Blood pressure lowering, fibrinolysis enhancing and antioxidant activities of Cardamom (Elettaria cardamomum)

Abstract

Elettaria cardamomum (L.) Maton. (Small cardamom) fruit powder was evaluated for its antihypertensive potential and its effect on some of the cardiovascular risk factors in individuals with stage 1 hypertension. Twenty, newly diagnosed individuals with primary hypertension of stage 1 were administered 3 g of cardamom powder in two divided doses for 12 weeks. Blood pressure was recorded initially and at 4 weeks interval for 3 months. Blood samples were also collected initially and at 4 weeks interval for estimation of lipid profile, fibrinogen and fibrinolysis. Total antioxidant status, however, was assessed initially and at the end of the study. Administration of 3 g cardamom powder significantly (p<0.001) decreased systolic, diastolic and mean blood pressure and significantly (p<0.05) increased fibrinolytic activity at the end of 12th week. Total antioxidant status was also significantly (p<0.05) increased by 90% at the end of 3 months. However, fibrinogen and lipid levels were not significantly altered. All study subjects experienced a feeling of well being without any side-effects. Thus, the present study demonstrates that small cardamom effectively reduces blood pressure, enhances fibrinolysis and improves antioxidant status, without significantly altering blood lipids and fibrinogen levels in stage 1 hypertensive individuals.

Full text

Indian Journal of Biochemistry & Biophysics
Vol 46, December 2009, pp 503-506
Blood pressure lowering, fibrinolysis enhancing and antioxidant activities of
Cardamom (Elettaria cardamomum)
S K Verma1* Vartika Jain2 and S S Katewa2
1Indigenous Drug Research Center, Department of Medicine, RNT Medical College, Udaipur 313 001, Rajasthan, India
2Laboratory of Ethnobotany and Agrostology, Department of Botany, University College of Science,
Mohan Lal Sukhadia University, Udaipur, Rajasthan
Received 22 September 2009; revised 26 November 2009
Elettaria cardamomum (L.) Maton. (Small cardamom) fruit powder was evaluated for its antihypertensive potential and its
effect on some of the cardiovascular risk factors in individuals with stage 1 hypertension. Twenty, newly diagnosed individuals
with primary hypertension of stage 1 were administered 3 g of cardamom powder in two divided doses for 12 weeks. Blood
pressure was recorded initially and at 4 weeks interval for 3 months. Blood samples were also collected initially and at 4 weeks
interval for estimation of lipid profile, fibrinogen and fibrinolysis. Total antioxidant status, however, was assessed initially and
at the end of the study. Administration of 3 g cardamom powder significantly (p<0.001) decreased systolic, diastolic and mean
blood pressure and significantly (p<0.05) increased fibrinolytic activity at the end of 12th week. Total antioxidant status was also
significantly (p<0.05) increased by 90% at the end of 3 months. However, fibrinogen and lipid levels were not significantly
altered. All study subjects experienced a feeling of well being without any side-effects. Thus, the present study demonstrates
that small cardamom effectively reduces blood pressure, enhances fibrinolysis and improves antioxidant status, without
significantly altering blood lipids and fibrinogen levels in stage 1 hypertensive individuals.
Keywords: Hypertension, Small cardamom, Fibrinolysis, Antioxidant, Elettaria cardamomum (L.) Maton
The hypertension is a multi-factorial disease prevalent
the worldover, and is a common cardiovascular risk
factor for ischemic heart disease (IHD) and
cerbrovascular accidents (CVA). It is usually associated
with an abnormal level of antioxidant status and reduced
fibrinolysis1,2. The drug treatment of mild hypertension
has been associated with metabolic alterations that
increase the risk of cardiovascular diseases, resulting in
stand off or even a negative overall effect3. In this regard
dietary spices and various plant products have been
evaluated2. The small cardamom (Elettaria carda-
momum Maton), the “Queen of Spices”, is one such
common spice which has shown some promise4.
The cardamom is a popular food additive and
flavoring agent used by people all over the world. Its
medicinal properties have been described in Ayurveda
and Unani system of medicine against gastrointestinal
disorders, cardiac disorders, renal and vesicular
calculi, dyspepsia, debility, anorexia, asthma,
bronchitis and halitosis5. It has been recommended
that one teaspoonful of cardamom powder if taken
with little honey twice a day is beneficial in high
blood pressure and heart disease6. The various animal
studies have shown its antioxidant7, antihypertensive8,
gastroprotective9, antispasmodic10, antibacterial11,
antiplatelet aggregation12 and anticancer13 properties.
The cardamom crude extract has demonstrated
blood pressure reduction in anaesthetized rats8 and
1,8-cineole, the pharmacologically active constituent
of its seeds has also demonstrated vasodilator activity
in normotensive rats14. However, no long-term
clinical studies have so far been carried out with
respect to its effect on blood pressure, lipid profile,
fibrinolysis, fibrinogen and total antioxidant status.
Thus, in the present study, the long-term effect of
cardamom on the above-mentioned parameters has
been investigated in a single blinded study.
Materials and Methods
Preparation of drug
Best quality fruits of Elettaria cardamomum were
collected from the local market and grinded well with
their outer shells to make a fine homogenous powder
and filled in gelatin capsules. Each capsule contained
0.75 g of the drug.
__________
*Corresponding author
Tel: +91-294-2484809, 09414168910
Fax: +91-294-2410541
E-mail: skvermaster@gmail.com

