Medicinal Plants Used in the Management Hypertension

Pulegone Prevents Hypertension through Activation of Muscarinic Receptors and Cyclooxygenase Pathway in L-NAME-Induced Hypertensive Rats

The current study was designed to determine pulegone's antihypertensive and vasoprotective activity in L-NAME-induced hypertensive rats. Firstly, the hypotensive dose-response relationship of pulegone was evaluated in normotensive anesthetized rats using the invasive method. Secondly, the mechanism involved in hypotensive activity was determined in the presence of pharmacological drugs such as atropine/muscarinic receptor blocker (1 mg/kg), L-NAME/NOS inhibitor (20 mg/kg), and indomethacin/COX inhibitor (5 mg/kg) in anesthetized rats. Furthermore, studies were carried out to assess the preventive effect of pulegone in L-NAME-induced hypertensive rats. Hypertension was induced in rats by administering L-NAME (40 mg/kg) orally for 28 days. Rats were divided into six groups which were treated orally with tween 80 (placebo), captopril (10 mg/kg), and different doses of pulegone (20 mg/kg, 40 mg/kg, and 80 mg/kg). Blood pressure, urine volume, sodium, and body weight were monitored weekly. After 28 days, the effect of pulegone on lipid profile, hepatic markers, antioxidant enzymes, and nitric oxide was estimated from the serum of treated rats. Moreover, plasma mRNA expression of eNOS, ACE, ICAM1, and EDN1 was measured using real-time PCR. Results show that pulegone dose-dependently decreased blood pressure and heart rate in normotensive rats, with the highest effect at 30 mg/kg/i.v. The hypotensive effect of pulegone was reduced in the presence of atropine and indomethacin, whereas L-NAME did not change its hypotensive effect. Concurrent treatment with pulegone for four weeks in L-NAME-treated rats caused a reduction in both systolic blood pressure and heart rate, reversed the reduced levels of serum nitric oxide (NO), and ameliorated lipid profile and oxidative stress markers. Treatment with pulegone also improved the vascular response to acetylcholine. Plasma mRNA expression of eNOS was reduced, whereas ACE, ICAM1, and EDN1 levels were high in the L-NAME group, which was facilitated by pulegone treatment. To conclude, pulegone prevented L-NAME-induced hypertension by demonstrating a hypotensive effect through muscarinic receptors and cyclooxygenase pathway, indicating its use as a potential candidate in managing hypertension.

Hypoglycemic and Vasorelaxant Effect of Passiflora edulis Fruit Peel By-Product

Passiflora edulis fo. flavicarpa (Passifloraceae) is popularly known as yellow passion fruit and its fruit peels are considered a rich by-product in bioactive compounds which has greatly beneficial health properties. The objective of this study was to evaluate the effects of P. edulis fruit peel extracts in a type 1 diabetes model and the potential vasorelaxant effect. The aqueous and hydroethanolic extracts were obtained from P. edulis fruit peels and orientin and isorientin flavonoids were identified in both extracts through ultra-high performance liquid chromatography. Pectin was only identified in the aqueous extract by high-performance steric exclusion chromatography and nuclear magnetic resonance. Regarding the vascular system, the hydroethanolic extract showed better vasorelaxant effects in the mesenteric artery rings when compared to the aqueous extract. These effects mainly occur by opening the potassium channels. In the type 1 diabetes model, extracts at doses of 400 and 600 mg/kg were able to restore the effect of insulin in diabetic rats which were not responding to its action. The antidiabetic effect was more significant for the aqueous extract. Thus, the results suggest that the hydroethanolic and aqueous extracts have greater potential to be used to treat cardiovascular diseases such as hypertension and as a hypoglycemic agent, respectively. Taken together, P. edulis fruit peel extracts proved to be a source of valuable bioactive raw material to produce nutraceuticals or pharmaceutical products.

The effect of red pepper/capsaicin on blood pressure and heart rate: A systematic review and meta-analysis of clinical trials

Several studies have assessed the effect of red pepper on blood pressure (BP) and heart rate (HR) and reported controversial results. The aim of this study was to perform a systematic review and meta-analysis of clinical trials that evaluated the effect of red pepper/capsaicin consumption on BP and HR. Medline, Scopus, Cochrane Library, and Google Scholar were systematically searched, from database inception to August 2020, to ascertain clinical trials that evaluated the effects of red pepper or capsaicin on systolic blood pressure (SBP), diastolic blood pressure (DBP), or HR. Pooled effect size was calculated using a random-effects method. We performed subgroup analyses to discern probable sources of between-study heterogeneity. Meta-analysis showed no significant effect of red pepper/capsaicin on SBP (0.43 mmHg, 95% CI: -1.15 to 2.01), DBP (-0.45 mmHg, 95% CI: -2.14 to 1.24), and HR (-0.60 bpm, 95% CI: -1.97 to 0.78). Although between-study heterogeneity was high for SBP and DBP, we could not discern the potential sources of heterogeneity. In conclusion, red pepper/capsaicin had no effect on BP and HR. The findings should be interpreted with caution because between-study heterogeneity was high. Further well-designed and high-quality studies are required to investigate the efficacy and safety of red pepper/capsaicin supplement on BP and HR.

