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Lemongrass and its applications for the treatment of hypertension

December 2021
Infectious Diseases and Herbal Medicine 2(1)

DOI:10.4081/idhm.2021.172

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CC BY-NC 4.0

Authors:

Chinese University of Hong Kong

Hypertension (high blood pressure) is the pre-symptom of car-diovascular disease. The number of people living with hyperten-sion has doubled to 1.28 billion and proportionally increased until today. This is a long-term disease and requires continuous monitoring. A traditional Chinese herbal, "Lemongrass", might be a good choice for the mainstay of hypertension. Some library search engines are used, such as SCI/SCIE, PubMed, and Scopus, within ten to twenty years, from 1999-2020. The searched keywords and phrases are "lemongrass", "formulation", "traditional Chinese medicine", "hydrogel", "hypertension", "lemongrass + tea formu-lation", "lemongrass + hydrogel", "Lemongrass + Hypertension", "Lemongrass + traditional Chinese medicine" etc. This mini-review discusses the background of hypertension, lemongrass, research progress, mechanism, lemongrass tea formulations, lemongrass with Traditional Chinese Medicine (TCM) formulations , and the lemongrass hydrogel application in the treatment of hypertension.

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Abstract

Hypertension (high blood pressure) is the pre-symptom of car-

diovascular disease. The number of people living with hyperten-

sion has doubled to 1.28 billion and proportionally increased until

today. This is a long-term disease and requires continuous monitor-

ing. A traditional Chinese herbal, “Lemongrass”, might be a good

choice for the mainstay of hypertension. Some library search

engines are used, such as SCI/SCIE, PubMed, and Scopus, within

ten to twenty years, from 1999-2020. The searched keywords and

phrases are “lemongrass”, “formulation”, “traditional Chinese

medicine”, “hydrogel”, “hypertension”, “lemongrass + tea formu-

lation”, “lemongrass + hydrogel”, “Lemongrass + Hypertension”,

“Lemongrass + traditional Chinese medicine” etc. This mini-

review discusses the background of hypertension, lemongrass,

research progress, mechanism, lemongrass tea formulations,

lemongrass with Traditional Chinese Medicine (TCM) formula-

tions, and the lemongrass hydrogel application in the treatment of

hypertension.

Introduction

Hypertension is a global problem with an estimated 26% of the

world’s population which has 972 million people, and will be

increased to 29% in 2025.1Some diseases, include stroke, chronic

heart and coronary heart diseases silent killers. It must take effec-

tive prevention or treatment measures for hypertension.2In west-

ern countries, several antihypertensive drugs such as diuretics, β-

blockers, calcium channel blockers, angiotensin-converting

enzyme inhibitors are common to lower blood pressure. However,

this is not a long-term treatment as it has adverse reactions, such as

dizziness, headaches, and body weakness.3Lemongrass is a natu-

ral herbal and doesn’t have any side effects, except for people

prone to skin and respiratory tract allergic reactions, it may be a

more suitable candidate for the treatment of hypertension.

Lemongrass

It is also known as Cymbopogon citratus. This thrives in warm

growing conditions and is a tropical herb packed with a strong cit-

rus flavour. Its leaves have a wide range of medical values, espe-

cially for the treatment of hypertension. According to the

Traditional Chinese Medicine (TCM) theory, lemongrass belongs

to the “Herbs that warm the Interior and expel Cold” category. Its

functions are to remove an internal cold and restore “Qi” within

the body through liver and lung meridians to improve blood cir-

culation as well as the “Qi” and “body fluids” to nourish the

body.4

Research progress

Accumulated evidence has shown that lemongrass

(Cymbopogon citratus) elicited relaxation on vascular smooth

muscle. The ease of vascular smooth muscle through prostacyclin

(PGI2) since inhibition of its synthesis by indomethacin resulted in

a contraction of hypertensive rat models become low blood pres-

sure.4,5 Dzeufiet et al. reported that the aqueous extract of

Cymbopogon citratus possessed antihypertensive activity in rats

by changing biochemical and oxidative status. It was also protect-

ed the liver, kidney, and vascular endothelium against damages to

the blood vessels induced by chronic consumption of ethanol and

sucrose.6Nambiar et al. indicated the properties of Cymbopogon

citratus, including antioxidant and anti-inflammatory for prevent-

ing the damage of blood vessels as it increased the level of nitric

oxide to help its vasodilation.7Later on in 2018, Somparn et al.

discovered the lemongrass water extract consisted of several

polyphenolic compounds such as gallic acid, iso-quercetin,

quercetin, rutin, catechin, and tannic acid, which decreased serum

lipid peroxidation to have the antioxidant and cardiotonic func-

tions.8

Mechanism

Lemongrass consists of phytoactive constituents, including

saponins, tannins, flavonoids, alkaloids, and anthraquinones.

