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Cardiovascular aspects of geriatric medicines in traditional Persian medicine; a review of phytochemistry and pharmacology.

ABSTRACT

Background: Geriatrics are a group of patients over 65 years and with multiple comorbidities and different functional impairments. Apart from decline in body mass, presence of exhaustion and general fatigue, an aged person may also suffer from various disorders. Approximately, around 30% of geriatric subjects have significant cardiovascular ailments. Apart from the intensive management of cardiovascular aspects I in elderly, monitoring of the complementary cardiac medicine in those people should be received more attention.

Purpose: There are many management lines for a cardio-geriatric condition in Traditional Persian Medicine (TPM). Accordingly, this paper aimed to deal with those medicaments as well as evidence-based clinical aspects and phytochemistry.

Methods: By searching through main pharmaceutical manuscripts of Persian medicine during 10th-18th centuries (A.D.), concurrently, natural medicines for geriatrics and remedies for cardiovascular ailments were derived. On the other side, related phytochemical and pharmacological aspects of those remedies were highlighted.

Results: In all, 38 cardiovascular and 34 geriatric medicaments were found in those manuscripts. Antihyperlipidemic and cholesterol lowering activities of those medicines were the most reported activities in current medicine. However, other pharmacological reports were related to hypotensive, coagulant, cardioprotective and cardiotonic activities. In regard of the chemical composition, medicaments were mainly of polyphenols and flavonoids and also most of the employed extracts and fractions were yielded from polar or semi-polar solvents.

Conclusion: With reference to these findings, flavonoid-rich medicaments from Persian medicine may be selected as considerable herbs for geriatrics with cardiovascular ailments.

Keywords:

Geriatric

Persian medicine

Cardiovascular

Phytochemistry

Introduction

Geriatrics are a group of patients over 65 years who may have various impairments and functional implications in addition to the aging process (Hilmer et al. 2007). Cardiovascular risk factors and disorders like stroke (due to increasing prevalence of atrial fibrillation) (Vasishta et al. 2001), heart failure (De Geest et al. 2003) and other related complications are known as one of the main concerns in the field of geriatric medicine.

In the line with common therapeutic approaches in the field of cardiology and geriatric medicine (Postema et al. 2013), popularity and acceptability of natural products and complementary therapies are increasing in both developed and developing countries. Therefore, traditional medicines are known considerable potential sources for drug discovery in various fields (Fabricant and Farnsworth 2001; Quan et al. 2014). Among various traditional systems of medicine such as Chinese medicine, Ayurveda, homeopathy and others, Traditional Persian medicine (TPM) is an old system with deep roots in antiquity and dates back to pre-historic time (Kordafshari et al. 2015). It is believed that Persians created the humoral theory of medicine (Zargaran 2014). Later, PM was flourished by Persian scholars like Avicenna and Rhazes in the early Islamic era (9-12th century AD, called as Islamic Golden Age) and became the main paradigm of medicine (as holistic and humoral medicine) whole around the world until 17th century AD (Zarshenas et al. 2013).

TPM has a deep view to geriatric care both in preventive approach and in the treatment. There are too many concepts and approaches in nutrition and treatment which can be found in TPM manuscripts (Emami et al. 2014; Emami et al. 2013). In addition, early Persian scholars had a deep attitude toward cardiovascular finding in the golden era of flourishing of their medical knowledge (Zargaran et al. 2013; Zarshenas and Zargaran 2015).

With reference to the medieval knowledge of Persian scholars in geriatrics and also their deep view in cardiology, current paper was compiled to draw together respective treatments for cardiovascular disorders of geriatrics from TPM approaches. Also proofs of pharmacology and phytochemical items of studied remedies were cited to serve an integrative approach of traditional aspects and current related evidences.

Materials and methods

Six main Persian pharmaceutical manuscripts of TPM were searched for geriatric remedies as well as those natural medicaments reported for cardiovascular diseases. Keywords for geriatric or elderly were as Mashayekh, Piran, Shoyukh and Sheikh. Keywords for cardiovascular aspects were as Chalb and also specific diseases of heart and cardiovascular system in TPM studied manuscripts. Manuscripts were as Kitab al-hawi fi al-tibb (Comprehensive Book on Medicine) authored by Rhazes (9th-10th centuries; Rhazes 2005), Kitab al-Qanun fi al-Tibb (Canon of Medicine) and Kitab al-adwiya al-qalbiya (The treatise on cardiac drugs) of Avicenna (10th-11th century; Ibn Sina 1998; Ibn Sina 2009), Ikhtiyarat-i Badil (Selections for Badi'i) written by Hajji Zayn al-Attar (14th century; al-Ansari 1992), Tuhfat al-mu'minin (Present for the Faithful) of Daylami Tunakabuni (17th century; Tunakabuni 2007), and finally Makhzan al-adviyah (The Storehouse of Medicaments) by Alavi Shirazi (18th century; Shirazi 2009). All employed manuscripts in the study are corrected and published currently. Authentication of reported medicinal herbs was performed by botanical textbooks such as "Matching the Old Medicinal Plant Names with Scientific Terminology", "Dictionary of Medicinal Plants", and "Dictionary of Iranian Plant Names" textbooks (Ghahraman and Okhovvat 2004; Mozaffarian 2006; Soltani 2004.). Furthermore, matching the related traditional diseases with current concepts was performed based on current published works. However we did not aim to specify and perfectly define and conform the traditional diseases of heart and cardiovascular system to the current respective terms. However, with focusing on the mentioned diseases, we tried to gather the related information.

To check the respective pharmacological activities and phytochemically responsible components, databases such as PubMed, Scopus, Google Scholar and ScienceDirect were searched. Keywords such as "Geriatric and Cardio-", "Geriatric and Heart", "Cardio-" and "heart" were used in addition to each medicinal plant filtered from traditional textbooks. Mechanisms or pharmacological activities of reported remedies in the field of geriatrics and cardiovascular medicine were cited and discussed.

Results and discussion

Cardiovascular diseases are often spoken as main causes of mortality in geriatrics. On the other hand, prescription of cardiovascular agents is much more frequent in this population than other classes of medicaments (Frishman et al. 2013; Montamat et al. 1989). The narrow therapeutic index of these medicines and also various physiologic changes and complications in elderlies are main concerns for practitioners (Pathy Sinclair and Morley 2006). Therefore, seeking for new and natural medicaments as adjuvant or complementary therapies for old age could be of importance.

In this study, reviewing the medieval and traditional manuscripts resulted in the appearance of 38 cardiovascular and 34 geriatric medicaments, respectively. Respectively, 24 and 25 families related to geriatrics and cardiology were derived. Main families in the side of geriatrics were from Rosaceae followed by Asteraceae, Lamiaceae and Fabaceae. On the other side, Lamiaceae and Zingiberaceae have shown the most cited families in the side of cardiovascular medicine. Many of mentioned plants for geriatrics were traditionally noted as preventive medicaments for that group. According to the belief of early Persian scholars, among those medicines for geriatrics, most of the remedies were remarked as general tonics which could also be beneficial in heart and cardiovascular weakness. Searching through contemporary knowledge revealed that out of 34 geriatric medicines, 19 plants possessed direct cardiac activities or related impacts. Among all 34 remedies which were cited specifically for geriatrics, 18 of those (more than of half) revealed to have cardiovascular and allied activities (Table 3). On the other side, 22/38 medicinal plants, traditionally cited as cardiac medicaments, showed to have proofs from current medicine. In all, six medicinal plants as Myrtus communis L., Melissa officinalis L., Ocimum basilicum L., Malus domestica Borkh., Terminalia chebula Retz., and Curcuma zedoaria (Christm.) Roscoe were cardioactive medicines which were specifically reported for geriatrics (Tables 1 and 2).

Apart from diseases of heart and cardiovascular system, many complications such as psychic disorders, obesity, endocrine impairments and oxidative stresses in an old body could also be life threatening (Musselman et al. 1998; Siti et al. 2015; Van der Kooy et al. 2007; Wilson and Kannel 2002). Regarding the presence of polyphenols and flavonoids in many of the medicinal plants, antioxidant and radical scavenging activities which are effective in the alleviation of cardiovascular ailments can be observed (Hertog et al. 1993). As many of the studied extracts and fractions of medicinal herbs reported in this review showed to be rich in phenols and flavonoids, they could possess antioxidant activities. Therefore, we did not focus on the respective effectiveness for these medicines.

