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Herbal remedies for treatment of hypertension

Authors:
  • Drugs testing laboratory avam anusandhan kendra

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Hypertension is a common problem facing many peoples today. Although billions of dollars are spent annually for the treatment and detection of cardiovascular disease, current conventional treatments have done little to reduce the number of patients with hypertension . Alternative medicine offers an effective way to decrease the rising number of people with high blood pressure. Research has found a variety of alternative therapies to be successful in reducing high blood pressure including diet, exercise, stress, management, supplements and herbs. Every year, more and more studies are being performed on herbal remedies for high blood pressure. There are many herbal drugs like Punarnava, Barberry, Rouwolfia, Garlic, Ginger, Ginseng and Arjuna which can safely use for the treatment of hypertension. This review highlight the herbs proved scientifically for the treatment of hypertension.
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ISSN: 0975-8232
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IJPSR (2010), Vol. 1, Issue 5 (Review Article)
Received 13 February, 2010; received in revised form 20 April, 2010; accepted 25 April, 2010
HERBAL REMEDIES FOR TREATMENT OF HYPERTENSION
Manish Agrawal
*1
, D. Nandini
2
, Vikas Sharma
1
and N. S. Chauhan
Department of Pharmaceutical Sciences, Dr. H. S. Gour University
1
,
Sagar (MP), India
Sagar Institute of Pharmaceutical Sciences
2
, Sagar (MP), India
Keywords:
Antihypertensive activity,
herbal remedies,
Phytochemical
ABSTRACT
Hypertension is a common problem facing many peoples
today. Although billions of dollars are spent annually for the
treatment and detection of cardiovascular disease, current
conventional treatments have done little to reduce the
number of patients with hypertension
.
Alternative medicine
offers an effective way to decrease the rising number of
people with high blood pressure. Research has found a
variety of alternative therapies to be successful in reducing
high blood pressure including diet, exercise, stress,
management, supplements and herbs. Every year, more and
more studies are being performed on herbal remedies for
high blood pressure. There are many herbal drugs
like
Punarnava, Barberry, Rouwolfia, Garlic, Ginger, Ginseng and
Arjuna which can safely use for the treatment of
hypertension. This review highlight the herbs proved
scientifically for the treatment of hypertension.
Correspondence to author:
Nagendra Singh Chauhan
Department of Pharmaceutical
Sciences,
Dr. H. S. Gour University, Sagar
(MP) India
Email:
chauhan.nagendra@gmail.com
ISSN: 0975-8232
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INTRODUCTION: Natural products from
plants, animals and minerals have been
the basis of the treatment of human
disease. Today estimate that about 80 %
of people in developing countries still
relays on traditional medicine based
largely on species of plants and animals
for their primary health care. Herbal
medicines are currently in demand and
their popularity is increasing day by day.
About 500 plants with medicinal use are
mentioned in ancient literature and
around 800 plants have been used in
indigenous systems of medicine. India is a
vast repository of medicinal plants that
are used in traditional medical treatments
[1]
. There has been an increase in demand
for the Phytopharmaceutical products of
Ayurveda in Western countries, because
of the fact that the allopathic drugs have
more side effects. Many pharmaceutical
companies are now concentrating on
manufacturing of herbal and
Phytopharmaceutical products
[2]
. In India,
around 20,000 medicinal plants have
been recorded. Chemical principles from
natural sources have become much
simpler and have contributed significantly
to the development of new drugs from
medicinal plants
[3-4]
. There are many
herbal drugs which are used for the
treatment of hypertension some of them
are listed in the following table 1:
Chemical Classification of
Antihypertensive Herbs:
Alkaloids- Rauwolfia, Papaver, Avis
tolochladebis, Loptis, jayonica,
Withenia, Golden seal, Bhringaraj
Terpenoids- Jatamansi, Inula
helenicum. Arnica montana, Coleus,
Jalbrahmi, Black cohosh forskohlii,
Sania syriaca
Steroid- Veratrum, Holarrhena
pubescens, satavari, bhringraj
,Clerodendroon trichotomum
Flavanoids -Devis scandens, Mitragyna
ciliate, Yaroow, Olive leaf, Hawthorn,
Arjuna, Ginkgo, Vitis vinifera, Alpinia
Volatile Oil - Black cumin seed, Ginger
Sterols - Cat’s claw
Tannin- African mistletoe, Arjuna
Pharmacological Classification of
Antihypertensive Herbs:
Centrally Acting- Withania (CNS
acting); Rauwolfia (catcholamine
depeleters); Hypericum (dopamine
and norepinephrine reuptake
inhibitors); Black cumin seed (CNS
acting and antioxidant)
Vasodialators- Garlic (via
hyperpolarisation through H
2
S);
Ginseng (direct smooth muscle
relaxant); Hawthorn, Vitis, Yarrow,
Olive leaf (endothelium dependent
vasodilation); Forskolin (Adenyl
cyclase pathway), Lotus
Diuretic Punarnava
Ace Inhibitors- Garlic (by allicin)
Cholesterol Synthesis Inhibitors- Cat’s
claw, African mistletoe
International Journal of Pharmaceutical Sciences and Research ISSN: 0975-8232
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3
TABLE 1: LIST OF PLANT USED AS ANTIHYPERTENSIVE AGENTS
COMMON
NAME
BOTANICAL
NAME
FAMILY
PART
USED
OTHER USES
Snakeroot
Rouvolfia
serpentina
Apocynaceae
root
Also has been used for anxiety and
psychosis , Cushing’s
Disease,dyskinesia
Garlic
Alium
sativum
Liliacae
Bulbils
Antibacterial,insecticidal,used in
digestive disorder,causes lowering
of cholesterol level
Ginseng
Panex
ginseng
Araliaceae
root
Adeptogen, pherodisiac,stimulant
St. John’s wort
Hypericum
perforatum
Hyperi -caceae.
aerial
parts
Antidepressant, sedative, relaxing
nervine, anti-inflammatory. Used
in anxiety, stress, depression,
menopausal nervousness,
menstrual cramps, neuralgia and
rheumatism
African
mistletoe
Lorentus
ben-wensis
Lorentheacae
leaves
Barkastringent and narcotic.
Scotch broom
Cystisus
scoparius
Papilionaceae
Seeds
Diuretic and cathartic. Emetic in
large doses The herb is used
chiefly in the form of sulphate in
tachycardia and functional
palpitation
Black cohosh
Cimicifuga
racemosa
Renanculaceae
Root
Osteoporosis, gynacological
disorders,kidney problems and in
premenstrual tension.
Cat’s claw
Uncaria
tomantosa
Rubeacae
Leaves
Analgesic,Antibacterial,Anticancer
ous,Anticoagulant,Antidepressant,
Antidysenteric,,anti-
inflammatory,antileukemic,antimu
tagenic
Lotus
Nelumbo
nucifera
Nelumbo-
naceae
Arial
parts
Tranquilizer, cardiotonic and in
kidney and skin diseases.
Ginger
Gingiber
officinalis
Zingiberaceae
rhizome
s
Flavour, as a condiment, aromatic,
carminative
Ginkgo
Ginkgo
biloba
Ginkgoaceae
Seed,
leaf.
Asthma, sputum and cough,
leucorrhoea.
