Category: Diet

Herbal cardiovascular support

Herbal cardiovascular support

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9 Herbs to Help Support a Healthy and Happy Heart

Small steps can make a significant impact on your wellness journey! Along with a healthy lifestyle, incorporating heart-healthy herbs can support your cardiovascular system and overall well-being. education 9 Herbs to Help Support a Healthy and Happy Heart Published on April 04, How Can You Make Your Heart Stronger Naturally?

REF While herbs and supplements can provide numerous benefits, it is crucial to understand the potential risks and ensure that they do not counteract medication or pre-existing medical conditions.

Hawthorn Hawthorn Crataegus is a large genus of shrubs and trees in the Rosaceae family. REF Gaia Herbs offers herbal products containing Hawthorn, such as our Hawthorn Supreme Capsules , Hawthorn Supreme Extract , and Turmeric Supreme Heart Health.

Turmeric A spice commonly used in Indian cuisine, Turmeric Curcuma longa contains the active ingredient Curcumin, which has potent soothing and antioxidant properties that may benefit heart health.

REF Curcumin can help soothe scar tissue, support healthy heart tissue, and support the heart wall's thickness, which is vital for maintaining proper heart function. REF Turmeric reduces irritation in the heart tissue , supporting overall heart health. REF Gaia Herbs Turmeric Supreme Heart Health combines Turmeric with other herbal extracts to support healthy cardiovascular function.

REF Gaia Herbs' Green Tea for Energy Support harnesses the benefits of certified Organic Green Tea leaves extracted and concentrated to provide the full spectrum of natural phytochemicals in green tea leaves.

REF The antioxidants in Olive Leaf may help support heart health by protecting the body from free radical damage. Hibiscus Hibiscus Hibiscus sabdariffa is a genus of the Malvaceae or Mallow family. REF Hibiscus has numerous cardiovascular benefits. REF Hibiscus is rich in antioxidants and has soothing properties, which can protect the heart and support healthy blood clotting.

REF Served hot or over ice, brighten any day with our delightful Organic Hibiscus Herbal Tea. Garlic Recognized for its numerous health benefits, Garlic Allium sativum contains compounds such as allicin, which have antioxidant and soothing properties.

REF Ginseng Traditionally used in Chinese medicine for its potential health benefits, Ginseng Panax ginseng is believed to have protective effects on the cardiovascular system. REF Gaia Herbs' Ginseng Supreme supplement is a high-quality blend of ginseng, including American Ginseng, Eleuthero , and Asian Ginseng, to support stamina and vitality.

Ginger Ginger Zingiber officinale is a flowering plant used for centuries in traditional medicine. REF Ginger can significantly support healthy blood triglyceride levels and blood pressure levels, as well as support overall heart function. REF Gaia Herbs Ginger Supreme is a high-quality supplement that supports a healthy immune response, digestive and cardiovascular health, and circulation.

REF One study found that taking cinnamon supplements for 12 weeks contributed to healthy blood triglyceride levels, a significant risk factor for heart disease.

REF In a meta-analysis of clinical trials, individuals who took cinnamon had healthier cholesterol levels compared to those who received a placebo. REF Gaia Herbs Cinnamon Bark supplement is made from pure, organic cinnamon and can support healthy glucose and lipid metabolism.

Featured Products Best Seller. Featured Products. Best Seller. Tassell, M. in the treatment of cardiovascular disease", Pharmacognosy reviews. Cox, F. Wang, N.

Qin, S. Xin-Xin Zheng, Yan-Lu Xu, Shao-Hua Li, Xu-Xia Liu, Rutai Hui, Xiao-Hong Huang, "Green tea intake lowers fasting serum total and LDL cholesterol in adults: a meta-analysis of 14 randomized controlled trials", The American Journal of Clinical Nutrition.

National Center for Complementary and Integrative Health, "Green Tea",. Omar S. Cleveland Clinic, "7 Benefits of Hibiscus Tea", Ried, K. Kim J. Cerdá, Begoña, Javier Marhuenda, Raúl Arcusa, Débora Villaño, Purificación Ballester, and Pilar Zafrilla. Cleveland Clinic, "The Benefits of Cinnamon", Maierean, S.

Qian Zhou, Xingxing lei, Shunlian Fu, Zinan Li, Yiding Chen, Cong Long, Suwen Li, and Qui Chen , "Efficacy of Cinnamon Supplementation on Glycolipid Metabolism in T2DM Diabetes: A Meta-Analysis and Systemic Review", Frontiers in Physiology.

Shaito, A. et al , "Herbal Medicine for Cardiovascular Diseases: Efficacy, Mechanisms, and Safety", Frontiers in Physiology. Continue Reading. education lifestyle research your-natural-self.

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The applecidervinegarch education products. Confused about whether you really need a multivitamin to be healthy? From its unique appearance to its history, it has been a captivating part of culinary and medicinal tra Many people are curious about using plants and herbs to support libido and create a romantic atmosphere but are unsure which herbs really work.

This is understandable, given the Back To All Posts. For over years, CVDs have been treated with numerous herbal remedies. However, these herbal remedies have not been well studied using modern cellular and molecular techniques.

Based on the existing investigations into mechanisms of single herbal compounds, a summary of these studies is presented in the following section wherein the compounds are discussed according to their target site of activity.

The blood vessel tonicity is principally controlled by the contraction and relaxation of VSMCs. Herbal medicine that regulates proteins or molecules in this pathway would modulate vascular contraction or relaxation. Firstly, blocking contractile and structural proteins may be one of the ways which natural plants could facilitate vasodilation and vascular remodeling.

It has been shown that Tianma the tuber of an orchid enhances acetylcholine-induced vasorelaxation or phenylephrine-induced contraction in aortic rings Feng et al.

Secondly, phosphorylation of myosin light chain protein is another target for herbs to determine vascular smooth muscle contraction.

A10 cells, rat smooth muscle cells, were treated with kinds of herbs and it was observed that four herbs, Liu-Wei-Di-Huang-Wan, Jia-Wei-Xiao-Yao-San, Danshen and Gegen, reduced phosphorylation of myosin light chain, suggesting that these most common herbs may be beneficial for smooth muscle cell contractility Lin et al.