On the other side, we also did not cite activities related to antidiabetic or glucose lowering effects in this survey. To focus only on cardiovascular system, this study searched the cardiovascular-related properties (direct cardio-protective, cardiotonic, antihypertensive, and anticoagulant properties) as reported by current knowledge. Table 3 has listed those medicinal plants with relevant evidence-based outcomes as well as phytochemical information on responsible components.

Mostly, remedies from the standpoints of Persian scholars have demonstrated hypolipidemic activities in current knowledge (22 reports/66 plants) (Table 3). The level of plasma lipids and cholesterol is a main factor in cardiovascular and especially ischemic heart diseases. As very few of these reported plants possessed the cited activities in human models, conducting large scale and multicenter clinical trials with considering the effectiveness and side effects in geriatrics may be of importance for investigators in this field.

Actually, hypertension nearly affects two-thirds of geriatric people and is a main risk factor for many cardiac diseases (Fleg et al. 2011). In this study, there were 9 reports for hypotensive and blood pressure lowering effects among reported medicines. Underlying mechanisms were mostly angiotensin converting enzyme inhibitory (ACE-I), calcium channel blacking effects or direct vasodilation. It is well accepted that ACE-is more effective and less accompanied by side effects in geriatrics (Fleg et al. 2011).

On the other side, blood viscosity and cardiac failure are two main key points in geriatrics' cardiovascular ailments (Miiller-Werdan et al. 2007). Among medicinal plants the presence of coumarin is highly responsible for anticoagulant activity (Abebe 2002). In our report, 5 plants showed antiplatelet and blood viscosity reducing activities. Carthamins are known chalcones in a reported herb, Carthamus tinctorius with such effect (Cho et al. 2000).

Heart failure in elderlies is the main reason of hospitalization (Rich et al. 1995) and cardiotonic agents are of most applicable lines of treatment. Steroids/sapogenins from Terminalia chebula as well as Berberine and related derivatives from Berberis vulgaris have increased cardiac contractility and thus can be effective in heart failure in geriatrics.

According to this survey and documents of traditional manuscripts, six medicinal herbs including Myrtus communis, Melissa officinalis, Ocimum basilicum, Malus domestica, Terminalia chebula, and Curcuma zedoaria were cited for both cardiology and geriatric approaches. Table 4 briefly described the phytochemistry of different classes of metabolites in these plants (Thomas 2000). With reference to the citations and proved cardio-geriatric activities, these herbs may be introduced as lead medicaments for cardiovascular protection in geriatrics. Other than the medieval citation of these medicines as cardio-geriatric natural medicaments, current studies have also confirmed their considerable effects in the field of heart and cardiovascular knowledge. Therefore, these medicines may be beneficial for assessment in cardiovascular complications in geriatric subjects.

Conclusion

Cardiovascular diseases are main causes of mortality in geriatrics. Most current cardiovascular medicaments are accompanied by considerable undesirable effects and also demonstrated narrow therapeutic indices. Therefore, cardiovascular-effective natural medicines with repeated traditional reports may be good and considerable sources of new drug discovery. Current study was performed to evidently report and describe geriatric and cardiovascular medicines from the standpoints of Persian physicians in medieval era. Searching through the current knowledge revealed that almost more than half of the reported medicinal herbs possessed cardiovascular effects which can be effective in geriatrics. Although the cardiovascular related investigations exerted positive and promising results, lack of human studies keeps the way toward introducing new natural cardio-geriatric medicines still closed.

ARTICLE INFO

Article history:

Received 28 September 2015

Revised 1 January 2016

Accepted 12 January 2016

Conflict of interest

We wish to draw the attention of the Editor to the following facts which may be considered as potential conflicts of interest and to significant financial contributions to this work.

References

Abebe, W., 2002. Herbal medication: potential for adverse interactions with analgesic drugs. J. Clin. Pharma. Ther. 27, 391-401.

Achuthan, C.R., Padikkala, J., 1997. Hypolipidemic effect of Alpinia galanga (Rasna) and Kaempferia galanga (Kachoori). Indian. J. Clin. Biochem. 12, 55-58.

Aftab, K., Atta Ur, R., Usmanghani, K., 1995. Blood pressure lowering action of active principle from Trachyspermum ammi (L.) sprague. Phytomedicine 2, 35-40.

Aissaoui, A., Zizi, S., Israili, Z.H., Lyoussi, B., 2011. Hypoglycemic and hypolipidemic effects of Coriandrum sativum L in Meriones shawi rats. J. Ethnopharmacol. 137, 652-661.

Akhondali, Z., Dianat, M., Radan, M., 2015. Negative chronotropic and antidysrhythmic effects of hydroalcoholic extract of Lemon Balm (Melissa Officinalis L.) on CaCl(2)-induced arrhythmias in rats. Electron. Phys. 7, 971-976.

al-Ansari, A., 1992. Ikhtiyarat-i Badii (Selections for Badii). Pakhsh Razi Press, Tehran.

Al-Jeboory, A., Abdul, L., Jawad. M., 1985. Cardiovascular and antimicrobial effects of myrtus communis. Indian J. Pharmacol. 17, 233.

Al-Yahya, M.A., Mothana, R.A., Al-Said, M.S., El-Tahir, K.E., Al-Sohaibani, M., Rafatullah, S., 2013. Citrus medica "Otroj": Attenuates oxidative stress and cardiac dysrhythmia in isoproterenol-induced cardiomyopathy in rats. Nutrients 5, 4269-4283.

Amrani, S., Harnafi, H., Gadi, D., Mekhfi, H., Legssyer, A., Aziz, M., Martin-Nizard, F., Bosca, L., 2009. Vasorelaxant and anti-platelet aggregation effects of aqueous Ocimum basilicum extract. J. Ethnopharmacol. 125,157-162.

Andraws, R., Chawla, P., Brown, D.L., 2005. Cardiovascular effects of ephedra alkaloids: a comprehensive review. Progress Cardiovasc. Dis. 47, 217-225.

Anila, L., Vijayalakshmi, N.R.. 2002. Flavonoids from Emblica officinalis and Mangifera indica-effectiveness for dyslipidemia. J. Ethnopharmacol. 79, 81-87.

Balasuriya, N., Rupasinghe, H.P.V., 2012. Antihypertensive properties of flavonoidrich apple peel extract. Food Chem. 135, 2320-2325.

Bankar, G.R., Nayak, P.G., Bansal, P., Paul, P., Pai, K., Singla, R.K., Bhat, V.G., 2011. Vasorelaxant and antihypertensive effect of Cocos nucifera Linn, endocarp on isolated rat thoracic aorta and DOCA salt-induced hypertensive rats. J. Ethnopharmacol. 134, 50-54.

Barbalho, S.M., Spada, A.P.M., Oliveira, E.P.d., Paiva-Fiiho, M.E., Martuchi, K.A., Leite, N.C., Deus, R.M., Sasaki, V., Braganti, L.S., Oshiiwa, M., 2009. Mentha piperita effects on wistar rats plasma lipids. Braz. Arch. Biol. Technol. 52, 11371143.

Boskabady, M.H., Shafei, M.N., Shakiba, A., Sefidi, H.S., 2008. Effect of aqueousethanol extract from Crocus sativus (saffron) on guinea-pig isolated heart. Phytother. Res. 22, 330-334.

Boskabady, M.H., Vatanprast, A., Parsaee, H., Boskabady, M., 2013. Possible mechanism of inotropic and chronotropic effects of Rosa damascena on isolated guinea pig heart. Darn 21, 38-45.

Boskabady, M.H., Vatanprast, A., Parsee, H., Ghasemzadeh, M., 2011. Effect of aqueous-ethanolic extract from Rosa damascena on guinea pig isolated heart. Iran. J. Basic. MEd. Sci. 14, 116-121.

Byun, S.J., Kim, H.S., Jeon, S.M., Park, Y.B., Choi, M.S., 2001. Supplementation of Areca catechu L. extract alters triglyceride absorption and cholesterol metabolism in rats. Ann. Nutr. Metab. 45, 279-284.

Chan, J.Y.Y., Yuen, A.C.Y., Chan, R.Y.K., Chan, S.W., 2013. A review of the cardiovascular benefits and antioxidant properties of allicin. Phytother. Res. 27, 637-646.

