Ispaghol Fibers For Decreasing Hyperlipidemia
Ispaghol Fibers For Decreasing Hyperlipidemia
INTRODUCSSION
Coronary heart disease is usually caused by a condition called atherosclerosis, which occurs when fatty material and a substance called plaque build up on the walls of your arteries. This causes them to get narrow. As the coronary arteries narrow, blood flow to the heart can slow down or stop. This can cause chest pain (stable angina), shortness of breath, heart attack, and other symptoms.1Coronary heart disease (CHD) is the leading cause of death in the United States for men and women.2Many things increase risk for heart disease. One of the most common cause/risk is fats in the blood circulation.3Cholesterol in our body synthesizes many hormones, vitamin D, and the bile acids that help to digest fat. It takes only a small amount of cholesterol in the blood to meet these needs.4,10,12 If human body have too much cholesterol in bloodstream, the excess is deposited in arteries, including the coronary arteries, where it contributes to the narrowing and blockages that cause the signs and symptoms of heart disease.5Psyllium or Plantago ovata Forsk is an annual plant grown primarily in India, southern Europe and the United States. Psyllium is cultivated primarily for its use as a laxative or as a dietary fiber ingredient in foods, such as ready-to-eat cereals. It is also known as blond psyllium, Indian psyllium and plantain. Although the seed alone contains the bioactive mucilage polysaccharide, the refined psyllium seed husk, known as the Ispaghula husk, is the psyllium component principally used as the soluble fiber source for laxatives, ready-to-eat cereals and nutritional supplements.6,9 In specific doses, it lowers serum total cholesterol and LDL- Cholesterol remarkably.7 Psyllium husk fiber is a viscous, mostly water-soluble fiber prepared by mechanical removal of the husk from blonde psyllium seed (Plantago ovata). Early or uncontrolled studies suggested that psyllium improved glycemic and lipid control in individuals with type 2 diabetes.8,14 The mechanism of psyllium’s possible hypocholesterolemic activity is not fully understood. The bioactive agent of psyllium is a soluble, viscous xylan fiber. It is thought that this polysaccharide stimulates the conversion of cholesterol to bile acids and that it stimulates fecal excretion of bile acids. Psyllium may also decrease the intestinal absorption of cholesterol.9
PATIENTS&METHOD
Study was conducted in the department of Pharmacology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi, from January to July 2006.Forty patients of primary hyperlipidemia were enrolled in the study, selected from ward and OPD of National Institute of Cardiovascular Diseases (NICVD), Karachi. Previously diagnosed and untreated primary hyperlipidemic patients of either sex, age range from 21 to 60 years were randomly selected. Patients with peptic ulcer, hepatic disease, alcoholism, hypothyroidism, diabetes mellitus, and renal disease were excluded from the study as these pathological conditions can mask hyperlipidemic abnormality of the patient.10 After explaining the limitations, written consent was obtained from all participants. The study period consisted of 90 days with fortnightly follow up visits. Name, age, sex, occupation, address, previous medication, date of follow up visit and laboratory investigations, etc of each patient was recorded on a Performa, especially designed for the study. All the base line assessments were taken on the day of inclusion (Day-0) in the study and a similar assessment was taken on Day-90 of research design. After fulfilling the inclusion criteria patients were divided in two groups, i.e.Drug-1 (3 gram of Psyllium husk) and Drug-2 (placebo capsules, containing equal amounts of partly grinded wheat) groups. Twenty hyperlipidemic patients of group-1 were provided packets containing 3 gram of Psyllium husk and were advised to take one packet thrice daily along with diet control and exercise for 40-60 minutes (brisk walk). This regimen was followed for 12 weeks.
Twenty hyperlipidemic patients of drug-2 group having borderline ‘high’ lipid profile were included in this group taken as control, and were advised to continue on isocaloric weight maintaing diet, i.e. step-1 diet and brisk walk for next three months. Patients of this group were provided capsules containing equal amount of partly grinded wheat and orange flavor, taken one capsule thrice daily after meal for three months.
Patients were advised to come in OPD, every two weeks for follow up to check blood pressure, weight, pulse rate and general appearance of the individual. Drug compliance to the regimen was monitored by interview and counseling at each clinical visits. Serum total cholesterol was estimated by the enzymatic calorimetric method (Rivelles et al 1994) using kit cat. # 303113050 by Eli Tech Diagnostic, France.10 Triglycerides were also