Infectious Diseases and Herbal Medicine 2021; volume 2:172

Correspondence: Siukan Law, E-mail: siukanlaw@hotmail.com

Key words: Lemongrass; traditional Chinese herbal medicine; hyper-

tension.

Conflict of interest: The authors have no conflict of interest to declare.

Availability of data and materials: All data generated or analyzed during

this study are included in this published article.

Ethics approval and consent to participate: Not applicable.

Informed consent: Not applicable.

Received for publication: 6 November 2021.

Revision received: 9 December 2021.

Accepted for publication: 9 December 2021.

This work is licensed under a Creative Commons Attribution

NonCommercial 4.0 License (CC BY-NC 4.0).

©Copyright: the Author(s),2021

Licensee PAGEPress, Italy

Infectious Diseases and Herbal Medicine 2021; 2:172

doi:10.4081/idhm.2021.172

[page 36] [Infectious Diseases and Herbal Medicine 2021; 2:172]

“Lemongrass” and its applications for the treatment of hypertension

Siukan Law,1Chuiman Lo2

1Independent researcher; 2Department of Chemistry, The Chinese University of Hong Kong, Shatin, New

Territories, Hong Kong, China

Non-commercial use only

[Infectious Diseases and Herbal Medicine 2021; 2:172] [page 37]

These bioactive components interact with the enzyme or transport

systems, especially for the Na+–K+ATPase and alpha epithelial

Na+channel [αENaC] mRNA that helps the renal tubules re-

absorption of H+. It is effective in acid-base and electrolyte home-

ostasis to reduce or control the level of blood pressure.9Rhiouani

et al. reported that saponin regulated the blood pressure and renal

function in hypertensive rats through the Na+–K+ATPase chan-

nel.10 Jouad et al. also identified that flavonoids in lemongrass

increased the concentrations Na+, K+, and 2Cl−of a urinary system

to influence the salt and water transport in renal tubules.11 Chen et

al. discovered the inhibitory effect of saponins on the Renin-

Angiotensin-Aldosterone System (RAAS) to maintain the level of

blood pressure, balance the acid-base condition, and control the

fluid volume in the body.12 The bioactive components in lemon-

grass are contributed to the Na+–K+ATPase and alpha epithelial

Na+channel [αENaC] associated with the body metabolism for the

prevention of hypertension.

Lemongrass tea formulation

Nowadays, lemongrass is formulated as a herbal tea drink to

prevent and treat hypertension. The lemongrass tea recipe is sim-

ple. Cut the lemongrass in 1 or 2 inches and add 5 cups of water, a

few mints with jiggery for boiling in 5 to 10 minutes. In 2012,

Ullah et al. reported lemongrass tea effectively reduced high blood

pressure and decreased heart rate.13 Koner et al. identified lemon-

grass tea as antioxidants to detoxify and clean the toxic substance

within our body. It regulated blood circulation and lowered blood

pressure by the potassium ion from lemongrass tea. This also lim-

ited cholesterol absorption and purified it in the liver to prevent

hypertension and heart diseases.14

However, excess consumption of lemongrass tea might influ-

ence the homeostatic mechanisms such as balancing the acid-base

and electrolytes of body fluid.9Some exhibit potential side effects,

including frequent urination and allergic reactions.15 Ekpenyong et

al. identified that if the lemongrass tea is at a high dose or as a pro-

longed treatment, the estimated Glomerular Filtration Rate (eGFR)

could be decreased and followed by a decline in the other renal

function indices.16

Lemongrass TCM formulation and clinical study

In the TCM formulation, lemongrass efficacy relieves wind

from the surface, removes blood stasis, and dredge collaterals. It is

used in the cure of cold, headache, stomach pain, diarrhea,

rheumatic arthralgia, bruises, and to regulate blood pressure. The

dosage of lemongrass for oral administration is about 3-9g in

Chinese medicine decoction.