Chang. C.J., Tzeng, T.-F., Liou, S.-S., Chang, Y.-S., Liu, I.M., 2012. Regulation of lipid disorders by ethanol extracts from Zingiber zerumbet in high-fat diet-induced rats. Food Chem. 132, 460-467.

Chen, S.-J., Wang, M.-H., Chen, l.-J., 1996. Antiplatelet and calcium inhibitory properties of eugenol and sodium eugenol acetate. Gen. Pharmacol. Vase. Syst. 27, 629-633.

Chithra, V., Leelamma, S., 1997. Hypolipidemic effect of coriander seeds (Coriandrum sativum): mechanism of action. Plant Foods Hum. Nutr. 51,167-172.

Cho, M.H., Paik, Y.S., Hahn. T.R., 2000. Enzymatic conversion of precarthamin to carthamin by a purified enzyme from the yellow petals of safflower. J. Agric. Food Chem. 48, 3917-3921.

De Geest, S., Scheuiweghs, L., Reynders, L, Pelemans, W., Droogne, W., Van Cleemput, J., Leventhal, M., Vanhaecke, J., 2003. Differences in psychosocial and behavioral profiles between heart failure patients admitted to cardiology and geriatric wards. Eur. J. Heart Failure 5, 557-567.

Ebrahim Sajjadi, S., Movahedian Atar, A., Yektaian, A., 1998. Antihyperlipidemic effect of hydroalcoholic extract, and polyphenolic fraction from Dracocephalum kotschyi Boiss. Pharma. Acta Helvetiae 73, 167-170.

Emami, M., Nazarinia, M.A., Rezaeizadeh, H., Zarshenas, M.M., 2014. Standpoints of traditional Persian physicians on geriatric nutrition. J. Evid. Based Complement. Altern. Med. 19, 287-291.

Emami, M., Sadeghpour, 0., Zarshenas, M.M., 2013. Geriatric management in medieval Persian medicine. J. Mid-Life Health 4. 210-215.

Ernst, E., 1987. Cardiovascular effects of garlic (Allium sativum): a review. Pharmatherapeutica 5, 83-89.

Ersoy, S., Orhan, L, Turan, N.N., [section]ahan, G., Ark, M., Tosun, F., 2008. Endothelium-dependent induction of vasorelaxation by Melissa officinalis L. ssp. officinalis in rat isolated thoracic aorta. Phytomedicine 15, 1087-1092.

Fabricant, D.S., Farnsworth, N.R., 2001. The value of plants used in traditional medicine for drug discovery. Environ. Health Perspect. 109. 69-75.

Fatehi-Hassanabad, Z., Jafarzadeh, M., Tarhini, A., Fatehi, M., 2005. The antihypertensive and vasodilator effects of aqueous extract from Berberis vulgaris fruit on hypertensive rats. Phytother. Res. 19, 222-225.

Fleg, J.L., Aronow, W.S., Frishman, W.H., 2011. Cardiovascular drug therapy in the elderly: benefits and challenges. Nat. Rev. Cardiol. 8, 13-28.

Frishman, W.H., Aronow, W.S., Cheng-Lai, A., 2013. Cardiovascular drug therapy in the elderly. Tresch. Aronow's Cardiovasc. Dis. Elderly. CRC Press, London.

Gazola, R., Machado, D.. Ruggiero, C., Singi, G., Macedo Alexandre, M., 2004. Lippia alba, Melissa officinalis and Cymbopogon citratus: effects of the aqueous extracts on the isolated hearts of rats. Pharmacol. Res. 50, 477-480.

Ghahraman, A., Okhovvat, A., 2004. Matching the Old Medicinal Plant Names with Scientific Terminology. Tehran University Press, Tehran.

Goyal, S.N., Arora, S., Sharma, A.K., Joshi, S., Ray, R., Bhatia, J., Kumari, S., Arya, D.S., 2010. Preventive effect of crocin of Crocus sativus on hemodynamic, biochemical, histopathological and ultrastuctural alterations in isoproterenol-induced cardiotoxicity in rats. Phytomedicine 17, 227-232.

Han, S.-Y., Li, H.-X., Ma, X., Zhang, K., Ma, Z.-Z., Jiang, Y., Tu. P.-F., 2013. Evaluation of the anti-myocardial ischemia effect of individual and combined extracts of Panax notoginseng and Carthamus tinctorius in rats. J. Ethnopharmacol. 145, 722-727.

Hansen, K., Adsersen, A., Christensen, S.B., Jensen, S.R., Nyman, U., Smitt, U.W., 1996. Isolation of an angiotensin converting enzyme (ACE) inhibitor from Olea europaea and Olea lancea. Phytomedicine 2, 319-325.

Harnafi, H., Serghini Caid, H., el Houda Bouanani, N., Aziz, M., Amrani, S., 2008. Hypolipemic activity of polyphenol-rich extracts from Ocimum basilicum in Triton WR-1339-induced hyperlipidemic mice. Food Chem. 108, 205-212.

Hertog, M.G.L, Feskens, E.J.M., Kromhout, D., Hertog, M.G.L., Hollman, P.C.H., Hertog, M.G.L., Katan, M.B., 1993. Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study The Lancet 342, 10071011.

Hilmer, S.N., McLachlan, A.J., Le Couteur, D.G., 2007. Clinical pharmacology in the geriatric patient. Fundam. Clin. Pharmacol. 21, 217-230.

Huang, T.H.W., Yang, Q., Harada, M., Li, G.Q,, Yamahara, J., Roufogalis, B.D., Li, Y., 2005. Pomegranate flower extract diminishes cardiac fibrosis in Zucker diabetic fatty rats: modulation of cardiac endothelin-1 and nuclear factor-kappaB pathways. J. Cardiovasc. Pharmacol. 46, 856-862.

Ibn Sina (Avicenna), 1998. Kitab al-Q|nun fi al-Tibb (Canon of medicine). Senior Press Superintendent, Jamia Hamdard Printing Press, New Delhi.

Ibn Sina (Avicenna), 2009. In: Borghei, H. Razavi (Ed.), The Book on Drugs for Cardiovascular Diseases Translated to Persina by. Nashre Ney/Tehran.

Imenshahidi, M., Hosseinzadeh, H., Javadpour, Y., 2010. Hypotensive effect of aqueous saffron extract (Crocus sadvus L.) and its constituents, safranal and crocin, in normotensive and hypertensive rats. Phytother. Res. 24, 990-994.

Jadeja, R., Thounaojam, M., Patel, D., Devkar, R., Ramachandran, A.V., 2010. Pomegranate (Punica granatum L.) juice supplementation attenuates isoproterenol-induced cardiac necrosis in rats. Cardiovasc. Toxicol. 10, 174-180.

Javed, L, Zia-Ur-Rahman, N., Khan, M.Z., Muhammad, F., Aslam, B., Iqbal, Z., Sultan, J.I., Ahmad, L, 2009. Antihyperlipidaemic efficacy of Trachyspermum ammi in albino rabbits. Acta Veterinaria Brno 78, 229-236.

Jindal, V., Dhingra, D., Sharma, S., Parle, M., Harna, R.K., 2011. Hypolipidemic and weight reducing activity of the ethanolic extract of Tamarindus indica fruit pulp in cafeteria diet- and sulpiride-induced obese rats. J. Pharmacol. Pharmacother. 2, 80-84.

Kareem, M.A., Krushna, G.S., Hussain, S.A., Devi, K.L., 2009. Effect of aqueous extract of nutmeg on hyperglycaemia, hyperlipidaemia and cardiac histology associated with isoproterenol-induced myocardial infarction in rats. Trap. J. Pharma. Res. 8, 337-344.

Khaksari, M., Ahmadi, M., Najafipour, H., Shahrokhi, N.. 2014. Effect of Bunium persicum aqueous extract plus endurance exercise on cardiorespiratory capacity and serum lipid profile. Avicenna J. Phytomed. 4, 118-126.

Khalili, A., Khosravi, M.B., Nekooeian, A.A., 2011. The effects of aqueous extract of vaccinium arctostaphylos leaves on blood pressure in renal hypertensive rats. Iran. Red Crescent Med. J. 13, 123-127.