Golden seal
Hydrastis
canadensis
Ranuculaceae
Rhizome
s and
roots
As an astringent in inflammation
of mucous membranes
Hawthorn
Crataegus
laevigata/
Crataegus
oxycantha
Rosaceae
Dried
flowers,f
rFruits,
leaves
In angina pectoris , hypertension
International Journal of Pharmaceutical Sciences and Research ISSN: 0975-8232
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4
COMMON
NAME
BOTANICAL
NAME
FAMILY
PART
USED
OTHER USES
and
monogyna)
and
twigs
Mistletoe
Viscum
album
Loranthaceae
leaves
cardiotonic, vasodilatory,
antispasmodic, tumor-inhibiting,
and thymus stimulating
Stinging nettie
Urtica dioica
Urticaceae.
leaves,
rootlets,
rhizome
s and
cortex
Diuretic, astringent,
antihaemorrhagic; eliminates uric
acid from the body, detoxifies the
blood. Externally, astringent and
haemostatic. Used internally for
the treatment of nephritis,
haemoptysis and other
haemorrhages.
Jalbrahmi
Centella
ascitica
Apiaceae
Whole
plant
Used in
insomnia,anxity,scleroderma and
vericosa vein disease
Black Cumin
Seeds
Nigella
sativa
Ranunculaceae
seed
Hypotensive action - due to its
volatile oils Diuretic agent
Arjuna
Termenalia
arjuna
Combretaceae.
bark
Barkused as a cardioprotective
and cardiotonic in angina and poor
coronary circulation; as a diuretic
in cirrhosis of liver and externally
in skin diseases, herpes and
leukoderma.
Ashwagandha
Withania
somnifera
Solanaceae.
Whole
plant
Rootused as an anti-
inflammatory drug for swellings,
tumours, scrofula and
rheumatism; and as a sedative and
hypnotic in anxiety neurosis.
Leaf anti-inflammatory,
hepatoprotective, Antibacterial.
Fruits and seedsdiuretic
Bhingaraj
Eclipta
prostrata
/Eclipta alba
Asteraceae
leaves
Rheumatism,hair fall, fever,
hepatitis, edema possessing
potent antihepatotoxic properties
Punarnava
(Hogweed)
Boerhavia
diffusa,
Nyctaginaceae
Whole
plant
Diuretic, bitter, cooling, astringent
to bowels, useful in leucorrhoea,
inflammations, asthma etc.
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5
COMMON
NAME
BOTANICAL
NAME
FAMILY
PART
USED
OTHER USES
Satawari
Asperagus
recemosus
Asparagaceae.
tuberous
dried
root
Used as a galactagogue and for
disorders of female genitourinary
tract; as a styptic and ulcer-
healing agent; as an intestinal
disinfectant and astringent in
diarrhoea; as a nervine tonic, and
in sexual debility for
permatogenesis.
Alpinia
Alpinia
zerumbet
Zingibaraeceae
Whole
plant
diuretic and antiulcerogenic
Ma Huang
(Herba Ephedra)
Ephedra
sinica,
Ephedra
intermedia
or Ephedra
equisetina.
Ephedraceae
Stem
In bronchospasm, asthma, and
bronchitis and in allergic Rhinitis.
Chinese Angelica
Angelicae
Gigantis
Apiaceae
Dried
root
Gynaecological disorders and
infertility.In rheumatism, ulcers,
anemia, and constipation; and in
the prevention and treatment of
allergic attacks.
Forskolin
Coleus
forskohlii
Lamiaceae.
Root
Antispasmodic
Hibiscus
Hibiscus
sabdariffa
Malvaceae
calyxes
Aromatic and mild laxative action
Raisins
Vitis vinifera
vitaceae
Seed
extract
Antioxidant,hypolipidemic,uterine
relaxent
Olive leaf
Olea
africana and
Olea
europea
Oleacae
Leaf
Sore throat, kidney problems and
backache. Leaf infusions are lotion
to treat eye infections or a gargle
to relieve sore throat, internally as
a remedy for colic or urinary tract
infections; powdered leaf is used
as styptic.
Yarrow
Achillea
wilhelmsii
Asteraceae
Dried
arial
parts
with
flower.
Antihyperlipidemic diaphoretic
and antipyretic, intestinal colic ,
diuretic and urinary antiseptic for
urinary retention or cystitis,
vulnerary and topical anti-
inflammatory
Specific Botanicals for treatment of
Hypertension:
Arjuna bark (Terminalia arjuna):
Terminalia arjuna is a deciduous tree
found throughout India. Its bark has been
used in Ayurvedic medicine for over three
centuries. Terminalia's active constituents
include tannins, triterpenoid saponins,
flavonoids, gallic acid, ellagic acid, OPCs,
phytosterols, calcium, magnesium, zinc,
and copper
5
. Several studies have
elucidated Terminalia's effects on various
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6
cardiac disorders including congestive
heart failure, coronary artery disease, and
hypertension. A study on its effects on
stable and unstable angina patients found
it effective for those with stable angina,
with a 50-percent reduction in angina
episodes and significant decrease in
systolic blood pressure
6
.
In a double-blind crossover
study, 12 subjects with refractory chronic
congestive heart failure (idiopathic dilated
cardiomyopathy (n=10); previous
myocardial infarction (n=1), or peripartum
cardiomyopathy (n=1)), received
Terminalia arjuna, at a dose of 500 mg
every eight hours, or placebo for two
weeks, each treatment protocol
separated by a two-week washout period,
as an adjuvant to conventional therapy.
Clinical, laboratory, and
echocardiographic evaluations were
carried out at baseline and at the end of
therapy. Terminalia, compared to
placebo, was associated with
improvement in symptoms and signs of
heart failure, decrease in echo-left
ventricular end diastolic and end systolic
volume indices, increase in left ventricular
stroke volume index, and increase in left
ventricular ejection fractions
7
. A study
with similar dosing on primarily post-
myocardial infarction angina patients
found improvements in cardiac function.
Prolonged use resulted in no adverse side
effects or signs of renal, hepatic, or
hematological abnormalities
8
.
It has been widely used in
Ayurvedic system of medicine for cardiac
disorders since ancient times
9, 10
.
Extensive reviews on various aspects of T.
arjuna have been published
11, 12
. Both
experimental and clinical studies showed
the beneficial effects of the bark in
congestive heart failure and in ischemic
heart disease and other cardiovascular
complications
13
. The aqueous extract
of T. arjuna showed contraction followed
by relaxation on isolated rat thoracic
aorta
14
. Results from our laboratory
demonstrated that 70% alcoholic extract
of T. arjuna reduced the platelet count on
chronic treatment to dogs. Singh et al.
reported that aqueous solution of 70%
alcoholic bark extract of T. arjuna
produced dose-dependent decrease in
heart rate and blood pressure in dogs,
though the mechanism was not
determined
15
. In the present
investigation, a systematic study was
performed to find the probable
mechanism of hypotension produced by
70% alcoholic extract of T. arjuna in
thiopental anaesthetized dogs.
The hypotension produced by 6
mg/kg body weight dose of the extract
was not blocked by atropine which could
block the response of selected dose of
acetylcholine indicating that the
muscarinic mechanism was not involved.
Studies with mepyramine maleate
indicate that histaminergic mechanism
was also not involved in the hypotension
produced by the extract. Studies with
propranolol which blocked the
hypotensive response of the extract
indicated that it may contain compounds
having adrenergic ß-receptor agonist
action. Even though propranolol is a non-
specific ß-blocker, it is clear that the
compounds present in the extract might
be adrenergic ß
2
-agonists, since
adrenergic ß
2
-receptor stimulation
produces hypotension. Moreover, with
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7
the limitations of our study, one cannot
completely ruled out the possibility that
the observed hypotensive responsive
could also be due to the effect of T.
arjuna directly on the heart there by
reducing the cardiac load. Earlier, it was
reported that aqueous soluble fraction of
70% alcoholic extract (dried) of
T. arjuna produced dose-dependent
hypotension and decrease in heart rate
16
and were attributed to principles of the
extract acting centrally. Our studies with
70% alcoholic extract dissolved in
propylene glycol indicate the likely
presence of compounds acting
peripherally through adrenergic ß
2
-
receptor mechanism and/or by direct
action on the cardiac muscle. Mallikarjuna
and co-workers studied the influence of
aqueous extract of T. arjuna on isolated
rat thoracic aorta and found contraction
followed by relaxant effect. It was felt
that the vasorelaxant effect of T.
arjuna extract could contribute to the
reported decrease in blood pressure in
anaesthetized dogs as observed
17
. The
same experiment on isolated vascular
smooth muscle lends support for our
observation that the hypotension could
be of peripheral origin.
