Efficacy of Ischemia Reversal Program (IRP) in Elderly Patients of Ischemic Heart Disease with Known History of Hypertension

Context: The prevalence figures of major cardiovascular diseases (CVDs)- Ischemic heart diseases (IHD) and Hypertension (HTN) have escalated to epidemic levels, in both developing and developed countries. Ischemia Reversal Program (IRP) is a combination of Panchakarma and allied therapy.

Aims: This study was conducted to evaluate the effect of IRP on VO2max, Duke’s Treadmill Score, systolic blood pressure (SBP), diastolic blood pressure (DBP) in IHD patients with known history of HTN.

Setting and Design: This observational study was conducted from January 2017 to January 2018, wherein the data of IHD patients (inducible ischemia on stress testing) with history of HTN, who attended out-patient departments (OPDs) at Madhavbaug clinics in Maharashtra, India were identified.

Materials and Methods: Data of patients who were administered IRP (60-75 minutes) with minimum 7 sittings over 90 days (± 15 days) were considered. Variables were compared between day 1 and day 90 of IRP.

Results: Out of 30 enrolled patients, 24 were males while 6 females. There was a significant improvement in Duke's score with subjects at moderate (43.3 %) and high (46.7 %) risk at baseline were significantly decreased to low (50 %) and moderate (50 %) after 90th day of therapy. IRP also showed significant improvement in VO2max from 18.14 ± 7.82 to 27.88 ± 7.31; p<0.001), SBP from 133.5 ± 16.36 to 121.87 ± 11.67, p< 0.004), DBP from 79.53 ± 8.53 to 75.3 ± 8.09, p< 0.05). Dependency on concomitant medicines was reduced. Number of patients not taking any conventional medicine increased from 10% at day 1 to 27% at day 90 of IRP.

Conclusion: IRP was effective in management of elderly IHD patients with history of hypertension; it had triple benefits i.e. anti-ischemic effect, as well as reducing the blood pressure and reducing the dependency on conventional medications, which carries favourable prognosis.