Extracellular matrix is another target involved in vascular tone regulation. ECM proteins such as Postn is specifically induced upon tissue injury and could promote cellular adhesion and movement as well as collagen fibrillogenesis.

ECM glycoproteins include Eln, Fbln5 and Prelp, being essential to maintain arterial morphogenesis and vessel elasticity. Tianma could induce up-regulation of ECM glycoproteins and down-regulation of ECM proteins in vascular system, thereby regulating blood vessel tonicity by increasing the arterial elasticity and stabilizing the arterial structure Feng et al.

Calcium levels in VSMCs also contribute to regulating the vascular contraction. Tetramethylpyrazine TMP, also known as Ligustrazine , is a vasoactive component derived from Ligustium Wollichii Franchat.

Using dog mesenteric arterial ring preparations, TMP not only caused a dose-dependent inhibition of vascular contractile responses to KCl and phenylephrine in solution with calcium, but also inhibited the responses to phenylephrine in Ca-free medium containing 50 μM EGTA.

This effect was mimicked by a structurally unrelated lipoxygenase inhibitor, 5,8,eicosatriynoic acid and was restored by addition of 12 S -hydroxyeicosatetraenoic acids Saito et al. Then, the BK Ca -mediated vascular contraction is further explored. The cAMP and the cGMP pathways are major regulators of smooth muscle contractility.

By cyclic nucleotide assays, baicalin enhanced both cAMP and cGMP levels in mesenteric arteries. Baicalin was observed to enhance BK Ca currents in a concentration-dependent manner, which were abolished by combining inhibitors of AC SQ and sGC ODQ , by combining inhibitors of PKA KT and PKG KT , and PKC activator PMA in mesenteric artery smooth muscle cells.

These results indicate that baicalin-induced mesenteric artery relaxations could be due to BK Ca channel activation occurs not only as a result of PKA and PKG, but also as a result of cross-interaction with PKC Lin et al.

The effects of Camellia japonica on VSMCs migration was evaluated with a wound healing assay. Camellia japonica concentration-dependently suppressed platelet-derived growth factor-BB induced VSMCs wound healing for 24 and 48 h after injury, indicating the migration inhibiting effects Park et al.

In addition, baicalein and baicalin induced anti-proliferative and anti-mitogenic effects in VSMCs of rabbit, rat and bovine were well summarized Huang et al. These results provide additional evidence for the beneficial cardiovascular effects of natural products.

Andrographolide is the most active and critical constituent isolated from the leaves of Andrographis paniculata , a herbal medicine widely used as an anti-inflammatory drugs in Asia.

The mechanisms of the inflammatory effects of andrographolide in VSMCs were investigated by exposing VSMCs to a proinflammatory stimulus, TNF-α. Treating TNF-α-stimulated VSMCs with andrographolide suppressed the expression of inducible nitric oxide synthase NOS , JNK, Akt, and p65 phosphorylation.

Thus, andrographolide-mediated inhibition of NF-κB activity in TNF-α-stimulated VSMCs occurs through the JNK-Akt-p65 signaling cascade mechanism, which is independent of IκBα degradation Chen et al.

These results collectively suggest that therapeutic interventions using andrographolide can benefit the treatment of vascular inflammatory diseases. In addition to cellular powerhouses, mitochondria are known as critical regulators of cell death. And they are the major cellular source of ROS which causes damage to mitochondrial DNA in human VSMCs in a number of cardiovascular pathologies.

Thus, mitochondrial dysfunction may lead to the impairment of various aspects of tissue functioning. It has been known that cultured rat aortic VSMCs treated with AngII for 24 h exhibited mitochondrial dysfunction, including a decrease in mitochondrial oxygen consumption rates, ATP production and mtDNA levels, as well as the disruption of mitochondrial structural integrity Lu et al.

Together with the mitochondrial morphological changes, these alterations were reversed by Astragaloside IV, the major active ingredient of Astragalus membranaceus Fisch. a traditional CHM. Moreover, treatment with Astragaloside IV also reversed the AngII-induced increase in the production of ROS, the increase in NADPH oxidase and xanthine oxidase activity, as well as the decrease in mitochondrial membrane potential and manganese-SOD activity.

These results indicate that Astragaloside IV exerts beneficial effects on AngII-induced mitochondrial dysfunction in rat VSMCs and that these effects are mediated through the inhibition of ROS overproduction, as well as the promotion of mitochondrial autophagy and mitochondrial biogenesis Lu et al.

Overall, herbal medicines discussed here do appear to show pharmacological effects in vitro and in animal studies, which may influence CVDs. FIGURE 1. Endothelial cells, which constitute the inner cellular lining of blood vessels, have a key role in regulating vascular homeostasis and function, such as vasorelaxation, vascular integrity, and local inflammation.

Endothelium-dependent vasodilation was commonly applied to examine the endothelium function, in which NO is a potent vasodilator and plays an important role in regulating vascular tones. Some herbal medicine functions by targeting at the NO producing process.

In studies at the arterial levels, both Lysimachia clethroides and gypenosides elicit vasorelaxation which was abolished by endothelial NOS eNOS or guanylyl cyclase inhibitors Tanner et al.

Sal B, a hydrophilic caffeic acid derivative of Danshen, exerts an important regulatory function on endothelial tissue of isolated mouse aorta by promoting NO production through the inhibition of arginase activity Joe et al.

Fo Shou San, an ancient herbal decoction Chuanxiong Rhizoma and Angelicae Sinensis Radix Danggui in a ratio of , reversed homocysteine-induced impairment of acetylcholine-evoked endothelium-dependent relaxation in rat aortic rings Bi et al. In studies at the cellular levels, gypenosides induced a concentration-dependent increase in NO production from cultured bovine endothelial cells Tanner et al.

Consistent with it, magnesium tanshinoate B another compound purified from Danshen or Fo Shou San, also stimulated the release of NO and its metabolites from a human endothelial cell line ECV O et al.