However, Mallikarjuna and co-
workers indicated that the vasorelaxant
effect of the extract was not blocked by
propranolol. The possible reason for this
variable effect could be due to the
difference in the active principles present
in different types of extracts used. This
indicates that the 70% alcoholic extract
might contain compounds to a higher
degree whose activity was blocked by
propranolol while the activity produced
by the constituents of aqueous extract
were not blocked by propranolol
[18]
.
Further investigations are needed on the
isolates of Terminalia arjuna to study
their cardiovascular effects in order to
explain more in detail of the observed
results
19
.
Hawthorne (Crataegus oxycantha and
Crataegus monogyna): Hawthorne has
been used traditionally for cardiovascular
disorders in many cultures. It contains a
number of active constituents including
flavonoids, catechins, triterpene saponins,
amines, and oligomeric proanthocyanidins
(OPCs). Hawthorne has been shown to
exert a mild blood pressure lowering
effect that can take up to four weeks for
maximal results
20
. It is believed that the
herb dilates coronary blood vessels
21
.One in vitro study on rat aorta found
proanthocyanidins extracted from
hawthorn relaxed vascular tone via
endothelium-dependent nitric oxide-
mediated relaxation
22
.
Olive Leaf (Olea africana and Olea
europea): Olive leaf extract is derived
from the leaves of the olive tree. The
entire leaf extract contains several
phytochemicals, including 20-percent
oleuropein, a complex structure of
flavonoids, esters, and multiple iridoid
glycosides, which acts as a vasodilator,
lowering blood pressure and preventing
angina attacks. Oleuropein is also being
recognized as a potent antioxidant
23, 24
.
The hypotensive action of olive leaf has
been studied for two decades. A clinical
study of Olea europaea aqueous extract
was conducted on two groups of
hypertensive patients, 12 patients
consulting for the first time, and 18
patients on conventional antihypertensive
International Journal of Pharmaceutical Sciences and Research ISSN: 0975-8232
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8
treatment. An aqueous extract was given
for three months, after 15 days of placebo
supplementation. Researchers noted a
statistically significant decrease of blood
pressure (p<0.001) for all patients,
without side effects
25
.
One of olive leaf's mechanisms of
action is vasodilation. In an in vitro study a
decoction of olive leaf caused relaxation
of isolated rat aorta endothelium. The
relaxant activity was independent of the
integrity of the vascular endothelium.
Oleuropeoside was found to be a
component responsible for vasodilator
activity; however, the researchers felt at
least one other principle was either a
vasodilator itself or potentiated the
relaxant effect of oleuropeoside
26
.
European Mistletoe (Viscum album): The
use of mistletoe in medicine has become
popular, not only because of its
hypotensive activity, but also because of
its anti-cancer properties. Mistletoe is
known to possess hypotensive,
cardiotonic, vasodilatory, antispasmodic,
tumor-inhibiting, and thymus stimulating
activity
27
. Its pharmacological effects,
including diuretic and hypotensive
activity, were studied using an alcohol
extract of Japanese and European
mistletoe. Both extracts showed blood
pressure lowering effects when
administered intravenously and orally to
cats
28
. Other researchers have reported
similar hypotensive effects of mistletoe in
experimental animal studies
29
.
Yarrow (Achillea wilhelmsii): Achillea
wilhelmsii (Asteraceae) has flavonoids and
sesquiterpene lactone constituents, which
have been found effective in lowering
blood pressure and lipids. A double-blind,
placebo-controlled trial examined the
antihyperlipidemic and antihypertensive
effects of Achillea. The researchers
randomly selected 120 men and women,
aged 40-60 years, and divided them into
two groups: (1) moderate hyperlipidemic
and (2) hypertensive subjects. Each study
group was treated either with an alcohol
extract of Achillea or placebo at a dose of
15-20 drops twice daily for six months
30
.
Blood pressure and serum lipids (total
cholesterol, triglycerides, LDL- cholesterol
and HDL- cholesterol) were measured at
the end of two, four, and six months. A
significant decrease was noted in
triglycerides after two months, and
significant decreases in triglycerides and
total- and LDL- cholesterol after four
months. Levels of HDL-cholesterol were
significantly increased after six months'
treatment. A significant decrease was
observed in diastolic and systolic blood
pressure after two and six months,
respectively (p<0.05).
Black Cumin Seeds (Nigella sativa):
Nigella sativa (Ranunculaceae) has a long
history of use in folk medicine as a
diuretic and hypotensive agent. In an
animal study, an oral dose of either
Nigella sativa extract (0.6 mL/kg/day) or
furosemide (5 mg/kg/day) significantly
increased diuresis by 16 and 30 percent,
respectively, after 15 days of treatment.
In the same rat study, a comparison
between Nigella sativa and nifedipine
found mean arterial pressure decreased
by 22 and 18 percent in the Nigella sativa
and nifedipine treated rats, respectively
31
.
The essential oil of Nigella sativa
seed has an antioxidant property that
International Journal of Pharmaceutical Sciences and Research ISSN: 0975-8232
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9
makes it useful in treating cardiovascular
disorders. Active constituents of Nigella
sativa are thymoquinone,
dithymoquinone, thymohydroquinone,
thymol
32
, carvacrol, t- anethole and 4-
terpineol. Hypotensive action of Nigella is
mainly due to its volatile oils. An animal
study found the volatile oil has the
potential of being a potent, centrally
acting antihypertensive agent. Thin-layer
chromatography (TLC) has confirmed
Nigella's antioxidant properties
33
.
Forskolin (Coleus forskohlii): Coleus
forskohlii has been used in Ayurvedic
medicine for many years. In 1974 the
Indian Central Drug Research Institute
discovered that forskolin, a component of
this plant, has hypotensive and
antispasmodic action. Forskolin's blood
pressure lowering effects appear to be
due to relaxation of arterial vascular
smooth muscle. In a study with isolated
heart tissue, forskolin activated
membrane-bound adenylatecyclase and
cytoplasmic cAMP-dependent protein
kinase. The researchers postulated the
positive inotropic effect was via an
enhanced calcium uptake by the heart
muscle cell. Another constituent from
Coleus, ditermene coleonol, has been
found to lower blood pressure in both rat
and cat models
34
.
Indian Snakeroot (Rauwolfia serpentina):
Rauwolfia is cultivated for the medicinal
use of its 30 alkaloids (particularly
reserpine found in the root), many used in
treating hypertension
35 .
Besides
reserpine, other alkaloids used in
hypertension and other cardiac disorders
are ajmaline, rescinnamine, serpentinine,
sarpagine, deserpidine, and chandrine.
Rauwolfia alkaloids work by controlling
nerve impulses along certain pathways
that affect heart and blood vessels,
lowering blood pressure. Rauwolfia
depletes catecholamines and serotonin
from nerves in the central nervous
system. In a controlled intervention trial,
389 subjects, ages 21-55 years, with
diastolic blood pressures 90-115 mm Hg
were examined for 7-10 years. Subjects
were randomly assigned to either a
combination of a diuretic and Rauwolfia
serpentina, or an identical placebo.