Lee et al. reported lemongrass suppressed the sympathetic ner-

vous system activity and blood pressure in a clinical study of 24

young male adults. Participants drank 180 mL of lemongrass tea

for two weeks every morning, and their average blood pressure

dropped from 153/90 mmHg to 141/82 mmHg.17

Lemongrass hydrogel

Could lemongrass be suitable for synthesizing hydrogel? De

Matos et al. indicated hydrogel integrating lemongrass-loaded

nanosponges with an enhanced antifungal effect in vitro or in

vivo.18 This nanosponges delivery system study may also act as a

carrier of an anti-hypertensive drug in the future. Earlier in 2013,

Campos et al. reported lemongrass antioxidant properties to pre-

vent endothelial dysfunction associated with an oxidative imbal-

ance promoted by different oxidative stimuli. It decreased the

Reactive Oxygen Species (ROS) production and inhibited the

vasoconstrictions induced by thromboxane A.19

Lemongrass hydrogel synthesis possibly relates to natural

polymers such as alginate, cellulose derivatives, and chitosan. It

depends on the biocompatible and biodegradable properties. The

nanoscale of lemongrass as carriers for a delivery system includes

Polycaprolactone (PCL), Polylactic Acid (PLA), polyurethane, and

Polyvinyl Pyrrolidone (PVP) because of the good tissue compati-

bility, solute permeability, and excellent electro-spinnability.20

Conclusion

The above information demonstrates that lemongrass and its

TCM formulations are possible candidates for the treatment of

hypertension. Herbal tea is not well-regulated and formulated in

TCM and its application for the hydrogel. However, this must pay

attention to the dosage of lemongrass in daily life and further

develop it into hydrogel. Much more works need to be done as the

previous investigations are inconclusive, such as qualitative and

quantitative assessments of lemongrass in the human body.

References

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4. Ekpenyong CE, Akpan E, Nyoh A. Ethnopharmacology, phy-

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potential of the aqueous extract which combine leaf of Persea

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citratus (D.C) Stapf. (Poaceae), fruits of Citrus medical L.

(Rutaceae) as well as honey in ethanol and sucrose experimen-

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spontaneously hypertensive rats. Therapie 1999;54:735-9.

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11. Jouad H, Haloui M, Rhiouani H, et al. Ethnobotanical survey

of medicinal plants used for the treatment of diabetes, cardiac

and renal diseases in the North centre region of Morocco (Fez–

Boulemane). J Ethnopharmacol 2001;77:175-82.

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rats. Exp Ther Med 2013;5:429-32.

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beverages: Exploring the pros and cons. Natural Beverages

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consumption on estimated glomerular filtration rate and creati-

nine clearance rate. J Ren Nutr 2015;1:57-66.

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suppressing autonomic nervous system activity in young

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2015;34:21.

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19. Campos J, Schmeda-Hirschmann G, Leiva E, et al.

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and oxidised low-density lipoprotein. Food Chem

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Review

Non-commercial use only

Exploring the Anti-Hypertensive Potential of Lemongrass—A Comprehensive Review

Article

Full-text available

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Lemongrass (Cymbopogon citratus (DC) Stapf) is a herb commonly used in folk medicine for many purposes. However, its anti-hypertensive potential has not yet been thoroughly studied. This paper reviews the anti-hypertensive effects of both lemongrass and its main compound citral in in vitro, ex vivo, preclinical and clinical studies. Lemongrass essential oil contains terpenes and their derivatives, whereas extracts contain different classes of polyphenols. Both citral and lemongrass display vasorelaxant activity ex vivo, acting by the promotion of endothelial nitric oxide/prostanoids secretion together with the blockage of calcium channels in the vascular smooth muscle. Citral also displays a negative chronotrope effect, probably due to a centrally mediated enhancement of parasympathetic activity. In both healthy and hypertensive animals, the acute administration of lemongrass results in a decrease in blood pressure, sometimes accompanied by a compensatory increase in heart rate. Similarly, in healthy and hypertensive human subjects, the consumption of lemongrass tea decreases blood pressure. Additionally, a weak/moderate diuretic activity has also been reported in animals and humans, although the mechanisms of action remain elusive. Future preclinical studies are necessary to identify other compounds with anti-hypertensive activity and additional pharmacological pathways. Although well tolerated, the safety profile of lemongrass should be better characterized.

