I. Historical
II. Consumption and Regulation
III. Benefits, Adverse Effects, and Drug Interactions
IV. Substances Used by Athletes

sympathomimetic impulses from the sympathetic nervous
system, adrenergic. vasoconstriction narrowing, decrease in the diameter of veins or
arteries.

GLOSSARY
angina chest pain caused by temporary lack of blood to an area of heart muscle cells, usually caused by severe obstruction of the artery supplying blood to the segment of cells.
arrhythmia general term for the irregularity or rapidity of the heartbeat, an abnormal heart rhythm.
arterial dilatation enlargement or increase in the luminal dia¬meter of the artery.
dyslipidemia the same as hyperlipidemia, elevated blood choles¬terol, LDL cholesterol, triglycerides, or low HDL cholesterol.
flavonoid any of a large group of crystalline compounds found in plants.
free radical an atom or group of atoms that is highly chemically reactive, because it has at least one unpaid electron; free radicals can attack cells.
free radical scavenger a substance that removes or destroys free radicals.
heart failure failure of the heart to pump sufficient blood from the chambers into the aorta; inadequate supply of blood reaches organs and tissues.

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• I. HISTORICAL
  In 350–377 BC, Hippocrates, the father of medicine, advised the use of diet and plant medicines. He tried to relieve the pain of his patients by asking them to chew willow bark, which contains salicylic acid. Long before Hippocrates, the ancient Sumerians (5000 BC), Egyptians, and the Chinese (1600–700 BC) were noted to use herbs such as onions, garlic, licorice, ginger, thyme, and Ayurveda was commonly used in India.
• II. CONSUMPTION AND REGULATION
  Alternative therapies with herbal, dietary, and vitamin supplements have escalated considerably in the western world during the past 10 years. Alternative therapies were used in more than 40% of adults in the United States during 1997, and a consumer poll in 1998 indicated that more than 30% of respondents use herbal remedies. In the United States the use of herbal therapy in 1997 was 12% vs. 2.5 percent in 1990, at a consumer cost of greater than $5 billion. During 2001, more than $17 billion was spent on dietary supplements with greater than $4.2 billion spent for herbal remedies in the United States.
• III. BENEFITS, ADVERSE EFFECTS, AND DRUG INTERACTIONS
  A. Danshen (Salvia miltiorrhiza)
• IV. SUBSTANCES USED BY ATHLETES
  Many athletes may indicate that they are not taking medications and fail to recognize that herbal preparations and dietary supplements may contain prohibited sub¬stances that are cardiovascular stimulants. Substances commonly used by athletes include ephedra alkaloids (e.g., Ma Hung or ephedrine) and guarana (caffeine). Adverse effects include arrhythmias and catecholamine cardiomyopathy.
• BIBLIOGRAPHY
  Appeldoorn, C. C. M., Bonnefoy, A., Lutters, B. C. H. et al. Gallic acid antagonizes P-selectin–mediated platelet–leukocyte interactions: Implications for the French paradox. Circulation, 111:106–112, 2005.