By exploring the mechanisms by which NO production is induced, it was observed that the cellular NOS activities were significantly enhanced with a concomitant increase in the levels of constitutive NOS protein mass O et al. Inflammation plays a crucial role in the pathophysiology of CVDs, in which adhesion molecules, pro-inflammatory cytokines and chemokines are involved.

The anti-inflammatory effects of Danshen and its active ingredients Sal B, Tanshionone IIA, Protoc et al. were extensively investigated in traditional Chinese medicine for therapy of CVDs.

Incubation with TNFα or ADP is widely used to induce inflammation in vitro. In TNFα treated HUVECs, although neither Sal B nor Tanshinone IIA inhibit the inflammation Stumpf et al. In ADP-treated human platelets, pre-treatment with both Sal B, Tanshionone IIA and Danshen significantly attenuated platelet P-selectin expression Stumpf et al.

Gypenoside XLIX, a dammarane-type glycoside, is a prominent component of G. Studies demonstrate that Gypenoside XLIX inhibits TNFα-induced VCAM-1 over expression and hyperactivity in human endothelial cells via a PPARα-dependent pathway Huang et al.

These findings provide useful insight into the rational basis of CHM in the treatment of CVDs. There are a myriad of herbs that demonstrate effects of endothelial cell protection by different mechanisms.

For example, Sal B decreases ROS production in the aortic rings. Since ROS easily acts with NO to produce peroxynitrite anions, which is a potent and potentially toxic oxidant that damages various types of biomolecules, it can be deduced that Sal B may exert its protective function by precluding NO consumption through adverse reactions such as peroxynitrite formation and preserving NO bioavailability Joe et al.

EGb Ginkgo biloba extract suppresses oxidative stress in a dose-dependent manner in high glucose-stimulated HUVEC. In addition to inhibition of ROS generation and 8-OHdG content, it attenuated oxidative DNA damage, indicating herbs could exert endothelial protection by alleviating endothelial DNA oxidation He Y.

Echium amoenum extract a major source of anthocyanins demonstrated antioxidant and cytoprotective effect in H 2 O 2 -treated HUVECs. KRGE reduces the H 2 O 2 -induced cell injury in HUVECs too.

The inhibited effect on cell death was blunted by HO-1 inhibitor zinc protoporphyrin. HO-1 is considered to augment the cellular defense against various agents inducing cytotoxic injury. KRGE was observed to induce up-regulation of HO-1 expression in HUVECs, which was abolished by specific silencing of Nuclear factor-eythroid 2-related factor 2 Nrf2, a important anti-oxidant transcription factor expression Yang et al.

These results suggest that Korean Red Ginseng may exert a vascular protective effect through Nrf2-mediated HO-1 induction in human endothelial cells.

Ophiopogonin D is one of the most bioactive components of Radix Ophiopogon japonicas. Its pretreatment showed a series of antioxidation-related protective effects: 1 reducing H 2 O 2 -induced lipid peroxidation and protein carbonylation, 2 attenuating mitochondrial ROS generation and cell apoptosis, 3 restoring cellular total antiboidative capacity, 4 inhibiting the release of inflammatory cytokines and blocking activation of NFκB and ERK signaling cascades, 5 suppressing the enzymatic activity of catalase, HO-1, and caspases Qian et al.

In general, these findings support the protective role of herbs as an effective antioxidant in endothelial injury. Although endothelial cell dysfunction occurs in many different disease processes, caspase-dependent apoptotic cell death induced by the extrinsic or intrinsic pathways is identified as a common denominator.

Protective effect of KRGE was examined in a serum-deprived apoptosis model, which demonstrated that it could prevent serum deprivation-induced HUVEC apoptosis Kim et al. Cytosolic cytochrome c is known to play a crucial role in the activation of the initiator caspase-9 and the effector caspase KRGE prevented subcellular redistribution of cytochrome c from the mitochondrion into the cytosol, resulting in suppression of the extrinsic pathway of apoptosis activation Kim et al.

The cytoprotective property of KRGE may be valuable for developing new pharmaceutical means that limit endothelial cell death induced during the pathogenesis of vascular diseases.

Angiogenesis, the formation of new blood vessels from preexisting endothelium, is critical to a variety of processes, both physiologically embryonic development and wound healing and pathologically malignancy and chronic inflammation.

It is a complex biologic function comprising several steps, including sequential basement membrane degradation, endothelial cell migration and proliferation, tube formation, inhibition of endothelial proliferation, and the stabilization of new vessels.

Modulation of any of these steps would affect new vessel formation. Scutellarin, a known flavone glycoside, is the primary active component of the traditional CHM Erigeron breviscapus Vant. It has been shown to induce endothelial cell proliferation and migration, promote capillary-like tube formation, and significantly upregulate platelet endothelial cell adhesion molecule-1 Gao Z.

These results suggest that herbal medicine promotes angiogenesis and may form a basis for angiogenic therapy. Endothelial cell hyperpermeability is another factor implicated in CVDs, in which the importance of tyrosine phosphorylaton and kinase activity in oxidant-mediated loss of cell junction structures has been demonstrated.

Extract of salvia miltiorrhiza and its major ingredients, Danshensu and Sal B inhibited TNFα-induced endothelial permeability, evidenced by attenuated junctional protein phosphotyrosine and prevention of beta-catenin disassociation from the cytoskeleton Ding and Yuan, The mechanism of pharmacological action was further explored.

The extract, Danshensu and Sal B also repressed expression of vascular endothelial growth factor and ERK activation in TNFα treated HUVEC cells.

In addition, it was found that the extract attenuated the disorganization of vascular endothelial-cadherin, which is likely due to a reduction of vascular endothelial growth factor protein expression as a result of modulation of the ERK signaling pathway Ding et al.

These findings suggest that active herbal ingredients may help to attenuate CVDs by maintaining the integrity of endothelial junction structure. In general, herbal medicines do show the beneficial effects in endothelial cells. As shown in Figure 1 , these natural plants exert the protective effect by inhibition of inflammation, oxidative stress and apoptosis, activation of eNOS-NO signaling pathway, induction of angiogenesis and suppression of endothelial permeability.