INTERVENSI KEPERAWATAN NON FARMAKOLOGI AROMATERAPI SERAI PADA PASIEN DENGAN PENINGKATAN TEKANAN DARAH

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Studi Literatur: Herbal Indonesia Berkhasiat Sebagai Anti Hipertensi

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Aug 2023

Nur Asiyah Siregar

Introduction: High blood pressure (hypertension) is often influenced by several factors including age and obesity It can be characterized by an increase in blood pressure on the walls of the arteries. Objective of the research: The purpose of this literature study is to summarize the various types of Indonesian herbal medicines that have antihypertensive effects. Method: The method used to write this article The electronic database indexed by Google Shoolar uses a literature review approach, the inclusion criteria taken based on journals published between 2016-2023. Result: Based on the research results of this review article, it was found that Indonesian shrubs could be an effective alternative therapy for treating high blood pressure (hypertension). Conclusion: We can find Indonesian herbal plants with their properties as hypertension drugs easily around us, such as red guava, turmeric, carrots, aloe vera, green grass jelly, wood sweet, garlic, noni, soursop leaves, avocado leaves, balimbing wuluh, celery, lemongrass, and ginger which can be an alternative treatment that is no less effective as blood pressure lowering hypertension cure.

Polymeric Carriers Designed for Encapsulation of Essential Oils with Biological Activity

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The article reviews the possibilities of encapsulating essential oils EOs, due to their multiple benefits, controlled release, and in order to protect them from environmental conditions. Thus, we present the natural polymers and the synthetic macromolecular chains that are commonly used as networks for embedding EOs, owing to their biodegradability and biocompatibility, interdependent encapsulation methods, and potential applicability of bioactive blend structures. The possibilities of using artificial intelligence to evaluate the bioactivity of EOs—in direct correlation with their chemical constitutions and structures, in order to avoid complex laboratory analyses, to save money and time, and to enhance the final consistency of the products—are also presented.

Essential Oils and Isolated Terpenes in Nanosystems Designed for Topical Administration: A Review

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Essential oils are natural products with a complex composition. Terpenes are the most common class of chemical compounds present in essential oils. Terpenes and the essential oils containing them are widely used and investigated by their pharmacological properties and permeation-enhancing ability. However, many terpenes and essential oils are sensitive to environmental conditions, undergoing volatilization and chemical degradation. In order to overcome the chemical instability of some isolated terpenes and essential oils, the encapsulation of these compounds in nanostructured systems (polymeric, lipidic, or molecular complexes) has been employed. In addition, nanoencapsulation can be of interest for pharmaceutical applications due to its capacity to improve the bioavailability and allow the controlled release of drugs. Topical drug administration is a convenient and non-invasive administration route for both local and systemic drug delivery. The present review focuses on describing the current status of research concerning nanostructured delivery systems containing isolated terpenes and/or essential oils designed for topical administration and on discussing the use of terpenes and essential oils either for their biological activities or as permeation enhancers in pharmaceutic formulations.

Lemongrass tea consumption and changes in Acid-Base Balance and Electrolyte homeostasis

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Full-text available

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Christopher Ekpenyong

Effect of lemongrass water extract supplementation on atherogenic index and antioxidant status in rats

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Acta Pharm

Cymbopogon citratus (DC) Stapf., commonly known as lemongrass, possesses strong antioxidant and cardiotonic properties. Lemongrass water extract contains several polyphenolic compounds including gallic acid, isoquercetin, quercetin, rutin, catechin and tannic acid. Rutin, isoquercetin catechin and quercetin are the flavonoids most abundantly found in the extract. The extract significantly decreased total cholesterol, low-density lipoprotein and atherogenic index in rats after treatment ( p < 0.05). Expression of genes and protein of sterol regulatory element binding protein-1c (SREBP1c) and HMG-CoA reductase (HMGR) was also lowered significantly in treated groups ( p < 0.05). Moreover, serum antioxidant capacity increased in treated rats in comparison with untreated ones ( p < 0.05) and was associated with decreased serum lipid peroxidation.

