Validation of the Ayurvedic construct, Rasadhatudushti, in adults at risk of cardiovascular diseases – A mixed-method study

BACKGROUND: Rasadhatudushti (RD), the deranged state of Rasadhatu, is a construct in Ayurveda mentioned as the cause of diseases affecting the circulatory channels and the heart, collectively called cardiovascular diseases (CVD). It is a morbid condition generic to some other disorders, hence is non-specific to CVD. It was observed that RD was present in majority of acute coronary artery disease in a cross-sectional, descriptive study in 250 patients stabilized after an acute episode. OBJECTIVES: To validate the available scale for assessing RD in the context of CVD risk. To study the prevalence of RD in participants at risk of cardiovascular diseases. METHOD: In the first part, validation of the scale for assessing RD, as mentioned in the texts, was done through standard steps for scale validation in the context of CVD risk. Psychometric analysis was done after administering the draft scale of 39 items in 218 participants above the age of 40 years who were not yet diagnosed with overt CVD conditions. Construct validation was done by comparing mean score of Framingham global risk score in high and low RD scores and comparing the reduction in CVD risk score assessed by Qrisk®2–2017 by life style modification and a conventional RD correction as add on. Second part was a cross sectional survey study to estimate the prevalence of RD in a specific population vulnerable to CVD. This was done in a sample of 160 sedentary government employees of Thiruvananthapuram District, Kerala, aged above 40, using the validated RD assessment scale. RESULT: –The final scale to assess RD, ‘RAS-RCVD’, with 25 symptoms was found to have concurrent validity using WHO/ISH risk prediction as the reference standard. Framingham global risk score also showed significant but low positive correlation with eight as the cut off for RD score. The reduction in mean (SD) Qrisk score was 2.53 (3.22) in the trial group receiving RD correction drug and 0.30 (3.43) in the control with statistical significance (p < 0.05). The prevalence of RD as assessed by RD score above the cut off in the second part of the study was 49.4%. The prevalence of RD was significantly high in participants with moderate to high risk for CVD (61.3%). CONCLUSION: – The construct RD was observed to be valid in pre-clinical states of CVD. There was a high prevalence of this morbid construct in moderate to high-risk individuals. Ayurvedic CVD prevention strategies need to target on correction of RD along with individual risk factor management.