Herbal Medicine: Back to the Future

Cardiovascular disease (CVD) is a major health problem worldwide with high morbidity and mortality. A lot of effective treatments with various classes of pharmaceutical synthetic drugs have shown significant benefits for controlling and preventing CVD on individuals with high CVD risks. Apart from these pharmacological agents, herbal medicines also are gaining their roles in the clinical practice in terms of CVD therapy and prevention. Herbal medicines represent the main therapeutic approaches of evidence-based complementary and alternative medicine for CVD and can be tracked back thousands of years ago in ancient China. Although more systematic, well-designed experimental and randomized clinical studies with sufficient sample sizes are essential to further explore the exact pharmacological mechanisms of herbal medicines and to validate their safety and pharmacokinetics, promising therapeutic effects against CVD are already evidenced from a number of herbs and herbal formulas containing potent ingredients. In this chapter, we focus on the significant effects and potential underlying mechanisms of some key herbal medicines, especially Chinese herbal formula Naoxintong, in the treatment of CVD, based on clinical and basic science reports, which might help to shed light on further exploration and clinical application of herbal medicines with cardiovascular protective effects.

Cardiovascular diseases (CVD),are the most significant cause of death in all age groups throughout the world. It is the major cause of death in most of the developed and developing countries. Coronary heart disease, congestive heart failure, high blood pressure, stroke, myocardial infarction are the major cardiovascular complications. Lagenaria siceraria (Molina), also known as Bottle gourd, is a member of Cucurbitaceae family. Lagenaria siceraria is broadly cultivated in tropical countries like India, Japan, Egypt, Thailand and most of the part of the world as a vegetable crop. Fruits of the plant have been reported to have potential beneficial effects in Ayurveda and other folk medicines. The fruit is traditionally used for its cardioprotective, cardiotonic, general tonic, diuretic, aphrodisiac and antidote activities. The edible portion of the fruits is a trustworthy source of certain phytoconstituents-like ascorbic acid, β-carotene, vitamin-B complex, choline, minerals, amino acids, triterepenoidcucurbitacins B, D, G, H, 22-deoxy cucurbitacin, β-glycosidedaseelasterase, sterols, triterpenes, flavonoids and carbohydrates. Modern pharmacological studies have shown that Lagenaria siceraria fruit possesses various cardioprotective properties. Chloroform and alcoholic extract of Lagenaria siceraria showed antihyperlipidemic potential in triton induced hyperlipidemia in rats. The fruit showed significant cardioprotective effects in Doxorubicin and Isoproterenol induced cardiotoxicity in rats. The fruit is reported to possess good antioxidant activity in vitro as well as in vivo. The present chapter is focused on in-depth scientific studies that have been carried out on cardioprotective potential of Lagenaria siceraria.

Olea europaea L. (Oleaceae), native of Mediterranean, Africa, south western Asia, Himalayas and naturalized in many other places, is an evergreen tree, being its main product, olive oil, one of the most typical component of the Mediterranean diet which has been associated with lower incidence of cardiovascular diseases. Moreover, Olea europaea extracts are used in traditional medicine worldwide to decrease the risk of cardiovascular diseases. For example, hot water extract of the fresh leaves is taken orally to treat hypertension. The number of people dying from cardiovascular diseases has been increasing and currently there is a huge trend to use natural products in the cardiovascular health. Thus, the ethnopharmacological relevance of Olea europaea is presented and critically discussed in this chapter, having in mind the scientific evidences that corroborate the true value of this species (mainly based on published in vivo studies and clinical trials) as an agent against cardiovascular diseases, and exposing the associated facts and myths. A survey of the currently available Olea europaea medicinal products will be highlighted, along with their potential adverse effects. In this way, it will be clearly shown that Olea europaea extracts used in traditional medicine are coming to the modern medicine, with their therapeutic effects scientifically validated.

Herbal remedies have been used throughout history both for culinary and medicinal purposes, including for prevention and treatment of cardiovascular disease (CVD). Some derivatives of herbs (aspirin, digitalis) are commonly used pharmacotherapies today [1, 2]. Although drug therapy of conventional risk factors for CVD is effective, there is growing awareness of dietary factors and herbal medicines and their use in the prevention and potential treatment of CVD. Many herbal remedies have not undergone careful scientific evaluation with clinical trials and are often available over the counter to lay persons and sold by unregulated agencies [3]. The American Herbal Products Association, the British Herbal Medicine Association, and the European Committee on Herbal Medicine Products Act has implemented product testing and registries to assure safety of herbal supplements. Because of their prevalent use, healthcare providers and patients should be informed about the potential for benefit and harm. This chapter reviews herbal remedies used for prevention and treatment of cardiovascular diseases and related conditions, including atherosclerosis and CVD risk factors, angina pectoris, peripheral vascular disease, venous insufficiency, hypertension, congestive heart failure, and arrhythmias. Additionally, we describe the use of antioxidant vitamins and micronutrient supplements in CVD prevention. Precautions, side effects and adverse interactions are also considered. We want to emphasize that more rigorous research to elucidate the physiologic and long-term effects of these therapies on cardiovascular morbidity and mortality, as well as open communication between patients and physicians regarding herbal medicine use is needed for appropriate use of therapy and to avoid complications.

