Cardiovascular aspects of geriatric medicines in traditional Persian medicine; a review of phytochemistry and pharmacology.
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.
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.
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.
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.
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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: firstname.lastname@example.org (M.M. Zarshenas).
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|
|Date:||Sep 28, 2016|
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