Khayyal, M.T., el-Ghazaly, MA, Abdallah, D.M., Nassar, N.N., Okpanyi, S.N., Kreuter, M.H., 2002. Blood pressure lowering effect of an olive leaf extract (Olea europaea) in L-NAME induced hypertension in rats. Arzneimittelforschung 52, 797-802.

Kianbakht, S., Abasi, B., Hashem Dabaghian, F., 2014. Improved lipid profile in hyperlipidemic patients taking vaccinium arctostaphylos fruit hydroalcoholic extract: a randomized double-blind placebo-controlled clinical trial. Phytother. Res. 28, 432-436.

Kordafshari, G., Kenari, H.M., Esfahani, M.M., Ardakani, M.R., Keshavarz, M., Nazem, E., Moghimi, M., Zargaran, A., 2015. Nutritional aspects to prevent heart diseases in traditional Persian medicine. J. Evid. Based Complement. Altern. Med. 20, 57-64.

Kulkarni, C.R., Joglekar, M.M., Patil, S.B., Arvindekar, A.U., 2011. Antihyperglycemic and antihyperlipidemic effect of Santalum album in streptozotocin induced diabetic rats. Pharma. Biol. 50, 360-365.

Kwon, E.-K., Lee, D.-Y., Lee, H., Kim, D.-O., Baek, N.-L, Kim, Y.-E., Kim, H.-Y., 2010. Flavonoids from the Buds of Rosa damascena inhibit the activity of 3-hydroxy3- methylglutaryl-coenzyme A reductase and angiotensin 1-converting enzyme. J. Agric. Food Chem. 58, 882-886.

Lau, C.-W., Yao, X.-Q., Chen, Z.-Y., Ko, W.-H., Huang, Y., 2001. Cardiovascular actions of berberine. Cardiovasc. Drug Rev. 19, 234-244.

Li, H.-X., Han, S.-Y., Wang, X.-W., Ma, X., Zhang, K., Wang, L., Ma, Z.-Z., Tu, P.-F., 2009. Effect of the carthamins yellow from Carthamus tinctorius L. on hemorheological disorders of blood stasis in rats. Food Chem. Toxicol. 47, 1797-1802.

Montamat, S.C., Cusack, B.J., Vestal, R.E., 1989. Management of drug therapy in the elderly. New England J. Med. 321, 303-309.

Mozaffarian, V., 2006. Dictionary of Iranian Plant Names. Farhang Moaser Press, Tehran.

Muller-Werdan, U., Meisel, M., Schirdewahn, P., Werdan, K., 2007. Elderly patients with cardiovascular diseases. Der Internist 48,1211-1219.

Muralidharan, A., Dhananjayan, R., 2004. Cardiac stimulant activity of Ocimum basilicum Linn, extracts.. Indian J. Pharmacol. 36, 163-166.

Musselman, D.L, Evans, D.L., Nemeroff, C.B., 1998. The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Arch. Gen. Psychiatr. 55, 580-592.

Parab, R.S., Mengi, S.A., 2002. Hypolipidemic activity of Acorns calamus L. in rats. Fitoterapia 73, 451-455.

Pardo-Andreu, G.L., Philip, S.J., Riafio, A., SSnchez, C., Viada, C., Nunez-Selles, A.J., Delgado, R., 2006. Mangifera indica L. (Vimang) protection against Serum Oxidative Stress in Elderly Humans. Arch. Med. Res. 37, 158-164.

Parsaee, H., Shafei, M., Boskabady, M., 2006. Effects of hydro-ethanolic extract of berberis vulgaris fruit on rabbit isolated heart. DARU 14, 208.

Patel, D.K., Desai, S.N., Gandhi, H.P., Devkar, R.V., Ramachandran, A.V., 2012. Cardio protective effect of Coriandrum sativum L on isoproterenol induced myocardial necrosis in rats. Food Chem. Toxicol. 50, 3120-3125.

Pathy, M.S.J., Sinclair, A.J., Morley, J.E., 2006. Principles and Practice of Geriatric Medicine, vol. 2, Fourth Ed. John Wiley & Sons, Ltd. Chichester.

Postema, P.G., Tan, H.L., Wilde, A.A., 2013. Ageing and Brugada syndrome: considerations and recommendations. J. Geriatr. Cardiol.: JGC 10, 75-81.

Quan, Y., Wang, Z.Y., Xiong, M., Xiao, Z.T., Zhang, H.Y., 2014. Dissecting traditional Chinese medicines by omics and bioinformatics. Nat. Prod. Commun. 9, 1391-1396.

Rajput, M.A., Khan, R.A., Qazi. N., Feroz, Z., 2012. Effect of methanol extract of ajwain (Trachyspermum ammi L) on blood coagulation in rats. J. Liaquat Univ. Med. Health Sci. 11, 105-108.

Ram, A., Lauria, P., Gupta, R., Sharma, V.N., 1996. Hypolipidaemic effect of Myristica fragrans fruit extract in rabbits. J. Ethnopharmacol. 55, 49-53.

Reddy, V.R.C., Kumari, S.R., Reddy, B.M., Azeem, M., Prabhakar, M., Rao, A.A., 1990. Cardiotonic activity of the fruits of Terminalia chebula. Fitoterapia 41, 517-525.

Rhazes, 2005. Kitab al-hawl fi al-Tibb (The Comprehensive Book on Medicine or Liber Continens). Academy of Medical Sciences, Tehran.

Rich, M.W., Beckham, V., Wittenberg, C., Leven, C.L., Freedland, K.E., Carney, R.M., 1995. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. New Engl. J. Med. 333, 1190-1195.

Rosa, A., Melis, M.P., Deiana, M., Atzeri, A., Appendino, G., Corona, G., lncani, A., Loru, D., Dessi, M.A., 2008. Protective effect of the oligomeric acylphloroglucinols from Myrtus communis on cholesterol and human low density lipoprotein oxidation. Chem. Phys. Lipids 155, 16-23.

Salgado, J.M., Curte, F., Mansi, D.N., 2008. Effect of gala apples (Malus domestica Borkh) on lipidemia of hyperlipidemic rats. Food Sci. Technol. (Campinas) 28, 477-484.

Samarghandian, S., Borji, A., Hidar Tabasi, S., 2013. Effects of Cichorium Intybus Linn on blood glucose, lipid constituents and selected oxidative stress parameters in streptozotocin-induced diabetic rats. Cardiovasc. Haematol. Disorders 13, 231236.

Shah, A., Gilani, A., 2012. Aqueous-methanolic extract of sweet flag (Acorns calamus) possesses cardiac depressant and endothelial-derived hyperpolarizing factormediated coronary vasodilator effects. J. Nat. Med. 66, 119-126.

Shah, A.J., Gilani, A.H., 2009. Blood pressure-lowering and vascular modulator effects of Acorus calamus extract are mediated through multiple pathways. J. Cardiovasc. Pharmacol. 54, 38-46.

Sheehan, M., Wong, H.R., Hake, P.W., Malhotra, V., O'Connor, M., Zingarelli, B., 2002. Parthenolide, an inhibitor of the nuclear factor-kappaB pathway, ameliorates cardiovascular derangement and outcome in endotoxic shock in rodents. Mol. Pharmacol. 61, 953-963.

Shirazi, A., 2009. Makhzan al-adviyah (The Storehouse of Medicaments). Tehran University of Medical Sciences, Tehran.

Shukri, R., Mohamed, S., Mustapha, N.M., 2010. Cloves protect the heart, liver and lens of diabetic rats. Food Chem. 122, 1116-1121.

Siti, H.N., Kamisah, Y., Kamsiah, J., 2015. The role of oxidative stress, antioxidants and vascular inflammation in cardiovascular disease (a review). Vascular Pharmacol. 71, 40-56.

Soltani, A., 2004. Dictionary of Medicinal Plants. Arjmand Press, Tehran.

Somova, LL, Shode, F.O., Ramnanan, P., Nadar, A., 2003. Antihypertensive, antiatherosclerotic and antioxidant activity of triterpenoids isolated from Olea europaea, subspecies Africana leaves. J. Ethnopharmacol. 84, 299-305.

Srivastava, K.C., Malhotra, N., 1991. Acetyl eugenol, a component of oil of cloves (Syzygium aromaticum L.) inhibits aggregation and alters arachidonic acid metabolism in human blood platelets. Prostaglandins Leukot. Essent. Fatty Acids 42, 73-81.