INDIAN J. BIOCHEM. BIOPHYS., VOL. 46, DECEMBER 2009
504
Study protocol, subject distribution and drug administration
After approval from Institutional Ethical
Committee, the study was conducted on 20 newly
diagnosed patients of essential hypertension (Primary
hypertension) between the ages of 35 to 50 yrs
(BMI<25), who attended medical Out Patient
Department of Maharana Bhopal General Hospital
attached to RNT Medical College, Udaipur.
All the patients selected were of stage 1 (≥140/90
to 159/99 mm Hg) hypertension of Joint National
Committee (JNC) VII15. The patients with stage 2
(≥160/100 mm Hg) hypertension of JNC VII,
secondary hypertension, diabetes, IHD, renal and
endocrine diseases were excluded. Similarly, the
patients who were smokers, alcoholics, on oral
contraceptives, lipid lowering drugs, dietary
restrictions or weight reduction program were
excluded from the study. All the selected patients
were not taking any anti-hypertensive medication and
unwilling to take allopathic medicine for
hypertension. They opted for herbal medicine for
treatment of hypertension. After informed consent,
two capsules of cardamom powder were administered
twice daily. The dose of 1.5 g twice a day was
decided based on ethnomedicinal recommendations
and as observed in the preliminary study4,6. During
the study period, the patients were advised not to alter
their dietary and exercise habits. They were also
instructed not to take any medication without prior
consultation.
Blood pressure measurement
The blood pressure was measured with a mercury
sphygmomanometer with a standard size cuff in
accordance with recommendations of JNC VII15.
Average of two or more readings with the gap of
5 min was taken at each time of blood pressure
recording. The blood pressure was recorded in sitting
position, initially and at every 4th week and the mean
blood pressure was determined by the formula:
Diastolic blood pressure + 1/3rd of pulse pressure.
Blood chemistry
The blood samples were collected in a fasting state,
initially and at the end of 4th, 8th and 12th week for the
analysis of fibrinolytic activity16, fibrinogen17, lipid
profile18-21. Fibrinolytic activity (units) was assessed
as euglobulin lysis time (ELT) in min and expressed
in units by dividing 10000 by ELT. Fibrinogen was
measured by chemical method as described by Nath
and associates17.
The serum cholesterol18, triglycerides19 and
HDL-C20 were estimated colorimetrically by
enzymatic methods employing test kits supplied by
Reckon Diagnostics P. Ltd., Baroda, India. VLDL
cholesterol and LDL cholesterol were calculated by
Friedwald formula21 as follows:
VLDL-C = Triglycerides/5 and
LDL-C = Total cholesterol - (HDL-C + VLDL-C)
Total antioxidant status was assessed initially and
at the end of the study using test kit supplied by
Randox, UK, where the color produced by ABTS
(2,2’-azino-di-[3-ethylbenzthiazoline sulphonate])
radicals is measured at 600 nm which is proportional
to concentration of antioxidants present in the
sample22.
Statistical analysis
Data were expressed as mean ± standard error
(SE). Results were statistically analyzed with
student’s t-test for paired data and a ‘p’ value less
than or equal to 0.05 was considered as significant.
Results and Discussion
Administration of cardamom in a dose of 1.5 g
twice daily significantly decreased systolic (p<0.01),
diastolic (p<0.01) and mean (p = 0.001) blood
pressure in stage 1 hypertensive individuals at the end
of 1 month (Table 1). Although the reduction in blood
pressure was statistically significant at the end of 4th
week, the levels did not reach up to the normal values
of less than 140/90 mm Hg. At the end of 8 weeks,
Table 1—Effect of Elettaria cardamomum (3 g) on blood pressure in stage 1 hypertensive individuals (n = 20)
[Values expressed as mean ± SE]
Blood pressure
(mm Hg)
Initial
(I)
4 Weeks
(II)
8 Weeks
(III)
12 Weeks
(IV)
Systolic 154.2 ± 3.14 143.4 ± 2.07a 139.4 ± 3.15b,c 134.8 ± 3.32d,e
Diastolic 91.8 ± 2.19 87.6 ± 1.43a 83.4 ± 2.54f,g 79.6 ± 1.92d,h
Mean 112.59 ± 1.77 106.19 ± 0.87* 101.86 ± 1.96f,p 97.99 ± 2.00d,k
p values: <0.01- a II vs I, b III vs I, k IV vs III; <0.001 – d IV vs I, f III vs I; = 0.05- e IV vs III; <0.05- g III vs II, h IV vs III;
= 0.001 - * II vs I; <0.02- p III vs II; NS –c III vs II (NS- Not significant)