Luteolin and apigenin derived glycosides from Alphonsea elliptica abrogate LPS-induced inflammatory responses in human plasma

ETHNOPHARMACOLOGICAL RELEVANCE

Numerous Alphonsea species including Alphonsea elliptica (mempisang) leaves and fruits are indigenously used in inflammatory conditions such as postpartum swelling and rheumatism in southeast Asian countries. In our previous in-vitro findings, A. elliptica methanol extract exhibited platelet-activating factor inhibition, suggesting the presence of phyto-constituents with anti-inflammatory potential.

AIM OF THE STUDY

However, so far there is no literature available on the anti-inflammatory activity of this species. Henceforth, based on the above background and our previous laboratory findings, we hypothesize that phytoconstituents of A. elliptica could possess anti-inflammatory potential against inflammatory mediators including prostaglandin-E₂ (PGE₂), cyclooxegenase-2 (COX-2) and cytokines (IL-1β and IL-6).

MATERIALS AND METHODS

Vacuum and column chromatography techniques were employed for the isolation of phytoconstituents. The structure elucidation was carried out using HRESI-MS, ¹H and ¹³C-NMR analysis and compared with the published literature. For cytotoxicity analysis, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was performed on peripheral blood mononuclear cells. In-vitro anti-inflammatory activities were evaluated against the levels of PGE₂, COX-2, IL-1β and IL-6 in lipopolysaccharide (LPS)-induced human plasma using enzyme-linked immunosorbent assay and radioimmunoassay.

RESULTS

Unprecedentedly, chromatographic purification of methanolic leaves extract afforded five flavones namely vitexin, isovitexin, orientin, isoorientin, schaftoside with three flavanols; kaempferol, myricetin and rutin from A elliptica. In cell viability analysis, isolates did not present cytotoxicity up to 50 μM. In anti-inflammatory evaluation, orientin and isoorientin exhibited strong (≥70%), while isovitexin and vitexin produced strong to moderate (50-69%) PGE₂, COX-2, IL-1β and IL-6 inhibition at 25 and 50 μM. Isoorientin, orientin, isovitexin, and vitexin showed significant (p < 0.05) and concentration-dependent PGE₂ inhibition with IC₅₀ values (μM) of 11.40, 14.71, 17.70 and 20.58 against indomethacin (8.80). Furthermore, isoorientin, orientin, isovitexin, and vitexin produced significant concentration-dependent inhibition with IC₅₀ values (μM) of COX-2: 7.13, 9.51, 12.81, 16.61; IL-1β 4.80, 6.20, 10.85, 14.51; IL-6: 4.01, 5.90, 11.51 and 14.88 as compared to dexamethasone: 5.29, 2.93, 3.72, respectively (p < 0.05).

CONCLUSION

Conclusively, isolated phytoconstituents are reported for the first time from the A. elliptica. Moreover, isovitexin, vitexin orientin and isoorientin abrogated LPS-induced inflammatory responses in human plasma at non-cytotoxic concentrations.

Simultaneous Use of Herbal Medicines and Antihypertensive Drugs Among Hypertensive Patients in the Community: A Review

In various countries, approximately 80% of patients use herbal medicine, both in single form or in combination with antihypertensive drugs, for the treatment of hypertension. Therefore, this research summarized studies on the simultaneous use of herbal medicines and antihypertensive drugs among hypertensive patients in the community. A literature search was conducted on PubMed in April 2020, and the following keywords were used: “herbal medicines” and “antihypertensive patients.” In total, 15 of 263 articles were found to be eligible in the initial research. Results showed that studies were performed in different countries worldwide including America and those in Europe, Asia, and Africa between 1960 and 2020. The factors associated with the use of herbal medicines and antihypertensive drugs were age, gender, education level, income, and residence. Herbal medicines and antihypertensive drugs are simultaneously utilized primarily due to their safety and high efficacy. Herbal medicine is frequently recommended by friends or colleagues, herbalists, advertisements, and health workers. Garlic is the most common herbal medicine used along with antihypertensive drugs. The side effects of combination therapy with herbal medicines and prescription drugs for the management of antihypertension include shortness of breath and cough, ulcers, diarrhea, knee cramps, and abdominal discomfort. The lack of communication between patients and health care workers could cause an increase in the simultaneous use of herbal medicines and antihypertensive drugs. Therefore, effective communication among health care workers and appropriate care are important in preventing the side effects and other risks of combined therapy.