Cardiovascular disorders are the most important reason of mortality all over the world. Atherosclerosis is the inflammation of the blood vessels, especially large muscular arteries, which is caused by a series of pathological conditions including hyperlipidemia, hypertension, some types of infection and diabetes mellitus. Despite the available chemical drugs to manage the disease, researchers are widely working on other approaches like herbal medicine for the management of atherosclerosis. Alone or as complementary therapy with chemical drugs, medicinal plants have shown beneficial effects for primary or secondary prevention of cardiovascular problems. In this chapter, we firstly introduce herbal remedies traditionally used for the treatment of atherosclerosis-associated disorders in ethnomedicine of different nations throughout the world, and then we discuss clinical evidence on the most relevant medicinal plants as well as the isolated phytochemicals used for the management of atherosclerosis.

Herbal Medicine (HM) also called herbology or herbalism is the study and utilization of plants or plant parts for therapeutic purposes. Cardiovascular diseases (CVDs) are the diseases that affect the cardiovascular system. Major CVDs include coronary artery disease, hypertension, heart failure, cardiac arrhythmias and cerebrovascular diseases such as different types of stroke. The causes of CVDs are diverse, but atherosclerosis and /or hypertension are amongst the most common. A copious numbers of herbal medicines are used against cardiovascular diseases. In recent years, there has been an unprecedented increase in the use of herbal medicine in China and also in Western countries. This chapter aims to highlight current herbal medicines (HMs) and their effect on cardiovascular diseases. The natural sources, mode of actions, specific targets of herbs, have been tabulated to provide readers an insight to the subject. The main focus of the chapter is to elaborate synergism, drug interaction, effect of individual herbs on various cardiovascular disorders and to pinpoint the side effects and fruitful effects associated with these herbal medicines (HMs).

Medicinal plants and their therapeutically active secondary metabolites have been functioning as prolific remedial resource from ancient times and among diverse range of chemical entities of ethno-medico-botanicals, bioactive potential of alkaloids are immense. The alkaloids, reported approximately from 20% of plant species, represent a diverse group of low molecular weight nitrogen-containing heterocyclic natural products, derived mostly from amino acids via transamination. In-depth experimental understanding of the metabolic regulation of the key metabolites is cynosure of modern herbal drug research. In this review we have streamlined both traditional and experimental knowledge elucidating utility aspects of plant based alkaloids as a curative tool to alleviate cardiovascular disorder which is the major cause of mortality and morbidity throughout the globe. Cardio-protection through plants and plant based formulations are reported in traditional medicines of many countries and present day research has demonstrated the role of alkaloids as anti-hypertensive, hypno-analgesic, anti-angiogenic, anti-ischemic, anti-depressant and vesorelaxant which have possibly attributed to their cardioprotective efficacy. In some cases antioxidative, antihypercholesteroemic, inhibition of platelet aggregation and anti-inflammatory activities of alkaloids have also reduced the risk of cardiovascular disorders. The cardioprotective drugs of plant origin in present day medical practice includes several alkaloids like tetrandrine and fangchinoline from members of genus Stephania; berberine from S. japonica and S. cepharantha; dauricine and daurisoline from Menispermum duricum; rhynchophylline and hirsutine from Uncaria rhynchophylla, reserpine, ajmaline, ajmalicine, yohimbine, serpentine from Ravolfia serpentina; dehydroevodiamine from Evodiae rutaecarpa, α-tomatine, and tomatidine from tomatoes etc. These alkaloids exhibit a wide array of mechanisms including in vivo vasodilation by lowering blood pressure or prolonging A-H and H-V intervals to widen ventricular action potentials. Among other significant mechanisms, there is alteration of calcium influx in response to activation of the voltage sensitive channels or negative inotropic actions, preferably due to interaction with sodium channels. Therefore, the present review is the summarized database of plant alkaloids investigated exclusively as a resource of cardio-protective therapeutics in both in vitro and in vivo models with the possible underlying mechanism of action with a note on their ethnopharmacological relevance and a glimpse on their structure activity relationship studies.