Diastolic blood pressure was reduced an
average of 10 mm Hg and systolic by 16
mm Hg in the active treatment group,
with no change in the placebo group
36
.
The Rauwolfia constituent
ajmaline not only lowers blood pressure,
but also has a potent antiarrhythmic
effect. Studies have shown that ajmaline
specifically depresses intraventricular
conduction, suggesting this would be
particularly effective in the treatment of
re-entrant ventricular arrhythmias
37
.
In one study of 100 patients with
essential hypertension, it was determined
that serum cadmium levels were 43-
percent higher and serum zinc levels 28-
percent lower in hypertensives when
compared with normotensive controls.
When the patients were put on ajmaloon,
a preparation from Rauwolfia serpentina,
blood pressure was lowered significantly.
It also appeared to decrease the elevated
serum cadmium levels in these individuals
38
.
Rauwolfia has been used for
anxiety and psychosis because at higher
doses it tends to calm a person and slow
them down. Several studies have shown
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10
reserpine to be effective in helping people
with Cushing’s disease. (Cushing’s disease
is a disorder in which the adrenal gland
makes too much cortisone). Tardive
dyskinesia, a side of certain antipsychotic
drugs, has been treated with reserpine.
Ginseng (Panax Ginseng): A very popular
plant root grown originally in China and
today also in Japan, Korea and North
America. Ginseng is commonly used as an
adaptogenic agent for fatigue, insomnia,
anxiety, depression and immune
enhancement. It is also used for
increasing resistance to environmental
stress and as a general enhancer of well-
being
39
.
This herb is also used for
improving physical and athletic
performance, improving cognitive
function, concentration and memory.
Ginseng has a variety of active
ingredients, consisting mainly of ginsenoid
saponins.
Ginseng is marketed either as a
single herb compound or in combination
with other herbs. The single herb
compound is available in tablet as well as
in alcoholic extracts (known as tinctures)
40
.Experiments in dogs showed that
intravenous administration of ginseng
extract caused an immediate drop in
blood pressure. The effect was long
lasting suggesting that it might be
facilitated by a Calcium channel blocking
like effect
41
and interference with
calcium mobilization into vascular smooth
muscle cells
42
. Rg1, one of the active
ingredients in Ginseng can stimulate the
production and release of nitric oxide
(NO) from endothelial cells. Another
ingredient, Ginsenoside Rb1 lowers blood
pressure and acts as a CNS depressant. It
also interferes with platelet aggregation
and coagulation. Interestingly, Ginseng
extracts exhibit a peripheral
vasoconstricting effect in low doses and
peripheral vasodilatation in high doses.
However, in cerebral and coronary vessels
it exhibits only a vasodilating effect
resulting in improvement in cerebral and
coronary blood flow
43
. These varying
effects can probably be attributed to the
many different saponins that present as
the active ingredients in this herb. The
potential of Ginseng to increase BP should
be emphasized as this herb is not suitable
for patients with hypertension and may
interfere with blood pressure lowering
medications. There is some evidence that
Panax ginseng can inhibit the cytochrome
P450 2D6 (CYP2D6) enzyme by
approximately 6%
44
. However,
contradictory research suggests that
Panax ginseng might not inhibit CYP2D6
(21). Until more is known, Panax ginseng
should be used cautiously in patients
taking drugs metabolized by these
enzymes
45
. Some of these drugs include
amitriptyline (Elavil), clozapine (Clozaril),
codeine, desipramine (Norpramin),
donepezil (Aricept), fentanyl (Duragesic),
flecainide(Tambocor), fluoxetine (Prozac),
meperidine (Demerol), methadone
(Dolophine), metoprolol (Lopressor,
Toprol XL).
Ginkgo (Ginkgo Biloba): The fruit and
leaves of the Ginkgo tree are commonly
used orally for dementia, including
Alzheimer's, vascular, and mixed
dementia. Ginkgo leaf is also used for
conditions associated with cerebral
vascular insufficiency, especially in the
elderly, including memory loss, headache,
tinnitus, vertigo, dizziness, concentrating
International Journal of Pharmaceutical Sciences and Research ISSN: 0975-8232
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11
difficulty
46
, mood disturbances and
hearing disorders. It is also used orally for
ischemic stroke. Ginkgo is also used for
cognitive disorders secondary to
depression and to improve cognitive
behavior and sleep patterns in patients
with depression and chronic fatigue
syndrome (CFS); eye problems, including
mascular degeneration and glaucoma;
attention deficit-hyperactivity disorder
(ADHD);
47
thrombosis; heart disease;
arteriosclerosis and angina pectoris. The
major active ingredients in the herb are
flavonoids and glycosides. Ginkgo is
marketed either as a single herb
compound or in combination with other
herbs
48
.
The single herb compound is
available in tablets. The vascular effect of
Ginkgo extract is very well established.
Considerable clinical as well as
experimental evidence suggest that
extracts from Ginkgo leaves induce
vasodilation and improve vascular blood
flow, particularly in the regions of the
deep seated medium and small arteries
[49]
. Overall, ginkgo leaf acts to increase
cerebral and peripheral blood flow
microcirculation, and reduce vascular
permeability
50, 51
. Ginkgo also has a
moderate blood pressure lowering effect.
Evidence suggests that ginkgo leaf extract
seems to increase pancreatic beta-cell
function in response to glucose loading
and modestly reduce blood pressure
[52]
.
There is conflicting evidence about
whether ginkgo induces or inhibits
CYP3A4
53
.Ginkgo does not appear to
affect hepatic CYP3A4
54
. However, it is
not known if ginkgo affects intestinal
CYP3A4. Preliminary clinical research
suggests that taking ginkgo does not
significantly affect levels of donepezil, a
CYP3A4 substrate. Although the evidence
regarding the effect of Ginkgo on
cytochrome P450 is not conclusive, it is
best that this herb be used cautiously in
patients taking drugs metabolized by
CYP3A4.
Garlic (Allium Sativum): The bulb of garlic
is commonly used for a variety of
ailments. Garlic is used for hypertension,
hyperlipidemia, coronary heart disease,
age-related vascular changes and
atherosclerosis, earaches, chronic fatigue
syndrome (CFS), and menstrual disorders.
Garlic is regarded as a potent platelet
aggregation inhibitor. Many of the
pharmacological effects of garlic are
attributed to the allicin, ajoene, and other
organosulfur constituents such as S- allyl-
L-cysteine. Fresh garlic contains
approximately 1% alliin
55
.One milligram
of alliin is converted to 0.458 mg allicin
which is regarded as the major active
compound in garlic. Further conversion
yields ajoene. The amount of allicin in
garlic preparations is dependent upon the
method of preparation. Taking low doses
of garlic powder orally, 300 mg per day
seems to slow the age-related aortic
elasticity decrease. Higher doses of 900
mg per day seem to slow development of
atherosclerosis in both aortic and femoral
arteries when used over a four-year
period
56
. Evidence suggests that taking
garlic orally can modestly reduce blood
pressure by 2% to 7% after 4 weeks of
treatment
57
.Garlic is thought to reduce
blood pressure by causing smooth muscle
relaxation and vasodilation by activating
production of endothelium-derived
relaxation factor [EDRF, nitric oxide.