Srividya, A., Dhanabal, S., Yadav, A.K., Sathish Kumar, M., Vishnuvarthan, V., 2012. Phytopreventive antihyperlipidemic activity of Curcuma zedoaria. Bull. Pharm. Res 2, 22-25.

Suchalatha, S., Shyamala Devi, C.S., 2004. Protective effect of Terminalia chebula against experimental myocardial injury induced by isoproterenol. Indian j. Exp. Biol. 42, 174-178.

Tauseef Siddiqui, M., Siddiqi, M., 1976. Hypolipidemic principles of Cicer Arietinum: Biochanin-A and formononetin. Lipids 11, 243-246.

Thomas, F., 2000. PDR for Herbal Medicine. Medical Economics Company, Montval New Jersy, pp. 829-830.

Tunakabuni, D., 2007. Tuhfat al-mu'minin (The Present for the Faithful). Research Center of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Nashre Shahr Press, Tehran.

Tzeng, T.-F., Lu, H.-J., Liou, S.-S., Chang, C.J., Liu, I.M., 2014. Lipid-lowering effects of zerumbone, a natural cyclic sesquiterpene of Zingiber zerumbet Smith, in high-fat diet-induced hyperlipidemic hamsters. Food Chem. Toxicol. 69, 132-139.

Umar, A., Imam, G., Yimin, W., Kerim, P., Tohti, I., Berke, B., Moore, N., 2010. Antihypertensive effects of Ocimum basilicum L. (OBL) on blood pressure in renovascular hypertensive rats. Hypertens. Res.: Off. J. jpn. Soc. Hypertens. 33, 727-730.

Van der Kooy, K., van Hout, H., Marwijk, FI., Marten, H., Stehouwer, C., Beekman, A., 2007. Depression and the risk for cardiovascular diseases: systematic review and meta analysis. Int. J. Geriatr. Psychiatr. 22, 613-626.

Vasishta, S., Toor, F., Johansen, A., Hasan, M., 2001. Stroke prevention in atrial fibrillation: physicians' attitudes to anticoagulation in older people. Arch. Gerontol. Geriatr. 33, 219-226.

Vineetha, V.P., Girija, S., Soumya, R.S., Raghu, K.G., 2014. Polyphenol-rich apple (Malus domesrica L) peel extract attenuates arsenic trioxide induced cardiotoxicity in H9c2 cells via its antioxidant activity. Food Funct. 5, 502-511.

Wilson, P.W.F., Kannel, W.B., 2002. Obesity, diabetes, and risk of cardiovascular disease in the elderly. Am. J. Geriatr. Cardiol. 11, 119-124.

Yust Mdel, M., Millan-Linares Mdel, C., Alcaide-Hidalgo, J.M., Millan, F., Pedroche, J., 2012. Hypocholesterolaemic and antioxidant activities of chickpea (Cicer arietinum L.) protein hydrolysates. J. Sci. Food Agric. 92,1994-2001.

Zargaran, A., 2014. Ancient Persian medical views on the heart and blood in the Sassanid era (224-637 AD). Int. J. Cardiol. 172, 307-312.

Zargaran, A., Zarshenas, M.M., Karimi, A., Yarmohammadi, H., Borhani-Haghighi, A., 2013. Management of stroke as described by Ibn Sina (Avicenna) in the Canon of Medicine. Int. J. Cardiol. 169, 233-237.

Zarshenas, M.M., Petramfar, P., Firoozabadi, A., Moein, M.R., Mohagheghzadeh, A., 2013. Types of headache and those remedies in traditional Persian medicine. Pharmacogn. Rev. 7, 17-26.

Zarshenas, M.M., Zargaran, A., 2015. A review on the Avicenna's contribution to the field of cardiology. Int. J. Cardiol. 182, 237-241.

Mohammad M. Zarshenas (a,b) *, Sahar Jamshidi (b), Arman Zargaran (c,d)

(a) Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

(b) Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran

(c) Department of Traditional Pharmacy, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran. Iran

(d) Research Office for the History of Persian Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Abbreviations: TPM, traditional Persian medicine; PM, Persian medicine.

* Corresponding author. Department of Phytopharmaceuticals (Traditional Pharmacy). School of Pharmacy. Shiraz University of Medical Sciences, Shiraz. Iran. Tel.: 71345 1583; fax: 713242 4256.

E-mail address: zarm@sums.ac.ir (M.M. Zarshenas).

http://dx.doi.org/10.1016/j.phymed.2016.01.014
Table 1
Herbal remedies for geriatrics reported in TPM.

Family          Scientific name                         Traditional
                                                        Name

Acoraceae       Acorus calamus L.                       Vaj
Amaryllidaceae  Allium sativum L.                       Soom
Anacardiaceae   Mangifera indica L                      Anbaj
Apiaceae        Bunium persicum (Boiss.) B. Fedtsch.    Kommoon
Arecaceae       Cocos nucifera L.                       Narjeel
Asteraceae      Tanacetum parthenium (L.) Sch. Bip.     Aghhovan
                Matricaria chamomilla L.                Baboonaj
                Carthamus tinctorius L.                 Ghortom
Boraginaceae    Myosotis scorpioides L.                 Azanolfar
                Echium amoenum Fisch. & Mey.            Lesan-al-sour
Combretaceae    Terminalia chebula Retz.                Ahlilaj
Cucurbitaceae   Bryonia dioica Jacq.                    Foshagh
Cuscutaceae     Cuscuta epithymum L.                    Aftimoon
Fabaceae        Lupinus termis L.                       Termes
                Abrus precatorius L.                    Ain-ol-deek
                Cicer arietinum 1.                      Hemmas
Juglandaceae    Juglans regia L.                        Jowz
Lamiaceae       Dracocephalum kotschyi Boiss            Zarringiah
                Melissa officinalis L.                  Badranjbooye
                Ocimum basilicum L.                     Reyhan
Meliaceae       Azadirachta indica LC. Juss             Azaaddrakht
Myristicaceae   Myristica fragrans Houtt.               jowzbooa
Myrtaceae       Myrtus communis L.                      Moord (As)
Oleaceae        Olea europaea L.                        Zeytoon
Poaceae         Saccharum officinarum L.                Sokkar
Polygonaceae    Persicaria bistorta (L.) Samp.          Anjebar
Punicaceae      Punica granatum L                       Jolnar
Rosaceae        Cotoneaster nummularius Fisch. & Mey.   Shirkhesht
                Prunus dulcis (Mill.) D.A.Webb          Lawz
                Malus domestica Borkh.                  Toffah
                Prunus mahaleb L.                       Hab-ol-mahlab
Rubiaceae       Coffea arabica L                        Bon
Smilacaceae     Smilax china L.                         Choob-e-chini
Zingiberaceae   Curcuma zedoaria (Christm.) Roscoe      Jadwar

Family          Scientific name                         Part used

Acoraceae       Acorus calamus L.                       Root
Amaryllidaceae  Allium sativum L.                       Root
Anacardiaceae   Mangifera indica L                      Bark, Fruit
Apiaceae        Bunium persicum (Boiss.) B. Fedtsch.    Seed
Arecaceae       Cocos nucifera L.                       Fruit
Asteraceae      Tanacetum parthenium (L.) Sch. Bip.     Flower
                Matricaria chamomilla L.                Aerial part
                Carthamus tinctorius L.                 Seed
Boraginaceae    Myosotis scorpioides L.                 Aerial part
                Echium amoenum Fisch. & Mey.            Flower
Combretaceae    Terminalia chebula Retz.                Fruit
Cucurbitaceae   Bryonia dioica Jacq.                    Fruit, Leaf
Cuscutaceae     Cuscuta epithymum L.                    Aerial part
Fabaceae        Lupinus termis L.                       Seed
                Abrus precatorius L.                    Seed
                Cicer arietinum 1.                      Seed
Juglandaceae    Juglans regia L.                        Fruit
Lamiaceae       Dracocephalum kotschyi Boiss            Root
                Melissa officinalis L.                  Leaf
                Ocimum basilicum L.                     Leaf
Meliaceae       Azadirachta indica LC. Juss             Flower
Myristicaceae   Myristica fragrans Houtt.               Fruit
Myrtaceae       Myrtus communis L.                      Fruit, Leaf
Oleaceae        Olea europaea L.                        Fruit oil, Leaf
Poaceae         Saccharum officinarum L.                Extract
Polygonaceae    Persicaria bistorta (L.) Samp.          Aerial part
Punicaceae      Punica granatum L                       Flower, Fruit
Rosaceae        Cotoneaster nummularius Fisch. & Mey.   Gum
                Prunus dulcis (Mill.) D.A.Webb          Seed oil
                Malus domestica Borkh.                  Fruit
                Prunus mahaleb L.                       Seed
Rubiaceae       Coffea arabica L                        Seed
Smilacaceae     Smilax china L.                         Root
Zingiberaceae   Curcuma zedoaria (Christm.) Roscoe      Root

Table 2 Cardiovascular remedies reported in TPM manuscripts.