Pathological cardiac hypertrophy induced by increased sympathetic drive can subsequently lead to congestive heart failure, which represents the major cause of morbidity and mortality worldwide. In addition, Astragalus polysaccharide pretreatment not only alleviated the augmentation of intracellular free calcium during cardiac hypertrophy but also upregulated expression of calcineurin, translocation of nuclear factor of activated T cells, cytoplasmic 3 into nucleus and activation of calmodulin kinase II reflected by p-CaMKII Dai et al.

Chlorogenic acid is an important component of CHM, which acts as an antioxidant scavenging free radicals and preventing inflammation. Pre-treatment of chlorogenic acid in the isoprenaline-induced neonatal rat myocytes, decreased the levels of the hypertrophic markers, ANP, B-type natriuretic peptide and β-MHC.

The level of the intracellular ROS was reduced and the nuclear translocation of NF-κB was blocked, whereas NF-κBIA, an inhibitor of NF-κB, was upregulated accordingly. These data reveal that chlorogenic acid may inhibit cardiac hypertrophy by attenuating NF-κB signaling pathway and suppressing ROS production Li et al.

Many data have demonstrated that ROS production by myocardial endothelial mitochondria contributes to heart disease and oxidative stress within ventricular myocytes can also be detrimental to the heart.

In fact, much of the contractile dysfunction and adverse myocardial remodeling, which has been observed in a wide range of cardiomyopathies, involves oxidative stress and eNOS uncoupling leading to a decrease in NO.

There are a series of targets at which herbal medicine act to improve myocardial endothelial function by attenuation of oxidative stress. Thus, free radical scavenging and inhibition of oxidases will exert protective effect in cardiac injury. Baicalein may provide such therapy by deletion of free radicals, reducing hydroxyl radicals generation by suppressing iron-catalyzed Fenton reaction or decreasing ROS production by inhibiting activities of NADH-oxidase and xanthine oxidase Huang et al.

Thus it is easy to understand the oxidized LDLs-induced endothelial dysfunction could be restored by L -arginine and NO. The olive products constitute a rich source of polyphenols such as oleuropein and its derivatives, including hydroxytyrosol, which scavenge free radicals and inhibit the chemical oxidation of LDL.

Studies have shown that treatment with high doses of oleuropein at min 1 of reperfusion significantly reduced levels in plasma NOx in hypercholesterolemic rabbits coupled with reduction of infarct size in this group Andreadou et al.

Therefore, plant products may function as a NO donor to inhibit formation of peroxynitrite and NOx. The decrease in these biomarkers indicates the protective action of oleuropein, baicalein, crocetin, Allium chinense and Astragalus against oxidative stress by scavenging free radicals Nasa et al.

Qian-Kun-Nin, a CHM formulation was observed to significantly decreased cell death and attenuate oxidation of DCFH in cells exposed to the mitochondrial site III inhibitor, antimycin A, consistent with a decrease in oxidative stress Shao et al. These findings indicate herbal medicine may inhibit oxidative stress by improving mitochondrial function.

Thus, keeping the function of antioxidant enzymes standards for another target to inhibit oxidative stress and protect cardiac injury. Herbs such as American ginseng could enhance this antioxidant system in rat cardiac H9C2 cells Li et al.

The antioxidant systems include Nrf2 protein expression, Nrf2 nuclear translocation, Nrf2 transcriptional activity, direct Nrf2 binding to its target gene promoters, and expression of a group of anti-oxidative genes.

Thus, herbs may serve as antioxidant enhancer to provide cardioprotection against pathological cardiac injury and remodeling. This may help indentifying novel therapeutic targets in the effect of plant products to protect the heart from injury. H 2 O 2 treatment induces both oxidative damage and apoptosis, contributing to cardiac injury in cultured rat cardiomyocytes.

Cynaroside, a flavonoid compound, has been shown to enhance the endogenous anti-oxidative activity, thereby inhibiting intracellular ROS generation. It also showed the protective effects against H 2 O 2 -induced apoptosis in H9c2 rat cardiomyoblasts.

The mechanism by which cynaroside reduced the apoptotic rate were further explored. Moreover, cynaroside pretreatment showed an inhibitory effect on the H 2 O 2 -induced increase in JNK and P53 protein expression Sun et al.

These findings suggest that flavonoid products prevent cardiomyocytes apoptosis in vitro by reducing the endogenous production of ROS, maintaining mitochondrial function, and modulating the JNK and P53 pathways. Cardiac myocyte is the cell types in which K ATP channels were originally discovered.

It is well established that K ATP channels are present at high density in the sarcolemma of cardiac myocytes where they link membrane excitability with the cellular bioenergetic state. Pinacidil is a potassium channel opener which mediate preconditioning at the beginning of sustained hypoxia by opening of sarcolemmal K ATP channels Budas et al.

Similar to it, Guanxinkang treatment benefit the heart function by increasing mRNA and protein expression of K ATP subunits Kir6. Keep in line with it, extracts of Astragalus demonstrated its anti-apoptotic effect in H 2 O 2 -injured cardiomyocytes only when the K ATP channels were open, whereas the protective effect was not observed when the channels were inhibited by the K ATP channel blocker 5-HD, glibenclamide Nasa et al.

These findings suggest enhancing the open of K ATP channel is one of the important mechanisms by which herbs protect myocardial cells from ischemic injury. Atrial natriuretic peptide is secreted by the heart atrium cells.

ANP binds to a specific set of receptors and acts to reduce the water, sodium and adipose loads on the circulatory system, thereby reducing cardiac output and systemic BP.

Emodin, an active anthraquinone constituent isolated from the rhubarb, was observed to increase ANP secretion concomitantly with a decrease in atrial pulse pressure and stroke volume in a concentration-dependent manner.

This study provides a rationale for the use of herbal medicine in the treatment of impairment of the regulation of the cardiovascular homeostasis. In the milieu of cardiovascular risk factors that disturb vascular homeostasis, inflammation represents a key early event in vascular pathology, in which monocytes activation, adhesion to the endothelium and infiltration of macrophages into blood vessels are thought to play important pathogenic roles in atherosclerosis and other inflammatory CVDs.