Clinical research suggests garlic oil can
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12
inhibit the activity of CYP2E1 by 39%
58
.Garlic oil should be used cautiously in
patients taking drugs metabolized by
these enzymes. There is inconsistent
information about the effects of garlic on
cytochrome P450 3A4 (CYP3A4)
isoenzymes
59
.Garlic is eaten in Asia, the
Middle East, and in many other cultures
on a daily basis. It is an ancient home
remedy that has been used for many
different purposes, including
hypertension, and reduces a number of
risk factors associated with cardiovascular
disease including
60
: (1) reducing total and
LDL-cholesterol, (2) increasing HDL-
cholesterol, (3) lowering triglycerides and
fibrinogen, (4) lowering blood pressure,
(5) improved circulation, (6) enhancing
fibrinolysis, (7) inhibition of platelet
aggregation, and (8) reducing plasma
viscosity. The blood pressure effect is
thought to be due to an opening of (Ca)
ion channels in the membrane of vascular
smooth muscle, affecting
hyperpolarization, resulting in
vasodilation
61
.
A garlic preparation containing
1.3-percent allicin at a large dose (2400
mg) was evaluated in an open-label study
in nine severely hypertensive patients
(diastolic blood pressure 115 mm Hg or
greater). Approximately five hours after
taking the garlic, the systolic blood
pressure fell an average of 7 mm Hg while
diastolic BP dropped an average of 16 mm
Hg. A significant decrease in diastolic
blood pressure lasted from 5-14 hours
after the dose and no significant side
effects were reported
62
.
Ma Huang (Ephedra sinica/Ephedra
intermedia): The dried herbaceous stem
of Ephedra sinica, Ephedra intermedia or
Ephedra equisetina
63
. Small doses of this
herb are commonly used In Traditional
Chinese medicine for the treatment of
asthma. All three Ephedra herbs contain
the phenylproamine alkaloids
64
l-
ephedrine, d-pseudoephdrine. E. sinica
contains 55-78% ephedrine and 12-23%
pseudoephedrine.However, this herb is
available for purchase in a variety of
exercise performance enhancing formulas
as well as weight loss formulas imported
for private non commercial use
65,
66
.Ephedrine, having a similar structure to
epinephrine, is a well known
sympathomimetic agent, acting on both α
and β -adrenergic receptors. By its β-
adrenergic action, it relaxes bronchial
muscles and produces the antiasthmatic
action. It produces myocardial stimulation
by its α- 1agonist effect
67
.Ephedrine also
constricts blood vessels by its α-agonistic
effect, causing an increase in blood
pressure and heart rate and increasing
myocardial contractility and cardiac
output
68
.Use of this herb has been
associated with severe adverse reactions
such as myocardial infarcts and cerebral
accidents. The ability of Ma Hunag to
increase BP should be emphasized as this
herb may possibly interfere with blood
pressure lowering medications
69
.
Dang Gui / Dong Quai/ Chinese Angelica
(Angelica sinesis): Dang Gui is the dried
root of Angelica sinesis.
70
.Dang Gui is also
used to manage hypertension,
rheumatism, ulcers, anemia, and
constipation; and in the prevention and
treatment of allergic attacks. The root of
Dang Gui contains about 0.2- 0.4% of
essential oil. The major active ingredients
include ferulic acid, ligusticide, angelicide,
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13
brefeldin A, butylphthalide, nicotinic acid,
and succinic acid. The herb also contains
several coumarin constituents
71
.Dang Gui
is usually marketed as a single herb
compound administered as powder
extract in capsules. This herb is used
extensively by the general population due
to its potent effects on gynecological
related disorders
72
.Dang Gui has a
number of known cardiovascular and
hematological effects: the essential oil
caused an increase in coronary blood flow
and decreased myocardial oxygen
consumption; it also has mild
antiarrhythmic effect
73
.
Some of the coumarin
constituents of this herb can act as
vasodilators and antispasmodics. Osthol
appears to inhibit platelet aggregation
and smooth muscle contraction and cause
hypotension. An Intravenous
administration of 1-4 gr/kg of the
aqueous extract of the root significantly
decreased arterial pressure and reduced
the resistance of coronary, cerebral and
femoral arteries in dogs thus significantly
increasing blood flow
74
.Preliminary
research suggests Dang Gui might protect
against ischemia-reperfusion injury . Dang
Gui has been reported to inhibit platelet
aggregation and its concomitant use with
coumadin increases the drug's
anticoagulant effects, increases INR and
may increase the risk of bleeding.
Grapes (Vitis vinifera): Reports have
shown the antioxidant, hypotensive,
hypolipidemic and vasodilatory effects of
grape (Vitis vinifera) seed extract. We
have recently shown the relaxatory effect
of grape leaf extract on rat uterus and
reduction of frog heart rate and
contractility
. 75
.The aim of the present
study was to investigate the relaxant
effect of Vitis vinifera leaf hydroalcoholic
extract (VLHE) on rat thoracic aorta
contractions induced by phenylephrine
and KCl and the role of aorta endothelium
on this action. Rat aorta was removed and
placed in an organ bath containing Krebs-
Henseleit solution and aorta contractions
were recorded isometrically.
The results demonstrate that VLHE
(0.125-2 mg/ml) reduces the endothelial
intact aorta reconstructed by
phenylephrine (1 μM) dose-dependently
(P<0.0001). Extract induced the same
response in endothelial denuded aorta,
but in a much lesser extent. The IC50 for
both groups were 0.45±0.08 and
1.73±0.23 mg/ml, respectively. However,
the contractile responses of these groups
were similar. VLHE (0.125-2 mg/ml)
reduced the contractions induced by KCl
(80 mM) dose-dependently (P<0.0001).
The relaxatory effect of VHLE on KCl
induced contractions was less than those
evoked by Phenylephrine. Vasorelaxatory
effect of VHLE on intact aorta was
attenuated by nitric oxide synthase
inhibitor (L-NAME, 100 μM) and gaunyl
cyclase inhibitor (methylene blue, 10 μM)
significantly, but was unaffected by
atropine (1 μM). The results suggest that
the greatest vasorelaxant effect of VHLE
on rat aorta is endothelium dependent
76
.
Punarnava (Boerhavia diffusa): Boerhavia
diffusa, commonly called hog weed, is
known as 'erimmirii' (which literally
means water-food). Punarnava is found
throughout India and Brazil. It is a very
important plant for urinary system.
Throughout the tropics, it is used as a
International Journal of Pharmaceutical Sciences and Research ISSN: 0975-8232
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14
natural remedy for Guinea worms.The
roots and leaves are considered to have
an expectorant action, to be emetic and
diuretic in large doses and are used in the
treatment of asthma
77
. The thick roots,
softened by boiling are applied as a
poultice to draw abscesses and to
encourage the extraction of guinea worm.
Punarnava contains b-Sitosterol, a-
2-sitosterol, palmitic acid, ester of b-
sitosterol, tetracosanoic, hexacosonoic,
stearic, arachidic acid, urosilic acid,
Hentriacontane, b- Ecdysone, triacontanol
78
. Punarnavoside (antifibrinolytic
glycoside, 0.03-0.05%); Boeravinones,
Lignans (liridodendrin, boeravine &
hypoxanthine deriv .); Flavones, Sterols;
Root contains Alanine, Arachidic acid,
Aspartic acid, Behenic acid, Boerhavic
acid, Boerhavone, Pot. nitrate (6.5%),
Oxalic acid, Punarnavine 1 and 2 etc.
Anti-hypertensive Liridodendrin &
Hypoxanthine are active antihypertensive
agents and the former is Ca channel
antagonist. This plant is a powerful
Rasayana dravya (longevity enhancer.
Punarnava enhances the quality of bodily
tissues, including nutrient plasma (Rasa
Dhatu), blood (Rakta Dhatu), muscle
(Mamsa Dhatu), fat (Meda Dhatu), bone
marrow and nerves (Majja Dhatu), and
reproductive fluids (Shukra Dhatu).
According to Ayurveda, Punarnava is
diuretic by increasing renal blood flow
79
.
