Improving the effectiveness of medical rehabilitation of patients with ischemic heart disease using dihydroquercetin

Cardiovascular diseases (CVD) are a leading cause of death in all industrialized countries. Coronary heart disease (CHD) occupies a leading position among CVDs. The relevance of CHD is determined by its role in disability and mortality in the population, as well as the financial costs associated with the treatment and rehabilitation of patients. The goals of treating patients with CHD are to improve quality of life by reducing the frequency of angina attacks and preventing acute myocardial infarction. In addition to lipid metabolism disorders, hemostatic disorders play a significant role in the development and progression of CHD. In particular, increased platelet activity leads to changes in blood rheology and an increased tendency to thrombosis, which leads to impaired microcirculation. Therefore, the inclusion of agents that target pathogenic mechanisms in rehabilitation programs for such patients appears promising. One such agent is the bioflavonoid dihydroquercetin (DHA), obtained from Siberian larch wood. It stimulates tissue blood flow, stabilizes microvascular barrier function, reduces capillary wall permeability, improves blood rheology, and thereby helps reduce microvascular congestion.

The aim of this study was to evaluate the effectiveness of the dietary supplement «Dihydroquercetin» (Evalar, JSC) in the comprehensive treatment of patients with coronary heart disease. The study demonstrated the positive effects of dihydroquercetin on cardiovascular disease (CVD): significant improvement in peripheral microcirculation hemodynamic parameters, a tendency toward normalization of cerebral hemodynamics, and a positive effect on lipid metabolism. This opens up new possibilities for the use of plant-based antioxidants in practical medicine.

1. Yakshina Alisa Dmitrievna. Cardiovascular Diseases in Russia: A Statistical Review. Science Through the Prism of Time. 2024; 1 (82).

2. Bichurin D.R. Cardiovascular Diseases. Regional Aspects / D.R. Bichurin, O.V. Atmaykina, O.A. Cherepanova. International Research Journal. 2023; 8 (134). URL: https://research-journal.org/archive/8–134–2023-august/10.23670/IRJ.2023.134.103 (accessed: 31.12.2023).

3. Battistoni A., Canichella F., Pignatelli G. et al. Hypertension in Young People: Epidemiology, Diagnostic Assessment and Therapeutic Approach. High Blood Press Cardiovasc Prev. 2015. Jul. 8.

4. Polonskaya A.A. Cardiovascular diseases as a medical and social problem / A.A. Polonskaya, Yu.S. Gorshunova, D.A. Tolmachev. Modern Science. 2021; 12–2: 110–114.

5. Boytsov S.A., Drapkina O.M., Shlyakhto E.V., Konradi A.O., Balanova Yu.A., Zhernakova Yu. V. et al. Study of the ESSE RF (Epidemiology of cardiovascular diseases and their risk factors in the regions of the Russian Federation). 10 years later. Cardiovascular Therapy and Prevention. 2021; 20 (5): 143–152.

6. Giampaoli S., Palmieri L., Donfrancesco C. et al. Osservatorio Epidemiologico Cardiovascolare / Health Examination Survey Research Group. Eur. J. Prev Cardiol. 2015. Sep. 22; (2 Suppl): 9–37.

7. Torlasco C., Calvanese C., Faini A. et al. Prevalence of hypertension and other cardiovascular risk factors in participants in the 2014 Hypertension World Day campaign in Italy. J. Hypertens. 2015 Jun; 33 Suppl. 1: e68.

8. Lavie C.J., Arena R., Swift D.L. et al. Exercise and the cardiovascular system: clinical science and cardiovascular outcomes. Circ Res. 2015 Jul 3; 117 (2): 207–19.

9. Danesh J., Collins R., Peto R. Lipoprotein(a) and coronary heart disease. Meta-analysis of prospective studies. Circulation. 2000; 102 (10): 1082–1085.

10. Galochkina A.V. et al. Study of the antiviral activity of dihydroquercetin during the replication of Coxsackie B4 virus in vitro. Voprosy virologii. 2016; 61 (1): 27–31. URL: https://www.elibrary.ru/item.asp?id=25968037

11. Kostyrya O.V., Korneeva O.S. On the prospects of using dihydroquercetin in the production of products with an extended shelf life. Vestn. VSUET. 2015; 4 (66): 165–170.

12. Schauss A.G. et al. Toxicological and Genotoxicity Assessment of a Dihydroquercetin-Rich Dahurian Larch Tree (Larix gmelinii Rupr) Extract (Lavitol). Int. J. Toxicol. 2015; 34 (2): 162–181. DOI: https://doi.org/10.1177/1091581815576975

13. Fomichev Yu.P. et al. Dihydroquercetin and arabinogalactan: natural bioregulators in human and animal life, application in agriculture and the food industry. Moscow: Nauchnaya Biblioteka, 2017. 702 p.; Scientific Opinion on taxifolin-rich extract from Dahurian Larch (Larix gmelinii). EFSA Journal. 2017; 15; (2): e04682. DOI: 10.2903/j.efsa.2017.4682

14. GOST 33504–2015. Food additives. Dihydroquercetin. Specifications. Moscow: Standartinform, 2016. 17 p.

15. Bizyuk L.A., Korolevich M.P. Antioxidant dihydroquercetin: clinical and pharmacological efficacy and routes of synthesis. Medical care: scientific and practical therapeutic journal. 2013; 1: 13–19. URL: https://www.elibrary.ru/item.asp?id=23878287

16. Scientific Opinion on taxifolin-rich extract from Dahurian Larch (Larix gmelinii). EFSA Journal. 2017; 15 (2): e04682. DOI 10.2903/j.efsa.2017.4682

17. Shchegolkov AM, Sychev VV, Shakula AV, Dergacheva LI. Improving the effectiveness of rehabilitation programs for patients with ischemic heart disease using dihydroquercetin. Bulletin of Restorative Medicine. 2009; 6: 71–74.

18. Klimko VV, Shakula AV, Shchegolkov AM, Yaroshenko VP, Sychev VV, Dergacheva LI. Comprehensive medical rehabilitation of patients with myocardial infarction in the functional recovery period with the inclusion of bioflavonoids.. Attending physician. 2010; 4: 77–81.

19. Plotnikov MB, Tyukavkina NA, Plotnikova TM. Medicinal products based on dikvertin. Tomsk: Tomsk University Press, 2005. 228 p.

20. Kolkhir VK. et al. Dikvertin – a new antioxidant and capillary-protective agent. J. Chem.- Pharm. 1995; 29 (9): 61–64.

21. Tarasova EA. Use of the new antioxidant drug Dikvertin in the treatment of patients with ischemic heart disease. Practical Phytotherapies. 1999; 1: 37–41.

22. Theriault A. et al. Modulation of hepatic lipoprotein synthesis and secretion by taxifolin, a plant flavonoid. J. Lipid Res. 2000; 41 (12): 1969–1979. DOI: https://doi.org/10.1016/S0022-2275(20)32358-0