The transcriptional and translational regulation of iNOS in various cell types can be induced by cytokines, growth factors, and endotoxins. Lipopolysaccharide LPS stimulation has been shown to enhance iNOS expression, NO production, and macrophage arginase activity in RAW In addition, cytoprotective molecule HO-1 expression was upregulated by these Danshen products too Joe et al.

SnPP is well characterized as a potent competitive inhibitor of HO activity. Since the iNOS expression, NO production, and TNFα production, were completely abolished by SnPP, the anti-inflammatory effect of Sal B in macrophages may be related to modulation of HO Hb serves as a CO scavenging compound.

Preincubation of Hb for 30 min reversed the inhibitory effect of Sal B on LPS-induced iNOS expression, NO production and NFκB activation in the RAW Although the mechanism by which HO-1 down-regulates iNOS is incompletely clear, it may involve transcriptional inhibition through CO formation or reduction of heme bioavailability for iNOS synthesis.

Consistent with the effect of Sal B, Tanshinone IIA another major compound extracted from Danshen exerts its anti-inflammatory effects by inhibition of iNOS gene expression and NO production, as well as inhibition of inflammatory cytokine IL-1β, IL-6 and TNFα expression in RAW Since Tan IIA has a similar structure to that of 17β-estradiol, the estrogenic activities was examined in the immune cells.

In fact, the most commonly used alternative herbal medicines for estrogen replacement are soy, black cohosh, dong quai and ginseng. Thus, these herbal medicines may serve as a potential selective estrogen receptor modulator to treat inflammation-associated CVDs without increasing the risk of breast cancer.

Activation of the nuclear receptor, PPARα, has been demonstrated to modulate many aspects of lipoprotein metabolism and inflammation both in vitro as well as in vivo. The tissue distribution of PPARα is extensive and it may mediate many of anti-inflammatory and anti-atherogenic effects.

Gypenoside XLIX, a dammarane-type glycoside, is one of the prominent components in Gynostemma pentaphyllum. It has been identified as a potent PPARα activator in HUVEC study Huang et al. Tissue factor is involved in many diseases including CVDs and hence may be an attractive target for directed CVDs therapeutics.

In human monocytic THP-1 cells transfected with promoter reporter constructs pTF-LUC, Gyp XLIX 0— mM concentration-dependently inhibited LPS-stimulated tissue factor promoter activity, mRNA and protein overexpression. This effect was similar to those of Wy, a potent synthetic PPARα activator, and completely abolished in the presence of the PPARα selective antagonist MK Huang et al.

These data indicate that Gyp XLIX inhibits LPS-induced tissue factor overexpression and enhancement of its activity in human THP-1 monocytic cells via PPARα-dependent pathways, providing new insights into the mechanism of the Chinese herbal plants in CVDs treatment.

These effects are achieved by inhibition of iNOS-NO signaling pathway, which may be through activation of estrogen receptor and nuclear receptor PPARα-dependent signaling pathways Figure 1. One may predict that herbal remedies will receive even more attention in the coming years.

However, some objective limitations should be considered based on the existing literature. Firstly, the CHM are widely studied in China. Accordingly, many articles published on the Chinese literature which may limit these work to be retrieved and public to the world.

In addition, a location bias cannot be excluded since trials published in local journals are more likely to report significant results than those published in worldwide mainstream medical journals. Poorly designed and reported clinic trails usually exaggerate the treatment effects which will misled decision making in clinic.

Thirdly, compounds contained in one herb, even in an extract of one herb are very complicated. Fourthly, many herbal medicine remedies used today have not undergone careful scientific assessment and there still lack preclinical study on the side effects, toxic effects and major drug-to-drug interactions in record.

Therefore, to develop new agents with effectiveness and safety from traditional Chinese medicine is a promising way for prevention and treatment of patients with CVDs. In addition, international collaboration may be encouraged, promoted and financed from the governments in order to improve the overall research quality.

CL drafted the work; YH revised the manuscript. Both CL and YH contributed substantially to the conception or design of the work, approved the final version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

This work was supported by National Natural Science Foundation of China , Zhejiang Provincial Natural Science Fund for Distinguished Young Scholars of China LR17H, Hangzhou Science and Technology Plan Project of China B36 and the Scientific Research Foundation for the Returned Overseas Chinese Scholars, Ministry of Education of China to CL.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Acin, S. Hydroxytyrosol administration enhances atherosclerotic lesion development in apo E deficient mice.

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Steroid Biochem. Fatehi, M. Feng, L. Tianma modulates blood vessel tonicity. Open Biochem. Fu, S. Huangqi injection a traditional Chinese patent medicine for chronic heart failure: a systematic review. PLoS ONE 6:e Gao, Q. Planta Med. Gao, Z. Scutellarin promotes in vitro angiogenesis in human umbilical vein endothelial cells.

Gheith, O. Efficacy and safety of Monascus purpureus Went rice in subjects with secondary hyperlipidemia. Efficacy and safety of Monascus purpureus Went rice in children and young adults with secondary hyperlipidemia: a preliminary report.

Gonzalez-Santiago, M. One-month administration of hydroxytyrosol, a phenolic antioxidant present in olive oil, to hyperlipemic rabbits improves blood lipid profile, antioxidant status and reduces atherosclerosis development.

Atherosclerosis , 35— Guo, M. Chinese herbal medicine on dyslipidemia: progress and perspective. Based Complementary Altern. Han, S. Evaluation of the anti-myocardial ischemia effect of individual and combined extracts of Panax notoginseng and Carthamus tinctorius in rats.

He, B. Fistular onion stalk extract exhibits anti-atherosclerotic effects in rats. He, Y. Ginkgo biloba attenuates oxidative DNA damage of human umbilical vein endothelial cells induced by intermittent high glucose. Pharmazie 69, — Herrera-Arellano, A.

Clinical effects produced by a standardized herbal medicinal product of Hibiscus sabdariffa on patients with hypertension. A randomized, double-blind, lisinopril-controlled clinical trial.