Prevalence and Associated Risk Factors of Hypertension: A Cross-Sectional Study in Urban Varanasi

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Hypertension is a major public health problem and important area of research due to its high prevalence and being major risk factor for cardiovascular diseases and other complications. Objectives . (1) To assess the prevalence of hypertension and its associated factors and (2) to estimate awareness, treatment, and adequacy of control of hypertension among study subjects. Methods and Materials . A community based cross-sectional study with multistage sampling design was conducted among urban population of Varanasi. A modified WHO STEPS interview schedule on 640 study subjects aged 25–64 years was used. Results . The prevalence of hypertension was 32.9% (male: 40.9%, female: 26.0%). Mean systolic and diastolic BP were 124.25 ± 15.05 mmHg and 83.45 ± 9.49 mmHg, respectively. Higher odds of being hypertensive were found in male subjects, eldest age group, married subjects, subjects of upper socioeconomic status, illiterate subjects, and retired subjects. Tobacco and alcohol consumption, overweight, obesity, and abdominal obesity were also associated with hypertension. Out of the total hypertensive 211 subjects, only 81 (38.4%) were aware about their hypertension status; out of those, 57 (70.4%) were seeking treatment and 20 (35.08%) had their blood pressure adequately controlled. Conclusion . Around one-third of the subjects were hypertensive and half of the study subjects were prehypertensive in this area. The awareness, treatment, and control of high blood pressure were also very low.

A Profile of Adverse Effects of Antihypertensive Medicines in a Tertiary Care Clinic in Nigeria

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Background There has been a dearth of comprehensive data on the profile of adverse reactions to antihypertensive medicines in the Nigerian setting despite increased use. Objective This study was aimed to characterize the adverse reactions experienced in the homogenously black African population. Methods The study was carried out at the University of Benin Teaching Hospital, Benin City, Nigeria, in consenting eligible hypertensive patients ≥18 years. Adverse reactions were sought using patient's self-report and a medicine-induced symptom checklist. Results A total of 514 patients (340 females) aged 22–97 years were studied. Thirteen percent, 27.6%, 26.7%, 22.0%, and 10.7% were on 1, 2, 3, 4, and ≥5 medicines, respectively, for control of their blood pressure with the frequency of adverse effects increasing proportionately up to four medicines. Adverse reactions to antihypertensive medicines were reported by a total of 93 (18.1%) patients. Diuretics – 27.9%, calcium channel blockers (CCBs) – 26.8%, and angiotensin-converting enzyme inhibitors (ACEIs) – 26.8% accounted for most of the adverse reactions seen, notably frequent micturition and headaches (CCB); excessive micturition and dizziness (diuretics); dry irritating cough (ACEI). Notable complaints for all patients using the checklist were increased frequency of micturition, reduction in libido, and headaches. The reactions resulted in the discontinuation and substitution of therapy in 49.5% of the patients. Conclusions The characterization of these reactions in Nigerians requires further studies as frequent micturition reported is still a neglected complaint in antihypertensive therapy.

Bioactivity analysis of lemongrass (Cymbopogan citratus) essential oil

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Diseases such as diabetes mellitus and gout are among the chronic diseases affecting worldwide population. Investigation is required to find the alternative approaches to treat these chronic diseases, such as plant based medicine. In this study, lemongrass (Cymbopogan citratus) was chosen and examined on the basis of their usage in traditional medicines throughout Southeast Asia. GCMS analysis revealed the major constituents of the lemongrass essential oil which compromise 67.769% and 67.328% of the total oil respectively. Total phenolic content of the essential oil was analyzed by Folin Ciocalteau method and the results indicated that highest amount of phenolic content was obtained from essential oil extracted from lemongrasses stalk, with phenolic concentration of 2100.769 mg/l GAE. Anti oxidant activity was examined by DPPH scavenging test and the highest inhibition was obtained by essential oil extracted from lemongrass stalk (89.5%). β-glucosidase inhibition assay was carried out using an in-vitro model for anti diabetic test and lemongrass stalk essential oil showed highest degree of inhibitory activity (89.63%). Anti gout test was examined by xanthine oxidase inhibition (XOI) assay with the maximum percentage of xanthine oxidase inhibition of 81.34% obtained from lemongrass stalk essential oil.