VERMA et al : HYPOTENSIVE, CLOT LYSIS AND ANTIOXIDANT ACTIVITIES OF CARDAMOM
505
further decrease was observed in systolic (p<0.01),
diastolic (p<0.001) and mean (p<0.001) blood
pressure and systolic blood pressure lowered to 139.4
± 3.15 from 143.4 ± 2.07 mm Hg. At the end of
3 months, the systolic (134.8 ± 3.32 mm Hg) and
diastolic (79.6 ± 1.92 mm Hg) blood pressure reached
within the range of normal level (>140/90 mm Hg), as
defined by JNC VII criteria (Table 1).
On an average, there was a fall of 19 mm Hg in
systolic and 12 mm Hg in diastolic blood pressure at
the end of 12 weeks (Fig. 1). This statistically
significant decrease in blood pressure is important in
terms of its long-term morbidity and mortality from
cardiovascular diseases. Randomized controlled trials
have shown that in patients with mild hypertension,
lowering of 5-6 mm Hg in diastolic and 10 mm Hg in
systolic blood pressure reduces stroke risk by about
one-third and risk of coronary events by about one-
sixth23,24.
The significant (p<0.05) enhancement of
fibrinolysis by cardamom at the end of 4, 8 and
12 weeks is worth noting (Table 2). In health, there
exists a dynamic equilibrium between fibrin
deposition and its cleaning by fibrinolytic process.
This fibrinolytic activity is influenced by drug, diet
and diseases like diabetes, IHD and hypertension25.
Fibrinolysis enhancement along with blood pressure
lowering effect is, therefore, a boon in disguise for
patients with stage 1 hypertension treated with
cardamom.
Besides its blood pressure lowering and fibrinolysis
enhancement properties, cardamom significantly
(p<0.05) improved total antioxidant status by 90%
after 12 weeks of its administration in stage
1 hypertensive individuals (Fig. 2). Furthermore,
favorable reductions were also observed in total
cholesterol (19%), triglycerides (15%), VLDL-C
(15%) and LDL-C (25%) levels at the end of
3 months of cardamom administration (Fig. 3).
However, the changes were statistically not significant.
Similarly, fibrinogen levels were remained
significantly unaltered throughout the study (Table 2).
The essential oil of cardamom contains around
25 identified compounds, of which 1,8-cineole and
terpinyl acetate are the major chemical constituents.
Fig. 1—Fall in systolic, diastolic and mean blood
pressure
(mm Hg) after 3 months administration of cardamom (3 g)
Table 2—Effect of Elettaria cardamommum (3 g) on fibrinolytic activity (FA) and fibrinogen (FB) in hypertensive individuals (n = 20)
[Values expressed as mean ± SE]
Parameter
Initial
(I)
4 Weeks
(II)
8 Weeks
(III)
12 Weeks
(IV)
FA
(Units)
70.81 ± 11. 94 113.2 ± 19.92 a 104.09 ± 12.28 b,d 113.84 ± 12.34c,e
FB
(mg %)
249.7 ± 23.46 238.36 ± 15.27* 237.53 ± 9.24*,d 247.61 ± 11.75*,e
p values: <0.05 : a II vs I, b III vs I, c IV vs I; NS: d III vs II, e IV vs III, * as compared to I. (NS: Not significant)
Fig.2—Effect of Elettaria cardamomum (3 g) on total antioxi
dant
status in stage 1 hypertensive individuals (n = 20)