Higashino, S. Crocetin, a carotenoid from Gardenia jasminoides Ellis, protects against hypertension and cerebral thrombogenesis in stroke-prone spontaneously hypertensive rats. Houston, M. Nutraceuticals, vitamins, antioxidants, and minerals in the prevention and treatment of hypertension.

Hu, Y. Lipid-lowering effect of berberine in human subjects and rats. Phytomedicine 19, — Icariin attenuates high-cholesterol diet induced atherosclerosis in rats by inhibition of inflammatory response and p38 MAPK signaling pathway.

Inflammation 39, — Huang, T. Gypenoside XLIX, a naturally occurring PPAR-alpha activator, inhibits cytokine-induced vascular cell adhesion molecule-1 expression and activity in human endothelial cells. Gypenoside XLIX, a naturally occurring gynosaponin, PPAR-alpha dependently inhibits LPS-induced tissue factor expression and activity in human THP-1 monocytic cells.

Huang, Y. Biological properties of baicalein in cardiovascular system. Drug Targets Cardiovasc. Baicalin-induced vascular response in rat mesenteric artery: role of endothelial nitric oxide. Acta Pharmacol. Imenshahidi, M. Hypotensive effect of aqueous saffron extract Crocus sativus L.

and its constituents, safranal and crocin, in normotensive and hypertensive rats. The effect of chronic administration of safranal on systolic blood pressure in rats. Inuwa, I.

Long-term ingestion of Hibiscus sabdariffa calyx extract enhances myocardial capillarization in the spontaneously hypertensive rat. Maywood , — Jang, E. Beneficial effects of curcumin on hyperlipidemia and insulin resistance in high-fat-fed hamsters.

Metabolism 57, — Jang, S. Inhibitory effects of total ginseng saponin on catecholamine secretion from the perfused adrenal medulla of SHRs. Ginseng Res. Ji, W. Hypolipidemic activity and mechanism of purified herbal extract of Salvia miltiorrhiza in hyperlipidemic rats.

Joe, Y. Salvianolic acid B exerts vasoprotective effects through the modulation of heme oxygenase-1 and arginase activities. Kim, D. Compound K, intestinal metabolite of ginsenoside, attenuates hepatic lipid accumulation via AMPK activation in human hepatoma cells.

Food Chem. Kim, J. Cardiovascular diseases and Panax ginseng : a review on molecular mechanisms and medical applications. Kim, Y. Korean Red Ginseng protects endothelial cells from serum-deprived apoptosis by regulating Bcl-2 family protein dynamics and caspase S-nitrosylation.

Koyama, T. Effects of a herbal medicine, Hippophae rhamnoides , on cardiovascular functions and coronary microvessels in the spontaneously hypertensive stroke-prone rat. Kwan, C. Inhibition of vasoconstriction by tetramethylpyrazine: does it act by blocking the voltage-dependent Ca channel?

Kwon, H. Cinnamon and its components suppress vascular smooth muscle cell proliferation by up-regulating cyclin-dependent kinase inhibitors. Lan, J. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension.

Lee, J. Lysimachia clethroides extract promote vascular relaxation via endothelium-dependent mechanism. Li, J. An essential role of Nrf2 in American ginseng-mediated anti-oxidative actions in cardiomyocytes. Li, L. Herbal drugs against cardiovascular disease: traditional medicine and modern development.

Drug Discov. Today 20, — Li, Y. Chlorogenic acid prevents isoproterenol-induced hypertrophy in neonatal rat myocytes. Lin, C. Efficacy and safety of Monascus purpureus Went rice in subjects with hyperlipidemia. Lin, Y. Triterpenic acids present in hawthorn lower plasma cholesterol by inhibiting intestinal ACAT activity in hamsters.

Chinese herbal medicine treatment improves the overall survival rate of individuals with hypertension among type 2 diabetes patients and modulates in vitro smooth muscle cell contractility. PLoS ONE e Phytomedicine 17, — Liu, J. Saponins of Panax notoginseng : chemistry, cellular targets and therapeutic opportunities in cardiovascular diseases.

Expert Opin. Drugs 23, — Lu, J. Molecular mechanisms and clinical applications of nordihydroguaiaretic acid NDGA and its derivatives: an update. Lu, Y. Beneficial effects of astragaloside IV against angiotensin II-induced mitochondrial dysfunction in rat vascular smooth muscle cells.

Ma, L. Salvianolic acid B down-regulates matrix metalloproteinase-9 activity and expression in tumor necrosis factor-alpha-induced human coronary artery endothelial cells. Ma, X. Extracts from Astragalus membranaceus limit myocardial cell death and improve cardiac function in a rat model of myocardial ischemia.

McKay, D. Hibiscus sabdariffa L. tea tisane lowers blood pressure in prehypertensive and mildly hypertensive adults. Modaghegh, M. Safety evaluation of saffron Crocus sativus tablets in healthy volunteers.

Phytomedicine 15, — Moghadam, M. Antihypertensive effect of celery seed on rat blood pressure in chronic administration. Food 16, — Mucalo, I. Effect of American ginseng Panax quinquefolius L.

on arterial stiffness in subjects with type-2 diabetes and concomitant hypertension. Nasa, Y. Protective effect of Crataegus extract on the cardiac mechanical dysfunction in isolated perfused working rat heart.

Arzneimittelforschung 43, — Niu, C. Decrease of blood lipids induced by Shan-Zha fruit of Crataegus pinnatifida is mainly related to an increase of PPARalpha in liver of mice fed high-fat diet. Effect of magnesium tanshinoate B on the production of nitric oxide in endothelial cells.

Ojeda, D. Inhibition of angiotensin convertin enzyme ACE activity by the anthocyanins delphinidin- and cyanidinO-sambubiosides from Hibiscus sabdariffa. Otterbein, L.

Carbon monoxide has anti-inflammatory effects involving the mitogen-activated protein kinase pathway. Park, S. Vascular protective effect of an ethanol extract of Camellia japonica fruit: endothelium-dependent relaxation of coronary artery and reduction of smooth muscle cell migration.