Family            Scientific name             Traditional name

Anacardiaceae     Pistacia vera L.            Kazbareh
Apiaceae          Coriandrum sativum L.       Kazboreh
                  Trachyspermum ammi (L.)     Nankhah
                    Sprague
Arecaceae         Areca catechu L.            Fofal
Asteraceae        Doronicum pardalianches     Daronaj
                    L.
                  Cichorium intybus L         Hendaba
Berberidaceae     Berberis vulgaris L.        Ambarbaris

Boraginaceae      Echium amoenum Fisch. &     Lesan-ol-haml
                    C.A.Mey.
Caryophyllaceae   Holosteum umbellatum L.     Jabreh

Combretaceae      Terminalia chebula Retz.    Ahlilaj
Ephedraceae       Ephedra sinica Stapf        Ormak

Elaeagnaceae      Elaeagnus angustifolia L.   Chabira
Fabaceae          Tamarindus indica L.        Tamre hendi
                  Haematoxylum                Aflanjeh
                    campechianum L.
Iridaceae         Crocus sativus L.           Zaferan
Lamiaceae         Nepeta menthoides Boiss.    Ostokhodos
                    8: Buhse
                  Melissa officinalis L.      Badranjbooye
                  Ocimum basilicum L.         Reyhan

                  Mentha x piperita L.        Naana
                  Scutellaria lateriflora L   Faranjamshak
Lauraceae         Cinnamomum camphora (L)     Kafoor
                    J.Presl
Lauraceae         Cinnamomum verum J.Presl    Darsini
Myrtaceae         Myrtus communis L           Moord (As)
                  Syzygium aromaticum (L.)    Charanfol
                    Merr. & L.M.Perry
Nymphaeaceae      Nymphae a alba L            Niloofar
Papaveraceae      Fumaria parviflora Lam.     Shahtareh
Phyllanthaceae    Phyllanthus emblica L       Amlaj
Rosaceae          Malus domestica Borkh.      Toffah
                  Pyrus communis L.           Komsari
                  Rosa damascena Mill.        Vard ahmar

Rutaceae          Citrus medica L.            Otroj
Salicaceae        Salix alba L.               Khalaf
Santalaceae       Santalum album L.           Sandal
Thymelaeaceae     Aquilaria sinensis          Ood
                    (Lour.) Spreng.
Zingiberaceae     Amomum aculeatum Roxb.      Ghagholeh
                  Zingiber zerumbet (L.)      Zaranbad
                    Roscoe ex Sm.
                  Alpinia galanga (L.)        Kholanjan
                    Willd.
                  Curcuma zedoaria            Jadwar
                    (Christm.) Roscoe

Family            Scientific name             Effects

Anacardiaceae     Pistacia vera L.            Cardiotonic
Apiaceae          Coriandrum sativum L.       Cardiotonic, Refresher
                  Trachyspermum ammi (L.)     To alleviate the
                    Sprague                     palpitation
Arecaceae         Areca catechu L.
Asteraceae        Doronicum pardalianches     Potent refresher
                    L.
                  Cichorium intybus L         Blood refiner
Berberidaceae     Berberis vulgaris L.        Blood refiner,
                                                Cardiotonic
Boraginaceae      Echium amoenum Fisch. &     Cardiac refresher
                    C.A.Mey.
Caryophyllaceae   Holosteum umbellatum L.     Blood refiner.
                                                Refresher
Combretaceae      Terminalia chebula Retz.    Refresher
Ephedraceae       Ephedra sinica Stapf        Cardiotonic
                                                (contractility)
Elaeagnaceae      Elaeagnus angustifolia L.   Refresher
Fabaceae          Tamarindus indica L.        Cardiotonic
                  Haematoxylum                Cardiotonic
                    campechianum L.
Iridaceae         Crocus sativus L.           Cardiotonic
Lamiaceae         Nepeta menthoides Boiss.    Tranquilizer,
                    8: Buhse                    Cardiotonic
                  Melissa officinalis L.      Tranquilizer, Refresher
                  Ocimum basilicum L.         To alleviate
                                                palpitation
                  Mentha x piperita L.        Refresher
                  Scutellaria lateriflora L   Refresher, Tranquilizer
Lauraceae         Cinnamomum camphora (L)     Refresher, Tranquilizer
                    J.Presl
Lauraceae         Cinnamomum verum J.Presl    Cardiotonic
Myrtaceae         Myrtus communis L           Cardiotonic
                  Syzygium aromaticum (L.)    Refresher
                    Merr. & L.M.Perry
Nymphaeaceae      Nymphae a alba L            Tranquilizer
Papaveraceae      Fumaria parviflora Lam.     Blood refiner
Phyllanthaceae    Phyllanthus emblica L       Cardiotonic, Refresher
Rosaceae          Malus domestica Borkh.      Potent cardiotonic
                  Pyrus communis L.           Cardiotonic
                  Rosa damascena Mill.        To alleviate
                                                palpitation
Rutaceae          Citrus medica L.            Cardiotonic
Salicaceae        Salix alba L.               Refresher
Santalaceae       Santalum album L.           Cardiotonic, Refresher
Thymelaeaceae     Aquilaria sinensis
                    (Lour.) Spreng.
Zingiberaceae     Amomum aculeatum Roxb.
                  Zingiber zerumbet (L.)      Cardiotonic
                    Roscoe ex Sm.
                  Alpinia galanga (L.)
                    Willd.
                  Curcuma zedoaria            Potent cardiotonic
                    (Christm.) Roscoe

Family            Scientific name             Part used

Anacardiaceae     Pistacia vera L.            Seed
Apiaceae          Coriandrum sativum L.       Seed
                  Trachyspermum ammi (L.)     Seed
                    Sprague
Arecaceae         Areca catechu L.            Fruit
Asteraceae        Doronicum pardalianches     Root
                    L.
                  Cichorium intybus L         Leaf, Seed
Berberidaceae     Berberis vulgaris L.        Fruit

Boraginaceae      Echium amoenum Fisch. &     Flower
                    C.A.Mey.
Caryophyllaceae   Holosteum umbellatum L.     Root

Combretaceae      Terminalia chebula Retz.    Fruit
Ephedraceae       Ephedra sinica Stapf        Aerial part

Elaeagnaceae      Elaeagnus angustifolia L.   Fruit, Flower, Leaf
Fabaceae          Tamarindus indica L.        Fruit
                  Haematoxylum                Seed
                    campechianum L.
Iridaceae         Crocus sativus L.           Flower
Lamiaceae         Nepeta menthoides Boiss.    Aerial part
                    8: Buhse
                  Melissa officinalis L.      Leaf
                  Ocimum basilicum L.         Leaf

                  Mentha x piperita L.        Aerial part
                  Scutellaria lateriflora L   Leaf, Seed
Lauraceae         Cinnamomum camphora (L)     Gum
                    J.Presl
Lauraceae         Cinnamomum verum J.Presl
Myrtaceae         Myrtus communis L           Fruit
                  Syzygium aromaticum (L.)    Fruit
                    Merr. & L.M.Perry
Nymphaeaceae      Nymphae a alba L            Flower
Papaveraceae      Fumaria parviflora Lam.     Leaf
Phyllanthaceae    Phyllanthus emblica L       Fruit
Rosaceae          Malus domestica Borkh.      Fruit
                  Pyrus communis L.           Fruit
                  Rosa damascena Mill.        Flower

Rutaceae          Citrus medica L.            Peel
Salicaceae        Salix alba L.               Flower
Santalaceae       Santalum album L.           Bark
Thymelaeaceae     Aquilaria sinensis          Bark
                    (Lour.) Spreng.
Zingiberaceae     Amomum aculeatum Roxb.      Pod
                  Zingiber zerumbet (L.)      Root
                    Roscoe ex Sm.
                  Alpinia galanga (L.)        Root
                    Willd.
                  Curcuma zedoaria
                    (Christm.) Roscoe

Table 3
Cardiovascular and allied activities of plants either for
geriatrics or reported as cardioactive natural medicaments.

