High blood pressure is among the most prevalent chronic disease in adults that impacts on the quality of life of patients, which are often subjected to physical rehabilitation. Chinese medicine intervention in patients with hypertension presents promising albeit inconclusive results, mostly due to methodological issues. This paper discusses asserted and neglected issues linking evidence-based and Chinese medicines as related to systemic arterial hypertension, as well as their impact on the physical rehabilitation of those patients. On the one hand, natural history of hypertension, pulse palpation, and herbal therapy are among the asserted issues because of the scientific evidence collected about them, either in favor or against its integration to the current medical practice. On the other hand, anatomical variations of vessels and comparative physiology are among the most commonly neglected issues because previous researches on integrative medicine ignored the possible effects of these issues as related to the study's outcome. The asserted issues highlighted in this paper stimulate the increasing use of Chinese medicine for health care and the continuity of research on integrative medicine in the cardiovascular field for rehabilitation. The neglected issues poses additional challenges that must not be overlooked in future research on this topic so that the integration of both traditional and current knowledge may be of benefit to the population with cardiovascular disease.
In this study, we investigated the possible mechanisms underlying the neuroprotective effects of coumestrol, a potent isoflavonoid with antioxidant activities and binding affinities for both estrogen receptors (ER) ER-alpha and ER-beta that are comparable to those of 17beta-estradiol, in a model of global ischemia in male subjects.
This study evaluated the association between the main plasma endogenous non-enzymatic antioxidant components and the increase in human antioxidant capacity (AC) after acute coffee intake. Ten adults were tested before and 90 min after consumption of coffee or water, in a crossover design, with a 7-day interval between tests. AC (FRAP and TRAP), ascorbic acid, ?-tocopherol and ?-tocopherol, albumin, bilirubin and uric acid were analyzed in plasma/serum. After coffee consumption FRAP and TRAP increased 2.6% and 7.6% (P<0.05), whereas after water consumption FRAP and TRAP decreased 2.5% and 1.0% (P <0.05), respectively. In general, AC assays correlated with uric acid and ?-tocopherol (r >0.75; P <0.04), independently of treatment and time point. Changes in AC assays after coffee intake did not correlate with endogenous components, which remained unchanged. These results suggest that coffee components spare endogenous antioxidants or are themselves the main contributors to plasma AC increase after coffee intake.
Global ischemia arising during cardiac arrest or cardiac surgery causes highly selective, delayed death of hippocampal CA1 neurons. Phytoestrogens are naturally occurring plant-derived compounds that are present in the human diet and are considered selective estrogen receptor (ER) modulators. The phytoestrogen coumestrol is a potent isoflavonoid, with binding affinities for both ER-? and ER-? that are comparable to those of 17 b-estradiol. The present study examined the hypothesis that coumestrol protects hippocampal neurons in ovariectomized rats in a model of cerebral global ischemia. Ovariectomized rats were subjected to global ischemia (10 min) or sham surgery and received a single intracerebroventricular or peripheral infusion of 20 ?g of coumestrol, 20 ?g of estradiol or vehicle 1h before ischemia or 0 h, 3h, 6h or 24h after reperfusion. Estradiol and coumestrol afforded significant neuroprotection in all times of administration, with the exception of estradiol given 24h after the ischemic insult. Animals received icv infusion of the broad-spectrum ER antagonist ICI 182,780 (50 ?g) or vehicle into the lateral ventricle just before the E2 or coumestrol administration. The ER antagonist abolished estradiol protection, consistent with a role of classical ERs. In contrast, ICI 182,780 effected only partial reversal of the neuroprotective actions of coumestrol, suggesting that other cellular mediators in addition to classical ERs may be important. Additional research is needed to determine the molecular targets mediating the neuroprotective action of coumestrol and the therapeutic potential of this phytoestrogen in the mature nervous system.
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