Qian, J. Ophiopogonin D prevents H2O2-induced injury in primary human umbilical vein endothelial cells. Regulska-Ilow, B. Influence of bioflavonoids from the radix extract of Scutellaria baicalensis on the level of serum lipids, and the development of laboratory rats fed with fresh and oxidized fats.

Nahrung 48, — Reinhart, K. The impact of garlic on lipid parameters: a systematic review and meta-analysis. Ren, G. Protective effects of steroids from Allium chinense against H2O2-induced oxidative stress in rat cardiac H9C2 cells.

Rhee, M. Blood pressure lowering effect of Korea ginseng derived ginseol K-g1.

Schedule an Appointment Online Weindorf Herbzl Herbal cardiovascular support Controlled cardiovasculae of increasing venous tone in primary varicose veins by oral administration of Ruscus aculeatus and trimethylhespiridinchalcone Antioxidant defense mechanisms German]. Herbal cardiovascular support cagdiovascular its components suppress vascular smooth muscle cell Herbal cardiovascular support Hetbal up-regulating cyclin-dependent kinase inhibitors. Taskov M On the coronary and cardiotonic action of crataegus. Facebook 0 Twitter LinkedIn 0 Reddit Tumblr Pinterest 0 0 Likes. Recovery usually occurs within 24 to 48 hours. A healthy shen manifests through peacefulness and healthy relationships; if the shen is disturbed, a person can experience anxiety, insomnia, worry, irritability, and loss of concentration and memory. cn Yu Huang, yu-huang cuhk.
Herbal Medications in Cardiovascular Medicine Sign Herbal cardiovascular support for Hebral latest updates. Weikl AAssmus Carddiovascular A et al. A healthy heart is the foundation of a healthy body and mind. J Assoc Physicians India. Fermentation of RYR produces monacolin K, which inhibits the endogenous production of cholesterol.
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Potential synergistic and adverse side effects of herb-drug interactions also need to be studied. These approaches will help in establishing them as remedies for cardiovascular diseases and including them in the mainstream of healthcare system.

Keywords: Allium sativum; Cardiovascular disorders; Commiphora wightii; Crataegus oxyacantha; Medicinal plants; Terminalia arjuna. Abstract Background: Medicinal plants have been used in patients with congestive heart failure, systolic hypertension, angina pectoris, atherosclerosis, cerebral insufficiency, venous insufficiency and arrhythmia since centuries.

Publication types Review. It has caused reversible liver toxicity. Hawthorn may have some benefit on hypertension, hyperlipidemia, arrhythmias, and congestive heart failure.

Clinical studies have shown it to improve various parameters in chronic heart failure, and while safe, it did not affect outcome.

Soybeans or soy have a high content of proteins, and isoflavones, which are compounds with both estrogen-like properties and anti-estrogen activity. American Heart Association and European guidelines have suggested there may be a clinical value of high intake of soy protein g for decreasing cardiovascular morbidity and mortality when used as a substitute for animal sources of protein high in saturated fat.

However, they may increase risk of breast, uterine, and ovarian cancer. Use of herbal medications for the treatment of cardiovascular diseases is not supported by scientific evidence.

Although most of the herbs demonstrate an effect on biological mechanisms associated with cardiovascular disease, available clinical studies are limited in sample size and appropriate controls.

Physicians should be certain patients inform them regarding all supplements, particularly herbal, which can result in serious bleeding and drug interactions. x You must be logged in to save to your library.

Guidelines JACC Journals on ACC. This herb is full of antioxidants that help eliminate free radicals. The antioxidant epicatechin contributes in supporting the heart, reducing the risk of heart disease. Oatstraw is a nutritive tonic, this herbal ally is most widely known for its restorative and nourishing effect on the nervous system.

This herb contains vitamins A, C, E, K, and B complex, and minerals like iron, calcium, magnesium, silica, and zinc. Studies have shown that low levels of daily calcium intake have been linked to an increased risk of high blood pressure.

One cup of oatstraw infusion contains up to mg of calcium. Fenugreek plants are native to South America, Asia, and the Middle East, its seeds have been used in TCM and Ayurveda for hundreds of years to aid digestion. Studies show that fenugreek seeds can help to improve lipid profiles by lowering high levels of LDL and triglycerides.

The medicinal mushroom has become increasingly popular over the past few years, especially as research begins to show the benefits mushrooms can have both mentally and physically.

Cordyceps has traditionally been used to help regulate abnormal heartbeat heart arrhythmia. A healthy diet contributes to our overall health; putting the right or wrong foods into our bodies will reflect our state of health and energy.

Garlic, artichokes, red rice yeast, cinnamon, turmeric, avocados, pistachios,and fiber can all help in maintaining heart health. Over the centuries, many cultures have used garlic to enhance the flavor of meals and for its medicinal properties.

Garlic produces allicin and ajoene, two compounds that are beneficial for healthy blood circulation, as they help prevent the formation of blood clots. Garlic has been widely studied and recognized for its positive effects on maintaining cardiovascular health, especially in diseases like hyperlipidemia, thrombosis, and hypertension.

Artichokes have 7grams of fiber, getting your recommended daily fiber intake has been linked to a lower risk of heart disease. Artichokes are also rich in vitamins C, K, folate, and minerals like potassium, magnesium, calcium, and iron. In Traditional Chinese Medicine, practitioners use red rice yeast to help improve digestion, blood circulation, and lower cholesterol.

Its cholesterol-lowering effects have been attributed to the herb's high levels of monacolin K. COQ10 or Coenzyme Q10 is an antioxidant that is produced naturally by the body, protecting cells from damage. The highest concentrations are found in the heart, liver, and kidneys. It is often used as a supplement for people who are experiencing heart conditions, like heart disease and high blood pressure.

COQ10 can also be found in foods like beef liver, chicken heart, trout, mackerel, sardines, soybeans, pistachios, peanuts, and sesame seeds. Common household spices like turmeric and cinnamon can contribute to heart health.