It is bitter, cooling, astringent to bowels,
useful in leucorrhoea, inflammations,
asthma etc. Each part has a different
therapeutic value and must be prepared
in its own way for maximum benefits.
Cat´s Claw (Uncaria tomentosa): Uncaria
tomentosa proliferates spontaneously all
over the Amazon rainforest, especially in
the upper Amazon region of Peru and
neighboring countries, and other tropical
areas of South and Central America,
including Peru, Colombia, Ecuador,
Guyana, Trinidad, Venezuela, Suriname,
Costa Rica, Guatemala, and Panama. It
has also been reported as far North as
Belize, and South into Paraguay. There are
as many as 60 species related to this plant
80
. Several different phytochemicals found
in the water extract of Uncaria tomentosa
have demonstrated different actions in
the blood and heart.Some alkaloids
contained in the extract have
demonstrated hypotensive and
vasodilating properties. These alkaloids
are rhynchophylline, hirsutine, and
mitraphylline
81
.
Rhynchophylline also has shown to
inhibit platelet aggregation and
thrombosis. The analyses conducted
there show that rhynchophylline has the
ability to inhibit the accumulation of
platelets and may also prevent and
reduce blood clots in blood vessels and
relax the blood vessels of endothelial
cells, dilate peripheral blood vessels,
lower the heart rate, and lower blood
cholesterol. Three sterols beta
sitosterol (80%), stigmasterol, and
campesterolhave been identified and
proven to be mild inhibitors of cholesterol
synthesis in vitro
[80]
This also means that
could help to prevent atherosclerosis,
inhibiting the formation of the
atherosclerotic plaque that occurs during
the progression of atherosclerosis.
Various chemicals in it are known to
promote the loss of water from the body,
International Journal of Pharmaceutical Sciences and Research ISSN: 0975-8232
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15
relax smooth muscles, and widen small
blood vessels in the hands and feet. All
these effects may help to lower blood
pressure. It has also been proposed that
the water extract of Uncaria tomentosa
could help prevent strokes, diseases of
the circulatory system, and heart attacks
(due to its lowering C-reactive protein
level activity).
Bhringraj (Eclipta Alba/Eclipta prostrate):
The herb contains wedelolactone and
dimethyl wedelolactone possessing
potent antihepatotoxic properties
.The
herb is a rich source of ascorbic acid. It
also contains an alkaloid, ecliptine. The
occurrence of mono-, di- and trithiophene
acetylenes together with a-terthenyl in
this species is noteworthy. The petroleum
ether extract of aerial parts contains a
trithienyl aldehyde, ecliptal, besides
stigmasterol and ß- sitosterol. The roots
are very rich in thiophene acetylenes
82
.
Eclipta is an effective anti-inflammatory
agent. It inhibited the higher levels of
histamine due to chronic inflammation
upto 58.67 percent. The ethanolic extract
of the dried whole plant E.prostrata and
its active constituent, culumbin, exhibited
remarkable antihypertensive activity on
anesthetized rats. No significant side
effects or toxicities have been found
either on histopathology of liver, kidney,
spleen, heart or on biochemical
parameters like SGOT, SGPT, BUN, etc.
Moreover, no appreciable changes have
been found in body weight and in specific
organ weight during the course of
investigation on Long Evans rats
83
.
Alpinia (Alpinia zerumbet): Alpinia
zerumbet is a medicinal plant originated
from West Asia, is used in the northeast
and southeast of Brazil as infusions or
decoctions as a diuretic, antihypertensive,
and antiulcerogenic. Experiments were
undertaken to determine whether a
hydroalcoholic extract obtained from
leaves of Alpinia zerumbet (AZE) induces
vasodilation in the mesenteric vascular
bed (MVB), and an antihypertensive effect
was also assessed in rats with DOCA-salt
hypertension. In MVB precontracted with
norepinephrine, AZE induces a long-
lasting endothelium-dependent
vasodilation that is not reduced by
indomethacin.
84, 85
Inhibition of NO
synthase by N-nitro-L-arginine methyl
ester (L-NAME) and guanylyl cyclase by
1H- [1, 2, 3] oxadiazolo [4, 4- a]
quinoxalin-1-one (ODQ) reduces the
vasodilator effect of AZE.
In vessels precontracted with
norepinephrine, the vasodilator effect of
AZE was not changed by 4-aminopyridine,
glibenclamide or by charybdotoxin plus
apamin. Concentrations of atropine,
pyrilamine, and yohimbine that
significantly reduced the vasodilator
effect of acetylcholine, histamine, and
clonidine, respectively, did not change the
vasodilator effect of AZE. HOE 140, which
significantly reduced the vasodilator
effect of bradykinin, induced a slight but
significant reduction on the vasodilator
effect of AZE
86.
Chronic oral
administration of AZE induced a
significant reduction in systolic, mean,
and diastolic arterial pressure in rats with
DOCA-salt hypertension. Probably the
vasodilator effect of AZE is dependent on
the activation of the NO- cGMP pathway
and independent of activation of ATP-
dependent, voltage-dependent, and
calcium-dependent K
+
channel.
International Journal of Pharmaceutical Sciences and Research ISSN: 0975-8232
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16
Bradykinin receptors may also
participate in the vasodilator effect of
AZE. Finally, the vasodilator and
antihypertensive effects of AZE
demonstrated in the present study
provide experimental support for the
indication of Alpinia zerumbet as an
antihypertensive medicinal
plant.Biochemical analysis performed
has shown that leaves of Alpinia
zerumbet are rich in flavonoids [(+) -
catechin; (-) - epicatechin; rutin;
quercetin; kaempferol 3- O- rutinosideo;
kaempferol 3-O-glucoronide;
kaempferol] and kava pyrones (dihydro-
5, 6-dehydrokawain and 5, 6-
dehydrokawain). Recently, many
experimental data have suggested that
polyphenols that occur in many
vegetables may participate in the
mechanism of beneficial effect of some
medicinal plants. It is also demonstrated
that in alcohol-free red wine and
products obtained from the skin of
vinifera grapes, both rich in
polyphenols, have vasodilator and
antihypertensive effects in experimental
animals
87
.
CONCLUSION: Lifestyle changes,
including diet, exercise, and stress
management, may contribute
significantly to lowering of blood
pressure. Supplements such as
potassium, magnesium, CoQ10, omega-
3 fatty acids, amino acids Aarginine and
taurine, and vitamins C and E have been
effectively used in the treatment of
cardiovascular disease, including
hypertension. They have proven
effective in lowering blood pressure and
improving heart functions. Among the
most researched and frequently utilized
for hypertension are Hawthorne,
Arjuna, Olive leaf, European mistletoe,
Yarrow, Black cumin seeds, Forskolin,
Indian snakeroot, and Garlic.
More research is indicated to
determine the full potential that
alternative medicine has to offer in the
management of hypertension. With the
increasing numbers of patients suffering
from hypertension and conventional
medicine failing to effectively control
the problem, alternative therapies offer
hope.
CHEMICAL CONSTITUENTS AND THEIR STRUCTURE:
Plant
Chemical
constituents
structure
Ephedra
sinica/Ephedra
intermedia
Ephedrine
Hawthorn
ProcynadinB-3 R=H
prodelfinidinB-3
R=OH
International Journal of Pharmaceutical Sciences and Research ISSN: 0975-8232
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17
Terminalia
arjuna
Ellagic acid
Rouwolfia
serpentine
Reserpine
Panax Ginseng
Amitryptylin
Uncaria
tomentosa bark
Mitraphylline
Alium sativum
Alliin
Rouwolfia
serpentine
Ajmaline
Coleus
forskohlii
Forskolin
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... 8 Approximately 75% to 80% of the world's population, predominantly in developing countries, uses herbal medicines for primary healthcare because of their better compatibility with the human body, lower costs than novel pharmaceuticals, and fewer side effects. 9 Persian medicine, an ancient and well-known traditional system of medicine, is based on the theory of humors for the prevention and treatment of diseases. 10 Persian medical scholars like Avicenna and Rhazes have described various types of diseases and recommended lifestyle modifications and herbal treatments for the alleviation of problems. ...