Interaction with indoor plants may reduce psychological and physiological stress by suppressing autonomic nervous system activity in young adults: A randomized crossover study

Article

Full-text available

Apr 2015
J Physiol Anthropol

Developments in information technology cause a great deal of stress to modern people, and controlling this stress now becomes an important issue. The aim of this study was to examine psychological and physiological benefits of interaction with indoor plants. The study subjects were 24 young male adults at the age of 24.9 ± 2.1 (mean ± SD). The crossover experimental design was used to compare the differences in physiological responses to a computer task and a plant-related task. Subjects were randomly distributed into two groups. The first group (12 subjects) carried out transplanting of an indoor plant, whereas the second group (12 subjects) worked on a computer task. Then, each subject switched activities. The psychological evaluation was carried out using the semantic differential method (SDM) and physiological evaluation using heart rate variability (low-frequency (LF) and high-frequency (HF) components) and blood pressure. Analysis of the SDM data showed that the feelings during the transplanting task were different from that during the computer task: the subjects felt more comfortable, soothed, and natural after the transplanting task than after the computer task. The mean value of total log[LF/(LF + HF)] (sympathetic activity) increased over time during the computer task but decreased at the end of the transplanting task, and the differences were significant. Furthermore, diastolic blood pressure was significantly lower after the transplanting task. Our results suggest that active interaction with indoor plants can reduce physiological and psychological stress compared with mental work. This is accomplished through suppression of sympathetic nervous system activity and diastolic blood pressure and promotion of comfortable, soothed, and natural feelings.

The global epidemiology of hypertension

Article

Feb 2020

Hypertension is the leading cause of cardiovascular disease and premature death worldwide. Owing to the widespread use of antihypertensive medications, global mean blood pressure (BP) has remained constant or has decreased slightly over the past four decades. By contrast, the prevalence of hypertension has increased, especially in low- and middle-income countries (LMICs). Estimates suggest that 31.1% of adults (1.39 billion) worldwide had hypertension in 2010. The prevalence of hypertension among adults was higher in LMICs (31.5%, 1.04 billion people) than in high-income countries (28.5%, 349 million people). Variations in the levels of risk factors for hypertension, such as high sodium intake, low potassium intake, obesity, alcohol consumption, physical inactivity and unhealthy diet, may explain some of the regional heterogeneity in hypertension prevalence. Despite the increasing prevalence, the proportions of hypertension awareness, treatment and BP control are low, particularly in LMICs, and few comprehensive assessments of the economic impact of hypertension exist. Future studies are warranted to test implementation strategies for hypertension prevention and control, especially in low-income populations, and to accurately assess the prevalence and financial burden of hypertension worldwide.

Ethnopharmacology, phytochemistry, and biological activities of Cymbopogon citratus (DC.) Stapf extracts

Article

May 2015

Cymbopogon citratus is a widely distributed perennial herb belonging to the Poaceae family and has been extensively consumed for its medicinal, cosmetic, and nutritional effects for centuries. A large number of reports have been published describing the pharmacological, biological, and therapeutic actions of this herb. In this review, we summarized the literatures on related studies (up to January, 2014) that highlighted the pharmacologic and biological effects of the major phytochemicals isolated from C. citratus extracts and its essential oil. The components of the essential oils found in C. citratus have a similar pharmacokinetic properties, including absorption, distribution, metabolism, and excretion. They are quickly absorbed following oral, pulmonary, and dermal administration. Based on the published reports, it can also be inferred that, after absorption from the small intestine, some phytochemicals in C. citratus can undergo oxidation, glucuronidation, sulfation, and/or O-methylation. Excretion is through urine, feces and/or expired volatiles. The biotransformation reactions of C. citratus bioactive constituents are essential for its relatively safe consumption and therapeutic applications. The data available so far warrant further studies evaluating C. citratus pharmacokinetics. Reliable pharmacokinetic data in humans would be critical for a better understanding of the the systemic handling of C. citratus. Copyright © 2015 China Pharmaceutical University. Published by Elsevier B.V. All rights reserved.

Lemongrass and its applications for the treatment of hypertension

Abstract

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