Plant name              Pharmacological activities

Plants traditionally reported as useful remedies for geriatrics

Acorus calamus          --Hypolipidemic activity versus Gemfibrozil
                        for 30 days (in vivo study)

                        --Blood Pressure-lowering, Vascular Modulator
                        (in vivo study)

                        --Coronary vasodilator effect (in vitro
                        study)

Allium sativum          --Effective on blood sugar, blood pressure,
                        coagulation, lipid profile (review on
                        previous works)

Mangifera indica        --Reduced lipid levels in
                        hyperlipidemia-induced rats (in vivo study)

                        --Prevented age-associated oxidative stress
                        in elderly (Human study)

Bunium persicum         --Increased cardiorespiratory capacity,
                        reduced cholesterol and triglyceride levels
                        in affected rats (in vivo study)

Cocos nucifera          --Vasorelaxant and antihypertensive effects
                        (in vitro study)

Tanacetum parthenium    --Ameliorated cardiovascular derangement and
                        improved hemodynamic profile (in vivo study)

Carthamus tinctorius    --Ameliorated anti-myocardial ischemia
                        injuries via decreasing oxidative stress and
                        inflammatory cascade (in vivo study)

                        --Decreased blood and plasma viscosity,
                        erythrocyte aggregation index, platelet
                        aggregation (in vivo study)

Terminalia chebula      --Decreased isoproterenol effects on lipid
                        peroxidation and myocardial necrosis (in vivo
                        study)

                        --Cardiotonic activity (increasing the
                        contraction force and cardiac output of frog
                        heart) (in vivo study)

Cicer arietinum         --Possessed hypolipidemic properties (in vivo
                        study)

                        --Hypocholesterolaemic activities (in vitro
                        study)

Dracocephalum           --Decreased the blood triglyceride, total
kotschyi                cholesterol and LDL-cholesterol levels (in
                        vivo study)

Melissa officinalis     --Provoked cardiac rate reduction without
                        altering the contractility (in vitro study)

                        --Vasorelaxation (thoracic aorta) via
                        nitric-oxide pathway (in vitro study)

                        --Reduced ventricular premature beats,
                        ventricular tachycardia, and ventricular
                        fibrillation (in vivo study)

Ocimum basilicum        --Cardiac stimulant (positive ionotropic and
                        negative chronotropic actions) (in vivo
                        study)

                        --Hypolipidemic activity (in vivo study)

                        --Vasorelaxant effect (thoracic aorta), anti-
                        platelet aggregation (in vitro study)

                        --Antihypertensive effects (in vivo study)

Myristica fragrans      --Hypolipidemic effect and platelet
                        anti-aggregatory ability (in vivo study)

                        --Hypolipidemic activity against
                        Isoproterenol myocardial infarction- induced
                        (in vivo study)

Myrtus communis         --Effects on cholesterol and human LDL
                        oxidation (in vitro study)

                        --Negative inotropic effect (isolated guinea
                        pig atria) (in vitro study)

Olea europaea           --Prevented the development of severe
                        hypertension and atherosclerosis, Blood
                        pressure lowering effect (in vivo study)

                        --Inhibited Angiotensin Converting Enzyme (in
                        vitro study)

Punica granacum         --Protective effects against
                        isoproterenol-induced cardiac necrosis in
                        rats (in vivo study)

                        --Reduced the up-regulated cardiac mRNA
                        expression and decreased cardiac fibrosis (in
                        vivo study)

Malus domestica         --Reduced total cholesterol and LDL serum
                        levels (in vivo study)

                        --Inhibited angiotensin converting enzyme (in
                        vitro study)

                        --Against Arsenic trioxide-induced
                        cardiotoxicity (in vitro study)

Curcuma zedoaria        --Antihyperlipidemic activities via reducing
                        the level of triglyceride (in vitro study)

Plants reported as remedies with cardiovascular activities in TPM

Coriandrum sativum      --Hypocholesterolaemic effects via induction
                        of related enzymes and increasing lipolytic
                        activities (in vivo study)

                        --Inhibition of myofibrillar damage in
                        Isoproterenol- induced cardiotoxicity (in
                        vivo study)

Citrus medica           --Attenuates oxidative stress and cardiac
                        dysrhythmia (in vivo)

Ephedra sinica          --[alpha]- and [beta]-adrenergic agonists
                        (Review)

Trachyspermum aami      --Antihyperlipidemic activity (in vivo study)

                        --Calcium channel blocker-like effects (in
                        vivo study)

                        --Anticoagulant (increased PT via extrinsic
                        pathway) (in vivo study)

Areca catechu           --Reduced absorption of triglyceride, plasma
                        lipid concentration and pancreatic
                        cholesterol esterase (in vivo study)

Cichorium intybus       --Reduced triglyceride, total cholesterol and
                        LDL as well as increasing HDL (in vivo study)

Berberis vulgaris       --Vasodilatory and antihypertensive
                        activities (in endothelial dysfunction
                        conditions; in vivo study)

                        --Improved heart contractility via activation
                        of the calcium channel (in vitro study)

                        --Positive inotropic, negative chronotropic,
                        antiarrhythmic, and vasodilator properties
                        (Review)

Vaccinium               --Improved lipid and cholesterol profile
arctostaphylos          (Human study)

                        --Hypotensive activities without changing
                        heart rate (in vivo study)

Tamarindus indica       --Hypolipidemic and weight-reducing
                        activities (in vivo study)

Crocus sativus          --Hypotensive properties (in vivo study)

                        --Cardio-protective effect in
                        Isoproterenol-induced toxicity (via
                        modulation of oxidative stress) (in vivo
                        study)

                        --Inhibited calcium channel blocker (in vitro
                        study)

Mentha piperita         --Decreased the level of LDL (in vivo study)

Syzygium                --Inhibited hyperglycemia-induced oxidative
aromaticum              tissue (in vivo study)

                        --Inhibited thromboxane B2 and prostaglandin
                        [E.sub.2] formation (Antiplatelet activity)
                        (in vitro study)

Rosa damascena          --Inhibited angiotensin I-converting enzyme
                        ([IC.sub.50]: 138.8 [micro]M) (in vitro
                        study)

                        --Inotropic and chronotropic effects via
                        stimulation of [beta]-adrenoceptors (in vitro
                        study)

Santalum album          Antihyperlipidemic effect in diabetic rats
                        (in vivo study)

Zingiber zerumbet       --Antihyperlipidemic effects (Reduction in
                        the accumulation of visceral fat; in vivo
                        study)

                        --Decreased in plasma and hepatic lipid
                        accumulation, increased fecal lipid excretion
                        (in vivo study)

Alpinia galanga         --Decreased total cholesterol, triglycerides
                        and phospholipids as well as increasing in
                        HDL (in vivo study)

Plant name              Fractions and           References
                        phytochemicals

Plants traditionally reported as useful remedies for geriatrics

Acorus calamus          --50% ethanol extract   (Parab and Mengi
                        (100 and 200 mg/kg)     2002)
                        and isolated saponins
                        (10 mg/kg)

                        --Ethyl acetate and     (Shah and Gilani
                        n-Hexane fractions      2009)

                        --Crude, Ethyl          (Shah and Gilani
                        acetate, n-Hexane       2012)
                        fractions

Allium sativum          --Allicin, Alliin       (Chan et ai. 2013;
                                                Ernst 1987)

Mangifera indica        --Flavonoids            (Anila and
                                                Vijayalakshmi 2002)

                        --Extract (Coated       (Pardo-Andreu et al.
                        tablets)                2006)

Bunium persicum         --Freeze-dried          (Khaksari et al.
                        aqueous extract         2014)

Cocos nucifera          --Ethanol extract       (Bankar et al. 2011)
                        (Phenols and
                        flavonoids),
                        Chlorogenic, Vanillic
                        and Feruiic acid

Tanacetum parthenium    --Sesquiterpene         (Sheehan et al. 2002)
                        lactone
                        (Parthenolide)

Carthamus tinctorius    --Hydroxysafflor        (Han et al. 2013)
                        yellow A,
                        Anhydrosafflor yellow
                        B, kaempferol