INDIAN J. BIOCHEM. BIOPHYS., VOL. 46, DECEMBER 2009
506
Recently, cardiovascular effects of 1,8-cineole, a
mono-terpenic oxide have been evaluated in animal
experimental studies. Interestingly, i.v. bolus injections
of 1,8-cineole (0.3-10 mg/kg) has elicited dose-
dependent decrease in mean aortic pressure. This effect
is related to an active vascular relaxation rather than
withdrawal of sympathetic tone14. In the present study,
the dose of 1,8-cineole administered was 1.44 mg/kg as
mentioned in our previous study4. However, other
constituents such as limonene, terpinolene and myrcene
may add to its pharmacological activity26. Recently,
crude extract of cardamom has also shown blood
pressure lowering activity along with diuretic and
sedative effects in animals8.
Moreover, in the present study not only cardamom
seeds, but the fruit shell containing flavanoids was
also used which might have some role in lowering
blood pressure and improving antioxidant status27.
Furthermore, the role of central neurogenic effect of
cardamom should also be considered in lowering the
blood pressure, as most of the patients had a feeling of
well being and tranquility. However, further
investigations are warranted to unmask the
mechanism of action.
In conclusion, the present study suggests that long-
term administration of cardamom has significant
blood pressure lowering effect along with fibrinolysis
and antioxidant enhancing properties in patients with
stage 1 hypertension. Thus, it may prove beneficial as
a dietary supplement to such patients. However,
further long-term placebo controlled study with a
large number of patients is warranted to further
establish its multiple therapeutic potential.
Acknowledgement
One of the authors (VJ) is highly thankful to CSIR,
New Delhi, India for providing financial assistance.
References
1 Kashyap M K, Yadav V, Sherawat B S, Jain S, Kumari S,
Khullar M, Sharma P C & Nath R (2005) Mol Cell Biochem
277, 89-99
2 Verma S K (2002) Effect of certain herbs on some risk
factors of ischemic heart disease in man. D.Sc. Thesis,
Indian Board of Alternative Medicine, Kolkata
3 Collins R, Peto R, Macmohan S, Herbert P, Fiebach N H &
Eberlein K A (1990) Lancet 335, 827-38
4 Verma S K, Jain V & Katewa S S (2007) South Asian J Prev
Cardiol 11, 183-192
5 The Wealth of India (2005) First Supplement Series, Vol. 3,
pp. 65-69, NISCAIR, CSIR publications, New Delhi
6 Sarkar P R (1986) Yogic treatments and natural remedies,
2nd edn., p. 60., AMPS Publications,Tiljala, Calcutta
7 Spices, cardamom, Description. Oxygen radical absorbance
capacity (ORAC) values of selected foods. Nutrient Data
Laboratory, Agriculture Research Service, US Department of
Agriculture (2007). Available online at: http://oracvalues.
com/spices-cardamom (cited 22 Nov 2008)
8 Gilani A H, Jabeen Q, Khan A U & Shah A J (2008)
J Ethnopharmacol 115, 463-472
9 Jamal A, Javed K, Aslam M & Jafri M A (2006)
J Ethnopharmacol 103, 149-153
10 Al-Zuhair H, El-Sayeh B, Ameen H A & Al-Shoora H
(1996) Pharmacol Res 34 (1-2), 79-82
11 Mahady G B, Pendland S L, Stoia A, Hamill F A, Fabricant D,
Dietz B M & Chadwick L R (2005) Phytother Res 19, 988-991
12 Suneetha W J & Krishnakantha T P (2005) Phytother Res 19,
437-440
13 Sengupta A, Ghosh S & Bhattacharjee S (2005) Asian Pac J
Cancer Prev 6, 118-122
14 Lahlou S, Figueiredo A F, Magalhaes P J C & Leal-Cardoso
J H (2002) Can J Physiol Pharmacol 80,1125-1131
15 Chobanian A V, Bakric G L, Black H R, Cushman W C,
Green L A, Izzo J L, Jones D W, Materson B J, Oparil S,
Wright J T & Roccella E J (2003) JAMA 2560-2572
16 Buckell M & Elliot F A (1958) J Clin Pathol 11, 403-405
17 Nath R L & Debnath B (1970) J Indian Med Assoc 54, 93-95
18 Allain C C, Poon L S, Chan C S G, Richmond W & Fu P C
(1974) Clin Chem 20, 470-475
19 Fossati P & Lorenzo P (1982) Clin Chem 28, 2077-2079
20 Izzo C, Grello F & Muradr E (1981) Clin Chem 27, 371-374
21 Friedwald W T, Levy R I & Fredrickson D S (1972) Clin
Chem 18, 499-502
22 Miller N J, Rice-Evans C, Davies M J, Gopinathan V &
Milner A (1993) Clin Sci 84, 407-412
23 Collins R & Macmohan S (1994) Br Med Bull 50, 272-278
24 Guyton A C & Hall J E (2006) Haemostasis and blood
coagulation. In: Text Book of Medical Physiology, 11th edn.,
Saunder, Philadelphia
25 Rani M, Nath K, Mehrotra T N & Mishra S D (1981)
J Postgrad Med 27,105-108
26 Marongiu B, Piras A & Porcedda S (2004) J Agric Food
Chem 52, 6278-6282
27 Kenneth D R, Setchell A D & Cassidy A (1999) J Nutr 129,
758
[
Fig. 3—Pattern of mean values of lipid profile du
ring 12 weeks
administration of 3 g cardamom in
hypertensive individuals
(n = 20) [P is not significant for all the parameters at all the levels]