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Background: Cardiovascular disease is a global epidemic which is commonly associated with obesity. Maximum aerobic capacity (VO2peak) and Duke treadmill score (DTS) are associated with prediction of risk of heart disease so any positive modification in these factors can prevent risk of heart disease. The present study was conducted to understand the role of low carbohydrate diet and Ayurveda based Ischemia Reversal Program (IRP) in management of Ischemic Heart Disease (IHD) with obesity.
Materials and Methods: A retrospective observational study was conducted in Madhavbaug Hospital in April 2017-2018. All patients with clinical evidence of IHD and BMI > 30 kg/m2 were included in the study. During the study period of 90 (±15) days, the patients received seven sessions of IRP which included a combination of Snehana / external oleation or massage, Swedana / passive heat therapy and Basti kadha. Simultaneously, patients were prescribed supervised low carbohydrate diet daily for 90 days. The primary efficacy end point was improvement in VO2 peak after 90 day therapy while secondary end points include reduction in reduction in Duke treadmill score, BMI, body weight, SBP, DBP after 90-day follow-up as compared to day 1 (baseline).
Results: A total of 50 patients were enrolled and after screening 37 were included in the study. Most of the enrolled patients were middle aged (53.22 ± 10.78 years) and female sex (59.45%). The primary end-point used in the present study (VO2 peak) increased significantly from 17.82 ± 7.23 on Day 1 to 26.65 ± 6.14.at day 90 (p<0.001). Such significant changes were also appreciable in the Duke treadmill score, BMI, SBP, DBP values measured on day 1 and day 90 respectively (p<0.001 for all). This was associated with an appreciable decrease in the concomitant allopathic medications used by the patients.
Conclusion: The present study revealed that treatment with low carbohydrate diet and ischemia reversal program caused significant improvement in VO2 peak, Duke’s treadmill score along with BMI, SBP, DBP of patients suffering from IHD with obesity. This suggests IRP with Local Coverage Determination (LCD) can be beneficial in reducing risk of heart disease in known IHD patients.