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Traditional medicine is a comprehensive term for ancient, culture-bound health care practices that existed before the use of science in health matters and has been used for centuries. Medicinal plants are used to treat patients with cardiovascular diseases, which may occur due to ailments of the heart and blood vessels and comprise heart attacks, cerebrovascular diseases, hypertension, and heart failure. Hypertension causes difficulty in the functioning of the heart and is involved in atherosclerosis, raising the risk of heart attack and stroke. Many drugs are available for managing these diseases, though common antihypertensive drugs are generally accompanied by many side effects. Medicinal herbs have several active substances with pharmacological and prophylactic properties that can be used in the treatment of hypertension. This review presents an overview of some medicinal plants that have been shown to have hypotensive or antihypertensive properties.
... Terpenoids (e.g. triterpenes, oleanolic), alkaloid, and some other classes of phytochemicals found in this plant extract have been reported to possess an antihypertensive effect [26][27][28]. The financial burden and high incidence of adverse effects associated with formulated antihypertensive drugs have intensified the need for researchers to search for medicinal plants that will possess an antihypertensive effect as they are cheaper and may possess a multifaceted mechanism of action that makes them more efficient. ...
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The use of glucocorticoids causes elevation of blood pressure (BP) in man and experimental rats. We evaluated the antihypertensive potential of methanol leaf extract ofStruchium sparganophora (SPA) on dexamethasone-salt-induced hypertension in rats. Rats were assigned randomly to six groups (n=4/group). Group A represented control, while BP elevation (BP≥140/90) was induced in groups B-F via single subcutaneous administration of dexamethasone at a dose of 2 mg/kg with 4% NaCl substituted as drinking water for 5 days. Groups B was left untreated and treatments of other groups twice daily (C-F) for 10 days were as follows: C: nifedipine 3 mg/kg D: nifedipine 3 mg/kg + SPA l300 mg/kg, E: SPA 300 mg/kg and F: SPA 600 mg/kg. BP was read using a noninvasive method, lipid profile and nitric oxide (NO) concentration were determined with appropriate procedures. SPA at 300 and 600 mg/kg markedly decreased the systolic and diastolic BP below suboptimal value of 140/90. Treatment with SPA caused increase (P<0.05) in the levels of HDL-cholesterol and NO as well as concomitant decrease in triglyceride concentration. This study revealed that SPA might lower blood pressure by increasing NO concentration and maintaining lipid homeostasis in hypertensive rats.
... Hypertension is an unceasing global health burden (Mills et al., 2020). Traditionally, several plant-derived drugs are in practice to treat hypertension in India and other countries (Agrawal et al., 2010;Neamsuvan et al., 2018;Pourjabali et al., 2017). Among plant-derived antihypertensive drugs, reserpine, an alkaloid from roots of Rauwolfia et al., 1996). ...
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Background : Oxidative stress has been associated in various pathophysiology of heart including hypertension, a global concern. The present work reports the effect of oral administration of different potencies of homeopathic preparations of R. erpentine (Q, 30c and 6c) on oxidative stress parameters of the ventricular cardiac tissue of hypertensive male rats. Method : Hypertension was induced in unilaterally erpentinesed male rats by injecting DOCA (25 mg/kg BW) twice in a week and 1% NaCl in drinking water. Hypertensive rats were treated with different potencies of R. erpentine(Q, 30c and 6c) orally twice a day for 30 days. Oxidative stress parameters (lipid peroxidation and protein carbonyl content) and activities of enzymatic antioxidants, superoxide dismutase, catalase, glutathione erpentine, glutathione reductase and glutathione S-transferase were measured in cardiac tissue. Transcript and translate level of SOD1, SOD2, CAT and transcript level of GPx and GR were analysed in cardiac tissue. Results : The enhanced oxidative stress parameters in post mitochondrial (PMF) and mitochondrial fractions (MF) of ventricular tissue were reduced in response to Q, 30c and 6c of R. erpentine. Superoxide dismutase activity in PMF of ventricular tissue was elevated in response to Q of R. erpentine. The mRNA and translated products of SOD1 were elevated in response to Q and 30c of R. erpentine. Translated products of SOD2 were increased in PMF in response to Q and 30c treatment. A reduction in its level in MF was recorded in response to 30c. Catalase exhibits a dual response i.e. its activity was upregulated and downregulated, respectively, in the PMF and MF in response to drug treatment. Although glutathione erpentine activity in the PMF of the ventricular tissue was decreased in response to 30c and 6c potencies, its activity in MF was elevated in response to 6c. Conclusions : Results suggest that homeopathic medicine R. erpentine reduces hypertension and associated oxidative stress in the cardiac tissue by modulating the antioxidant defence system.
... Approximately 75%-80% of the world population consume herbal medicines, mostly in developing countries, to treat diseases, including hypertension (Tabassum and Ahmad 2011). Several herbs are commonly taken by patients, especially for hypertension (Mansoor 2001;Agrawal et al. 2010;Tabassum and Ahmad 2011). These herbs might stimulate substantial herbalmedication interactions and could alter the pharmacodynamics of certain drugs and induce toxicities, especially for drugs with narrow therapeutic indices; thus, this concern should be studied more (Bushra et al. 2011;Fasinu et al. 2012;Palleria et al. 2013). ...
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Context Garden cress (GC), fenugreek (FG), and black seed (BS) are traditional herbal medicine for managing hypertension. Objective The effects of the three herbs on the pharmacodynamics of metoprolol tartrate (MT) in hypertensive rats were investigated. Materials and methods Wistar rats were divided in five groups (n = 6). Group I served as normal control group and Group II (hypertensive control group) had rats treated orally with N-nitro L-arginine methyl ester (L-NAME, 40 mg/kg/day) only. Groups III, IV, and V rats were orally treated with L-NAME (40 mg/kg/day) + GC (300 mg/kg, once daily), L-NAME (40 mg/kg/day) + FG (300 mg/kg, once daily) and L-NAME (40 mg/kg/day) + BS (300 mg/kg, once daily), respectively, for 2 weeks, and on the 14th day, blood pressure and heart rate were recorded using a tail-cuff blood pressure-measuring system. On the 16th day, a single dose of MT (10 mg/kg) was orally administered, and the rats’ blood pressure and heart rate were recorded. Results GC, FG, and BS decreased systolic blood pressure (SBP) by 8.7%, 8.5%, and 8.7%, respectively, in hypertensive rats. A greater decrease in SBP by 14.5%, 14.8%, and 16.1% was observed when hypertensive rats were treated with L-NAME + GC + MT, L-NAME + FG + MT, and L-NAME + BS + MT, respectively. Similarly, hypertensive rats treated with the combination of herbs and MT had significantly lower diastolic blood pressure (DBP) than those treated with herbs alone and those treated with L-NAME alone. Conclusions The combination of investigated herbs and MT had a beneficial effect on hypertension. However, the concurrent administration of drugs, particularly those predominantly cleared through CYP450 2D6-catalyzed metabolism, with the three investigated herbs should be considered with caution.
