Medicinal Plants for the Prevention and Treatment of ...

1 UNESCO EOLSSSAMPLE CHAPTERSETHNOPHARMACOLOGY - Vol. II - Medicinal Plants for the Prevention and Treatment of coronary Heart disease - Gail B. Mahady Encyclopedia of Life Support Systems (EOLSS) Medicinal Plants FOR THE Prevention AND Treatment OF coronary HEART disease Gail B. Mahady, Department of Pharmacy Practice, Program for Collaborative Research in the Pharmaceutical Sciences, UIC/NIH Center for Botanical Dietary Supplements Research, University of Illinois at Chicago, USA. Keywords: artichoke, atherosclerosis, coronary heart disease , garlic, ginkgo, guggul, hyperlipidemia, red wine, resveratrol, saffron, tea. Contents 1. Introduction coronary Heart disease and Treatment 2. Artichoke (Cynara scolymus) Clinical studies In vitro and in vivo studies 3.

2 Garlic (Allium sativum) Clinical studies Antihypercholesterolemic activity Antihypertensive activity Effects on platelet aggregation and myocardial infarction 4. Guggul (Commiphora mukul) Clinical studies Antihyperlipidemic effects 5. Ginkgo (Ginkgo biloba) Clinical studies Antioxidant activity Inhibition of Platelet Aggregation Hematological effects In vitro and in vivo studies Antioxidant and antiplatelet activities Enhancement in coronary blood flow Vasodilatation Inhibition of Platelet Aggregation and Thrombus Formation Blood Pressure Regulation 6. Hawthorn (Crataegus species) Clinical studies Cardiac insufficiency In vitro and in vivo studies Inotropic effects Antiarrhyythmic effects Ischemic-reperfusion injury Vasodilation and coronary blood flow Antihypertensive effects Antioxidant effects 7.

3 Red wine (Vitis vinifera) and resveratrol UNESCO EOLSSSAMPLE CHAPTERSETHNOPHARMACOLOGY - Vol. II - Medicinal Plants for the Prevention and Treatment of coronary Heart disease - Gail B. Mahady Encyclopedia of Life Support Systems (EOLSS) In vitro studies Effects on nitric oxide Effects on infectious components 8. Saffron (Crocus sativus) Clinical studies Antioxidant effects In vitro and in vivo studies Antiatherosclerotic effects. Antihypertensive activity. 9. Tea (Camellia sinensis) Clinical studies 10. Conclusion Glossary Bibliography Biographical Sketch Summary Statistics from the World Health Organization indicate that the burden of chronic diseases, including coronary heart disease , cancers, diabetes and obesity contributes 59% of the million deaths reported in 2001.

4 With coronary heart disease (CHD) ranking as the primary contributor to morbidity and mortality worldwide, it is not surprising that a great deal of research is now focused on identifying new therapeutic alternatives to prevent and treat this disease . With the caveat that the most consistent recommendations from a public health perspective involve multiple changes in diet and exercise, Medicinal Plants are also a viable option for the Treatment and Prevention of CHD. While there are literally hundreds of Plants used around the globe used traditionally for the Treatment of CHD, very few of these Plants have been thoroughly scientifically investigated.

5 However, some Medicinal Plants have sufficient pre-clinical and more clinical data, indicating that these botanical dietary supplements and their constituents have a possible use in strategies to reduce the prevalence and mortality of cardiovascular disease either in the general population or subsets of individuals at high risk. Some well-investigated examples include artichoke, garlic, ginkgo, guggul, hawthorn, and tea. For these Plants significant preclinical and clinical data exist indicating that these botanicals may be beneficial in the Prevention and Treatment of CHD. The focus of this review will be primarily on those Medicinal Plants used traditionally to treat CHD that have some evidence of effect in human studies or that have a preclinical data base sufficient to warrant clinical evaluations.

6 1. Introduction According to the World Health Organization, the burden of chronic diseases, including coronary heart disease (CHD), cancers, diabetes and obesity contributed 59% of the million deaths reported worldwide in 2001. With CHD ranking number one as the main contributor to morbidity and mortality worldwide, there is a significant interest in identifying Plants that have cardioprotectant and cardiotonic activity, as well as the phytochemicals responsible for these activities. To date, the evidence suggests that the health benefits of complex plant constituents are even more considerable than we UNESCO EOLSSSAMPLE CHAPTERSETHNOPHARMACOLOGY - Vol. II - Medicinal Plants for the Prevention and Treatment of coronary Heart disease - Gail B.

7 Mahady Encyclopedia of Life Support Systems (EOLSS) thought due to the large numbers of phytochemicals present in each plant. New evidence suggests that in order to understand the health benefits of plant-based supplements and foods, we will need to take into account the fact that complex mixtures of phytochemicals found in foods and other botanicals may act synergistically. These new revelations may in time dispel the magic bullet theory , which suggests that only pure compounds are the most efficacious. There is also no doubt that the emerging new fields of nutrigenomics and pharmacogenomics will play an important role in determining the interaction of these complex substances with the genetic variability of individuals and will determine the individual response and its magnitude to phytochemicals.

8 coronary Heart disease and Treatment coronary heart disease includes all diseases of the circulatory system including acute myocardial infarction, ischemic heart disease , valvular heart disease , peripheral vascular disease , arrhythmias and stroke. While the dietary association with CHD is clearly important, several genes and variants have been associated with increased CHD risk, including some encoding components for the renin angiotensin system, and mutations in the genes encoding the hepatic low-density lipoprotein LDL receptor protein, apolipoprotein E, lipoprotein lipase and interleukin-6 and leptin. Thus, future food and Medicinal plant research should focus on the assessment of how phytochemical constituents interact or regulate the expression of these genes.

9 Globally, there are literally hundreds of plant-based medicines used in traditional systems of medicine for the Treatment of CHD and its sequelae. The majority of these Plants are used alone or in combination with other herbs. Most of these plant-based medicines have not been scientifically investigated and there is little scientific or clinical data supporting their therapeutic use. However, for some specific botanicals (dietary supplements and herbal Medicinal products) there are significant clinical data suggesting that the use of these products may reduce chronic disease prevalence and mortality either in the general population or subsets of individuals at high risk.

10 With the caveat that the most consistent recommendations to the general public for CHD Prevention includes multiple changes in diet and exercise, several botanical dietary supplements including: artichoke (Cynara scolymus), garlic (Allium sativus), ginkgo (Ginkgo biloba), guggul (Commiphora mukul), hawthorn (Crateagus species), red wine (Vitis vinifera), saffron (Crocus sativa), and tea (Camellia sinensis) may also be beneficial and will be highlighted in this review. 2. Artichoke (Cynara scolymus). Officially, Medicinal artichoke products consist of the dried radical leaves of Cynara scolymus L. (Asteraceae). However, the fresh lower part of the flower head is also official in the African Pharmacopoeia and is used in African traditional medicine.