                        --Carthamins yellow     (Li et al. 2009)

Terminalia chebula      --Ethanol extract       (Suchalatha and
                                                Shyamala Devi 2004)

                        --Steroids/             (Reddy et al. 1990)
                        sapogenins, saponins,
                        tannins and
                        anthraquinone
                        derivatives

Cicer arietinum         --Biochanin-A and       (Tauseef Siddiqui and
                        Formononetin            Siddiqi 1976)

                        --Protein               (Yust Mdel et al.
                        hydrolysates            2012)

Dracocephalum           --Hydroalcoholic and    (Ebrahim Sajjadi et
kotschyi                polyphenol fraction     al. 1998)

Melissa officinalis     --Aqueous extract       (Gazola et al. 2004)

                        --Lyophilized aqueous   (Ersoy et al. 2008)
                        extract

                        --70% ethanol extract   (Akhondali et al.
                        (polyphenols)           2015)

Ocimum basilicum        --95% ethanol and       (Muralidharan and
                        distilled water         Dhananjayan 2004)
                        extract

                        --Polyphenol-rich       (Hamafi et al. 2008)
                        extract

                        --Aqueous extract       (Amrani et al. 2009)

                        --Aqueous extract       (Umar et al. 2010)

Myristica fragrans      --Ethanol extract       (Ram et al. 1996)

                        --Aqueous extract       (Kareem et al. 2009)

Myrtus communis         --Oligomeric            (Rosa et al. 2008)
                        acylphloroglucinols,
                        semi myrtucommulone
                        and myrtucommulone A

                        --Aqueous (adenosine-   (Al-Jeboory et al.
                        like compounds)         1985)

Olea europaea           --Isolated              (Khayyal et al. 2002;
                        triterpenoids           Somova et al. 2003)

                        --Aqueous extract       (Hansen et al. 1996)
                        (Secoiridoids)

Punica granacum         --Fresh fruit juice     Qadeja et al. 2010)

                        --Methanol extract      (Huang et al., 2005)

Malus domestica         --Fruit (15 and 25%     (Salgado et al. 2008)
                        apple diets, Phenolic
                        compounds and
                        tannins)

                        --Flavonoid-rich        (Balasuriya and
                        (Quercetin) extract     Rupasinghe 2012)

                        --Methanol and          (Vineetha et al.
                        aqueous (Polyphenol-    2014)
                        rich)

Curcuma zedoaria        --Hydroalcoholic        (Srividya et al.
                        extract (alkaloids)     2012)

Plants reported as remedies with cardiovascular activities in TPM

Coriandrum sativum      --Coriander seeds,      (Aissaoui et al.
                        aqueous extract         2011; Chithra and
                                                Leelamma 1997)

                        --Methanol extract      (Patel et al. 2012)
                        (polyphenol-rich)

Citrus medica           --Ethanol extract       (Al-Yahya et al.
                        (Phenolic and           2013)
                        flavonoid content)

Ephedra sinica          --Alkaloids             (Andraws et al. 2005)

Trachyspermum aami      --Seed powder           (Javed et al. 2009)

                        --70% ethanol           (Aftab et al. 1995)
                        (Thymol)

                        --Methanol extract      (Rajput et al. 2012)
                        (soaked for 30 days)

Areca catechu           --Hydroalcoholic        (Byun et al. 2001)
                        extract

Cichorium intybus       --Ethanol extract       (Samarghandian et al.
                                                2013)

Berberis vulgaris       --Aqueous extract       (Fatehi-Hassanabad et
                                                al. 2005)

                        --Hydroalcoholic        (Parsaee et al. 2006)
                        extract

                        --Berberine,            (Lau et al. 2001)
                        tetrahydroberberine
                        and 8-oxoberberine

Vaccinium               --Hydroalcoholic        (Kianbakht et al.
arctostaphylos          extract                 2014)
                        (Anthocyanins)

                        --Aqueous extract       (Khalili et al. 2011)
                        (Leaves)

Tamarindus indica       --Ethanol extract       (Jindal et al. 2011)
                        (Flavonoids and ploy-
                        phenolic compounds)

Crocus sativus          --Aqueous extract,      (Imenshahidi et al.
                        crocin and safranal     2010)

                        --Crocin                (Goyal et al. 2010)

                        --Aqueous-ethanol       (Boskabady et al.
                        extract                 2008)

Mentha piperita         --Juice and tea         (Barbalho et al.
                                                2009)

Syzygium                --Essential oil         (Shukri et al. 2010)
aromaticum              (Eugenol, eugenyl
                        acetate)

                        --Eugenol and sodium    (Chen et al. 1996;
                        eugenol acetate,        Srivastava and
                        acetyl eugenol          Malhotra 1991)

Rosa damascena          --Flavonoids and        (Kwon et al. 2010)
                        flavonoid glycosides

                        --Aqueous-ethanol       (Boskabady et al.
                        extract                 2013; Boskabady et
                                                al. 2011)

Santalum album          --Petroleum-ether       (Kulkarni et al.
                        fraction                2011)

Zingiber zerumbet       --Ethanol extract       (Chang et al. 2012)

                        --Zerumbone, a          (Tzeng et al. 2014)
                        natural cyclic
                        sesquiterpene

Alpinia galanga         --Ethanol extract       (Achuthan and
                                                Padikkala 1997)

Table 4
Description of some main secondary metabolites in cited
cardio-geriatric medicines.

Plant                   Class of metabolite     Phytochemical
                                                compositions

Myrtus communis         -Essential oil          1, 8-cineol, [alpha]-
                                                pinene, myrtenol,
                                                myrtenyl acetate,
                                                limonene

                        -Tannins                Gallotannins,
                                                condensed tannins

                        -Acylphloroglucinols    Myrtocommulon A and B

                        -Polyphenolic           Gallic acid
                        compounds

                        -Flavonoids             Kaempferol,
                                                quercetin, myricetin

                        -Anthocyanins

Melissa officinalis     -Essential oil          (Main constituents)
                                                Geranial, neral,
                                                citronellal Linalool,
                                                geraniol, geranyl
                                                acetate

                        -Glycosides of          Eugenol glucoside
                        alcoholic or phenolic
                        components of the
                        essential oil

                        -Caffeic acid           Rosmarinic acid
                        derivatives

                        -Flavonoids             Cynaroside,
                                                naringenin,
                                                cosmosiin,
                                                rhamnocitrin,
                                                isoquercitrin

                        -Triterpene acids       Ursolic acid

                        -Unsaturated            Coumaric acid
                        carboxylic acid

Ocimum basilicum        -Essential oil          Chavicol methyl
                                                ether, linalool and
                                                eugenol

                        -Caffeic acid           Rosmarinic acid
                        derivatives

                        -Flavonoids             Luteolin-7-
                                                Oglucoside,
                                                isoquercitrin,
                                                apigenin-7-
                                                Oglucoside and
                                                rhamnocitrin

                        -Phenyl propanoids      Ferulic acid,
                                                Hydroxycinnamic acid

Malus domestica         -Fruit acids            Malic, Quinic,
                                                citric, succinic, and
                                                lactic acid

                        -Caffeic acid           5-caffeoyl quinic
                        derivatives             acid

                        -Aromatic substances    Hexanal, hexanol,
                        -Pectins and tannins    beta-damascenone.
                                                ethyl butyrate

                        -Vitamins               Ascorbic acid

Terminalia chebula      -Tannins                Gallotannins
                                                (terchebulin,
                                                terflavin,
                                                punicalagin,
                                                corilagin, chebulic
                                                acid, and chebulinic
                                                acid)

                        -Monosaccharides/       D-glucose, D-
                        oligosaccharides        fructose, saccharose

                        -Fruit acids            Quinic acid, shikimic
                                                acid

                        -Flavonoids             Luteolin, rutin, and
                                                quercetin

Curcuma zedoaria        -Essential oil          Zingiberene, 1,8
                                                cineole, camphor,
                                                camphene, borneol

                        -Curcuminoids           Curcumin, des-and
                                                bisdesmethoxycurcumin
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Author:Zarshenas, Mohammad M.; Jamshidi, Sahar; Zargaran, Arman
Publication:Phytomedicine: International Journal of Phytotherapy & Phytopharmacology
Article Type:Report
Date:Sep 28, 2016
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