Dyslipidemia is a group of disorders of lipoprotein metabolism, which includes over production or deficiency of lipoproteins or both. It is regarded as primary risk factors for atherosclerotic disease, especially coronary heart disease. Dyslipidemia components may include elevated LDL cholesterol, elevated triglycerides or both and/or low HDL (protective) cholesterol. It is a pathological condition in which lipid levels are deranged. In developed countries, it is a major contributor to cardiovascular morbidity and mortality.
Unani scholars have mentioned it as a major public health problem leading to dreadful complications such as angina pectoris (Waja‘al- Qalb), palpitation (Khafaqan) myocardial infarction (Iflas al Qalb), obesity (Siman-e- Mufrit), diabetes mellitus (Ziabetus Shakri), cancer (Sartaan) and abrupt death etc.
In India approximately 25-30% of urban and 15-20% rural subjects are suffering from dyslipidaemia. Although, it is more common among males, but it affects both the genders. 30 to 40 years age group has tendency to high prevalence, but above 60 years it become markedly high. Men are more prone than women. In developed countries, most dyslipidemias are hyperlipidemias; that is, an elevation of lipids in the blood. This is often due to their dietary habits and lifestyle.
Types of Dyslipidemia: It is of two types
Risk Factors of Dyslipidemia
Several risk factor associated with Dyslipidaemia are, obesity, hypertension, diabetes mellitus, sedentary life style, fatty/oily diets, hypothyroidism, excessive alcoholism and smoking.
If dyslipidaemia is not treated/ managed on time, it may lead to co-morbid symptoms like dyspnoea, lethargy, tiredness, weight gain, loss of appetite, poly cystic ovarian disease and complications like hypertension, hypothyroidism, infertility, poly cystic ovarian disease, atherosclerosis, coronary artery disease and lastly cardiovascular death.
Effect of dyslipidemia on the human body
Dyslipidemia can cause heart disease, heart attack, peripheral artery disease (reduced blood flow in the limbs, usually the legs), or stroke. Low levels of HDL and high levels of triglycerides can also increase fat build-up in the arteries.
Unani Concept of Dyslipidemia
In Unani classical literatures, the term Dyslipidemia, as such is not mentioned however scholars have described it under the broad headings of Dasumat-e- Dam (Greesy blood) & Siman-e- Mufrit (Obesity) along with the abnormalities of Hazm-e- Kabidi as the main cause of dyslipidaemia.
Pathological changes mentioned under the heading “Saman-e- mufrat” (obesity) are same as dyslipidemia. Samn-e- mufrat (Obesity) is a disease caused by su-e- mizaj-e- balgham.
Samn-e- mufrat (obesity) is related to fasaad-e- hazm-e- kabidi, kasrat-e- buroodat-e- kabid (excessive coldness of liver), which causes excessive quantity of phlegm (ghalba-e- balgham) in blood resulting disturbed metabolism.
Unani physicians have clearly mentioned that all the white and colourless fluid of the body comes in the category of phlegm (balghami khilt), when this khilt-e- balghami became abnormal in quality and quantity this will lead to phlegmatic diseases (balghami amraz) and will cause pathological changes in the body.
In samn-e- mufrat (obesity), hararat-e- ghariziya reduces and leads to less supply of rooh to the vessels.
The causes responsible for samn-e- mufrat (obesity) are same which are responsible for dyslipidemia, these are heredity, martoob ghiza, kasrat-e- ghiza, rahat, lack of exercise, martoob roghaniyat, intake of excessive alcohol especially after meal.
In Classical Unani literature, there is a concept of Quwt-e- Tabaiyah, which provides the functions of Taghziya (nutrition), Namiya (growth) and Tanasuliya (reproduction) in the body and drive out the waste products (Fuzlat) from the body. Kabid (Liver) is the prime organ of Quwat-e-Tabaiya.
Quwat-e- Ghazia is one of the types of Quwat-e- Tabaiya which is responsible for ingestion, digestion, absorption, transformation and assimilation of ghiza (Food) and excretion of waste products from the body.
Quwat-e- Ghazia is served by four kinds of subordinate faculties (Quwat-e-Khadima). Hazm-e- Kabidi is one of the parts of Quwat-e-Hazema i.e. type of subordinate faculty of Quwat-e-Ghazia. Hazm-e- Kabidi is aimed at benefiting its own cells as well as the entire body.
Hippocrates (Buqrat) was the first Unani Physician, who gave comprehensive explanation of Saman-e- Mufrat including its complications, later on renowned Unani physicians like Galen, Ali- Ibn Abbas Majoosi and Ibn-e- Rushd have mentioned the concept of Shaham (fat) and Siman-e-Mufrit in their treatises.
Zakariya Razi described the importance of dieto- therapy in the management of samn-e- mufrat (obesity).
Ibn-e- sina has mentioned the importance of evacuation of morbid material (istifragh) in the management of obesity. He stated that the diuretic (Mudirr) and laxative (Mulayyan) Unani drugs, reduce the body weight by hindering the digestive process via inhibiting the absorption of digested food.
Ismail Jurjani and Ibn-e- Nafees pointed out that obese people are more prone to develop cardiac and cerebral complications such as Khafqan (palpitation), Sakta (stroke), Ghashi (syncope), concealed haemorrhage, coma and sudden death.
Usool-e- Ilaj (Principles of Management)
Management/ Treatment of Dyslipidemia
Reducing elevated levels of low-density-lipoprotein cholesterol (LDL-C) significantly reduces the incidence of coronary heart disease (CHD) events and mortality in hypercholesterolemia patients.
Currently, various synthetic agents are being used in the treatment/ management of dyslipidaemia, however, Long term use of these medicine may leads to various adverse/ side effects like: hepatotoxicity, renal dysfunction, flushing, pruritus of the face and upper trunk, dyspepsia, myopathy, bloating, constipation, skin rashes, urticaria, myalgias, fatigue, headache, impotence, acanthosis nigricans,anaemia, hair loss etc.
Unani modalities of treatment/ management are safe, cost effective and easily available for better management of dyslipidaemia.
Treatment modalities available in Unani system of medicine for the management of dyslipidaemia are:
Single Unani Drugs used for the management of Dyslipidemia
Renowned Unani physicians like Hippocrates (Buqrat), Galen (Jalinoos), Zakaria Rhazi, Ali Ibn-e- Abbas Majoosi, Sheikh Ibn-e- Sina, Ismail Jurjani etc. have recommended various drugs, which are hot in temperament to modulate liver functions and also scientifically reported to have anti-dyslipidaemic activity.
Unani name Scientific name
Compound Unani Formulations
Some compound Unani formulations, which has been scientifically proven for anti-dyslipidemic activity on human subjects and are highly effective for the management of dyslipidemia and obesity (saman-e- mufrat) are: