Systematic Reviews and Meta-Analyses on Effects of Ayurvedic Interventions for Hypercholesterolemia, Hypertension, and Coronary Heart Diseas

Heart disease is the number one cause of death globally. Because of numerous side effects and increasing cost of conventional treatments, there is a growing interest in complementary healing approaches like Ayurveda. However, in lack of sufficient scientific evidence, safety and efficacy profile of these interventions has not yet been established. Systematic reviews and meta-analysis are the gold standard of evidence upon which clinicians, consumers, policymakers rely. Until this time, there are no Cochrane or other systematic reviews and meta-analysis on Ayurvedic interventions for cardiovascular disorders. This study was conducted with an aim to explore the efficacy of Ayurvedic interventions in hypercholesterolemia, hypertension and coronary heart disease, strength of the evidence and their possible side effects.;Cochrane guidelines for systematic reviews and meta-analysis were followed to design, formulate and implement search strategies, select studies, collect, abstract and analyze data, assess risk of bias, and report and interpret results.;Evidence from results were classified as per guidelines from American Academy of Neurology. Three meta-analyses of 64 studies on 2629 people studying effects of 10 different Ayurvedic interventions for hypercholesterolemia, high blood pressure and coronary heart disease, concluded that there is moderate to high strength evidence that several Ayurvedic herbal preparations are safe and effective. They pose no known side effects and thus can be used as dietary supplements or as an adjuvant to conventional therapy for better results. It was observed that Commiphora mukul (guggulu) reduced total cholesterol and low density lipoprotein levels by approximately 16 mg/dL and 18 mg/dL respectively with high certainty evidence. Similarly, garlic and Terminalia arjuna (arjuna) based formulas also had high to moderate strength evidence of their efficacy to reduce cholesterol levels. On the other hand, Arjun Vachyadi compound and Rauwolfia serpentina based formulas were found to have moderate certainty evidence to reduce high blood pressure. It was also observed that Ayurvedic formulas with arjuna as a chief ingredient are capable of improving left ventricular ejection fraction by 12 % with a moderate strength of evidence. Findings of these systematic reviews and meta-analysis encourage future researchers to conduct methodologically rigorous randomized clinical trials studies with a larger sample size.