... Manish et al. [48] and Thomas et al. [49] stated that many individuals today suffer from pulmonary hypertension with huge amount of money going into the treatment with little effectiveness. They showed that pulmonary hypertension is characterized mainly by enhancing the pulmonary vascular resistance. ...
Chapter
Pulmonary hypertension is caused by a rise in the vascular tone thus affecting the structural composition of the pulmonary arteries. There are various symptoms that are associated with pulmonary hypertension, which includes among others, lungs inflammation, apoptosis inhibition, remodeling of pulmonary vascular and hypoxia. It has been established that the application of medicinal plant could be applied for effective management of pulmonary hypertension. Therefore, this chapter intends to provide a detailed information on some medicinal plant that could be applied for effective management of pulmonary hypertension. Detailed information on isolation, purification, and extraction of the active constituents present in plants that are utilized for the treatment of pulmonary hypertension were also highlighted. Specific techniques for structural elucidation of the active compound were also highlighted. Detailed information on the biochemical pathway involved in the activities of phytochemical in medical plant in the treatment of pulmonary hypertension as well as detailed facts on the modes of action involved in the application of medicinal treatment of pulmonary hypertension were also highlighted.
... Leaf was applied on fresh wounds as a styptic, and used in the treatment of malaria, diabetes, coughs, urinary tract infections, backaches, kidney problems and to stop nose bleeds as a snuff. Leaf infusion was used as lotion for the treatment of eye infections and relieve sore throats and diphtheria [205][206][207][208]. ...
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As a result of accumulated experience from the past generations, today, all the world's cultures have an extensive knowledge of herbal medicine. In recent years, ethno medicinal studies has received much attention as this brings to light the numerous little known and unknown medicinal virtues especially of plant origin which needs evaluation on modern scientific lines such as phytochemical analysis, pharmacological screening and clinical trials. This review was designed to highlight the traditional uses of medicinal plants.
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Essential oils that derive from aromatic plants are typically obtained by steam distillation known as important sources of novel therapeutic molecules. Also, during distillation, part of these essential oil components become dissolved in and remain in the distillation water . and giving a ‘product’ called as hydrosol, which is also known as the distillate water. Hydrosol possess various applications in health, cosmetic and food industries selectively contains polar volatile components. Also, it finds application in aromatherapy that has been steadily gaining popularity in today’s society as a form of complementary and alternative medicine. This review discusses bio-active properties of some important hydrosol and their medicinal potential.
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A Practical, Authoritative CompendiumThis handbook catalogs 365 species of herbs having medicinal or folk medicinal uses, presenting whatever useful information has been documented on their toxicity and utility in humans and ani-mals. Plants from all over the world - from common cultivars to rare species - are included in these 700 pages. The toxicity of these species varies, but the safety of each has been formally or informally questioned by the Food and Drug Administration, National Cancer Institute, Department of Agriculture, Drug Enforcement Administra-tion, or Herb Trade Association. Easy-to-Locate Facts and FiguresDesigned to enable fast access to important information, this hand-book presents information in both catalog and tabular forms. In the catalog section, plants are presented alphabetically by scientific name. (The index permits you to locate an herb by its common name.) A detailed sketch of the chief identifying features accompa-nies most catalog entries. For each species the following information, as available, is presented and referenced: Family and colloquial namesChemical contentUses and applications - present and historicalProcessing, distribution, and economic potentialToxicological agents and degree of toxicityPoison symptoms in humans and animalsTreatment and antidotes References to original literature Five Tables of Accessible DataGiven a plant species, you can easily determine its toxins; or, given a toxin, you can discover which plants contain it. These and other data are presented in convenient tabular formats as appendixes to the handbook. Other information contained in these tables include toxicity ranking and other toxicity data (as applicable), such as mode of contact, organs affected, and lethal dose; and proximate analyses of selected foods. These tables are titled: Medicinal Herbs: Toxicity Ranking and PricelistToxins: Their Toxicity and Distribution in Plant GeneraHigh Plant Genera and Their ToxinsPharmacologically Active PhytochemicalsProximate Analyses of Conventional Plant Foods
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From the aqueous extract of Alpinia zerumbet (Pers) B. L. Burttet Smith. (= Alpinia speciosa K. Schum.) flavonoids and kava pyrones were obtained. The flavonoids identified as rutin (1), kaempferol-3-O-rutinoside (2), kaempferol-3-O-glucuronide (3), (+)-catechin (4) and (−)-epicatechin (5) are well known substances that can contribute to the hypotensive, diuretic and antiulcerogenic activity of the aqueous extract of the plant, while the kava pyrones dihydro-5,6-dehydrokawain (6) and 5,6-dehydrokawain (7) have been described as antiulcerogenic and antithrombotic. The compounds were identified from their UV, 1H- and/or 13C-NMR, hydrolytic and co-TLC data. The well known activity of these compounds, which have not been previously isolated from the leaves of Alpinia zerumbet, may explain the use of the plant in the treatment of hypertension. © 1998 John Wiley & Sons, Ltd.
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The Mediterranean diet, rich in fresh fruits and vegetables, has been associated with a lower incidence of cardiovascular disease and cancer, partly because of its high proportion of bioactive compounds such as vitamins, flavonoids and polyphenols. The major lipid component of such diet is the drupe-derived olive oil, that can be distinguished from other seed oils for the peculiar composition of its non-triglyceride fraction. In fact, several minor components, including polyphenols, grant the oil its particular taste and aroma. Oleuropein, the most abundant among these components, has been shown to be a potent antioxidant endowed with antiinflammatory properties. We investigated the effects of oleuropein on NO release in cell culture and its activity toward nitric oxide synthase (iNOS) expression. The results show that oleuropein dose-dependently enhance nitrite production in LPS-challenged mouse macrophages. This effect was blocked by the iNOS inhibitor L-NAME, indicating increased iNOS activity. Also, Western blot analysis of cell homogenates show that oleuropein increases iNOS expression in such cells. Taken together, our data suggest that, during endotoxin challenge, oleuropein potentiates the macrophage-mediated response, resulting in higher NO production, currently believed to be beneficial for cellular and organismal protection.
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Antioxidant mechanisms have been proposed to underlie the beneficial pharmacological effects of EGb 761, an extract from Ginkgo biloba leaves used for treating peripheral vascular diseases and cerebrovascular insufficiency in the elderly. In vitro evidence has been reported that EGb 761 scavenges various reactive oxygen species, i.e. nitric oxide, and the Superoxide, hydroxyl, and oxoferryl radicals. However, the ability of EGb 761 to scavenge peroxyl radicals (reactive species mainly involved in the propagation step of lipid peroxidation) has not been investigated. To characterize further the antioxidant action of EGb 761, we measured the protective effects of EGb 761 during: (1) the oxidation of B-phycoerythrin by peroxyl radicals generated in aqueous solution by 2,2′-azobis (2-amidinopropane) hydrochloride (AAPH); and (2) the reaction of luminol or cis-parinaric acid with peroxyl radicals generated from 2,2′-azobis (2,4-dimethylvaleronitrile) (AMVN) in liposomes or in human low density lipoprotein (LDL), respectively. To evaluate the peroxyl radical scavenging activity of EGb 761 in a more physiologically relevant model of damage to lipid-containing systems, we also analyzed the effect of the extract on the oxidation of human LDL exposed to the azo-initiators in terms of: (1) accumulation of cholesterol linoleate ester hydroperoxides, (2) depletion of α-tocopherol and β-carotene, and (3) changes in intrinsic tryptophan fluorescence. EGb 761 afforded protection against oxidative damage in all the systems we analyzed; thus, it is an efficient scavenger of peroxyl radicals. This result extends the oxygen radical scavenging properties of the extract and supports the hypothesis of an antioxidant therapeutic action of EGb 761.