exercise are achieved in only onethird of all patients with peripheral vascular disease because of concomitant cardiological or orthopedic diseases and/or lack of motivation.
➤ Clinical value of herbal medicine: Ginkgo biloba extracts are useful alternatives to the corresponding synthetic drugs and chemical remedies.
Recommended Herbal Remedies (Overview)
Symptomatic Treatment
➤ Ginkgo leaf (Ginkgo bilobae folium).
– Action: The acetone-based dry ginkgo biloba leaf extract received a positive monograph rating. The therapeutic effects of ginkgo biloba extract (GBE) are largely determined by its flavone glycoside and sesquiterpene lactone components.
• Positive rheological effect (reduction of erythrocyte and platelet aggregation)
• Inhibits free radical production
• Increases prostacyclin synthesis
• Antagonizes platelet-activating factor (PAF)
• Neuroprotective
• Improves cellular energy metabolism
– Dosage and administration: Daily dose of 120–160 mg, taken orally in 2 or 3 divided doses, for a period of at least 6 weeks.
– Side effects: Although very rare, mild gastrointestinal complaints, headaches, and allergic reactions can occur.
Prophylactic Treatment
➤ Garlic (Allii sativi bulbus).
– Action, formulations, and dosage.
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