*9.1.1 Diet modification*

Diet modification is of utmost significance for persons suffering from chronic heart diseases to maintain their disease conditions [55, 56]. These may include:


## *9.1.2 Rest and exercise*

Patients diagnosed with heart failure were traditionally counseled for engaging in physical activity in the hopes of preventing their condition from deteriorating. Numerous investigations have reported that physical rest has come to be recommended only in cases of acute heart failure or instability in chronic heart failure [58]. Physical exercise is critical for reducing obesity, overweight and is also useful for chronic cardiovascular suffering. Even if no weight is lost, exercise can help reduce the risk factors for CVDs and assist weight loss efforts for those who are overweight and have type 2 diabetes.

## *9.1.3 Ventilatory support: oxygen and non-invasive ventilation*

Oxygen has been utilized extensively outside of hospitals as well as in emergency rooms due to the widespread belief that it may alleviate breathlessness and increase myocardial oxygenation, regardless of the fact that oxygen saturation levels should be maintained and available for heart patients. On the other hand, supplementary oxygen and supported breathing such as ventilation should be stored or reserved for cardiac patients who are experiencing hypoxemia. Several research findings have comprehensively evaluated the effects of elevating fraction of inspired oxygen (FiO2), oxygen deficiency produces a decline in cardiac output as well as enhances systemic vascular resistance (SVR), and ventricular filling pressures [65].

#### **9.2 Pharmacological management of cardiovascular diseases**

Pharmacological management involves two approaches –


#### *9.2.1 Treatment with allopathic medicines*

Different types of medications are recommended for cardiac patients depending on their disease conditions. In **Table 5**, major classes of cardiovascular drugs are presented along with their mechanisms of action.



#### **Table 5.**

*Major classes of cardiovascular drugs and their mechanisms of actions with examples of each class.*

**Figure 5.** *General mechanism of antihypertensive drugs (significantly modified as per study design) [66].*

**Figure 6.**

*Proposed anti-anginal mechanism for nitrates, beta-blockers and calcium channel blockers (designed with biorender).*