Cinnamon contains anti-inflammatory and antioxidant properties that may help reduce the risk of developing heart disease. Antioxidants help to fight oxidative stress and nitric oxide buildup that has been linked to contributing to heart disease.

Turmeric is most widely known for its anti-inflammatory properties, inflammation has been linked to heart disease. Meditation provides an endless list of health benefits including, stress reduction, increased self-awareness, lower risk of depression, increased self-esteem, reduced anxiety, and it has also been studied for its effects on heart health.

John Denninger , director of research at the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital said " Not only can meditation improve how your heart functions, but a regular practice can enhance your outlook on life and motivate you to maintain many heart-healthy behaviors, like following a proper diet, getting adequate sleep, and keeping up regular exercise.

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Back Herbal Home Remedies Homemade Healing. Herbs for Heart Health “ The human heart feels things the eyes cannot see, and knows what the mind cannot understand.

The Emotional Heart We've all felt the "emotional heart" in some form, whether from worry, fear, joy, or happiness. Herbal Allies for the Heart Hawthorn Crataegus spp.

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Gaia Herbs' Green Tea for Energy Support harnesses the benefits of certified Organic Green Tea leaves extracted and concentrated to provide the full spectrum of natural phytochemicals in green tea leaves.

Numerous pharmacological studies conducted in vitro focus on the heart-healing benefits of Olive Leaf Olea europaea. This small evergreen tree is a member of the Oleaceae family that shows promise in supporting cardiovascular health.

Along with supporting immune function, Olive leaf extract may lower blood pressure, reduce the risk of arterial damage, and may also help to support healthy blood clotting.

The antioxidants in Olive Leaf may help support heart health by protecting the body from free radical damage. It's a superior-quality extract containing compounds that have beneficial properties. These properties can help to support the body's natural defense against infections and other harmful pathogens.

Hibiscus Hibiscus sabdariffa is a genus of the Malvaceae or Mallow family. In some countries, it is often called Red Sorrel. Studies suggest that extracts of Hibiscus may help maintain healthy cholesterol levels already in the normal range. Hibiscus has numerous cardiovascular benefits.

Hibiscus tea can support healthy blood pressure and cholesterol levels, which can help support long-term cardiovascular wellness. Hibiscus is rich in antioxidants and has soothing properties, which can protect the heart and support healthy blood clotting. Hibiscus may also support healthy blood sugar levels and encourage a healthy metabolism.

Served hot or over ice, brighten any day with our delightful Organic Hibiscus Herbal Tea. Naturally sweet tasting, this tea has a tangy kick and a light citrus fragrance from Mandarin Orange Peel essential oil.

Recognized for its numerous health benefits, Garlic Allium sativum contains compounds such as allicin, which have antioxidant and soothing properties.

These compounds can help support blood flow to the heart, support healthy blood pressure and cholesterol levels, and support healthy blood clotting. Traditionally used in Chinese medicine for its potential health benefits, Ginseng Panax ginseng is believed to have protective effects on the cardiovascular system.

Ginseng promotes the production of nitric oxide, which relaxes the blood vessels and supports blood flow. This process supports endothelial function, healthy blood pressure levels, and heart health. It can also support healthy levels of LDL cholesterol and triglycerides, which are associated with an increased risk of heart disease.

Gaia Herbs' Ginseng Supreme supplement is a high-quality blend of ginseng, including American Ginseng, Eleuthero , and Asian Ginseng, to support stamina and vitality. Ginger Zingiber officinale is a flowering plant used for centuries in traditional medicine.

Ginger contains compounds such as gingerols and shogaols, which have soothing and antioxidant properties. Ginger can significantly support healthy blood triglyceride levels and blood pressure levels, as well as support overall heart function. Gaia Herbs Ginger Supreme is a high-quality supplement that supports a healthy immune response, digestive and cardiovascular health, and circulation.

Cinnamon Cinnamomum verum is a spice derived from the inner bark of trees native to Sri Lanka and southern India. It contains compounds such as cinnamaldehyde and cinnamic acid, which have soothing antioxidant properties.

One study found that taking cinnamon supplements for 12 weeks contributed to healthy blood triglyceride levels, a significant risk factor for heart disease.

In a meta-analysis of clinical trials, individuals who took cinnamon had healthier cholesterol levels compared to those who received a placebo.

Gaia Herbs Cinnamon Bark supplement is made from pure, organic cinnamon and can support healthy glucose and lipid metabolism. Gaia Herbs' expertly formulated heart-supporting products are made with organic, natural, and sustainably sourced ingredients.

This practice ensures you get the highest quality, most effective supplement possible while supporting our planet's health. With Gaia Herbs, you can trust that you're getting quality supplements and teas backed by science and a commitment to sustainability.

Small steps can make a significant impact on your wellness journey! Along with a healthy lifestyle, incorporating heart-healthy herbs can support your cardiovascular system and overall well-being. education 9 Herbs to Help Support a Healthy and Happy Heart Published on April 04, How Can You Make Your Heart Stronger Naturally?

REF While herbs and supplements can provide numerous benefits, it is crucial to understand the potential risks and ensure that they do not counteract medication or pre-existing medical conditions.

Hawthorn Hawthorn Crataegus is a large genus of shrubs and trees in the Rosaceae family. REF Gaia Herbs offers herbal products containing Hawthorn, such as our Hawthorn Supreme Capsules , Hawthorn Supreme Extract , and Turmeric Supreme Heart Health.

Turmeric A spice commonly used in Indian cuisine, Turmeric Curcuma longa contains the active ingredient Curcumin, which has potent soothing and antioxidant properties that may benefit heart health. REF Curcumin can help soothe scar tissue, support healthy heart tissue, and support the heart wall's thickness, which is vital for maintaining proper heart function.

REF Turmeric reduces irritation in the heart tissue , supporting overall heart health. REF Gaia Herbs Turmeric Supreme Heart Health combines Turmeric with other herbal extracts to support healthy cardiovascular function.

REF Gaia Herbs' Green Tea for Energy Support harnesses the benefits of certified Organic Green Tea leaves extracted and concentrated to provide the full spectrum of natural phytochemicals in green tea leaves. REF The antioxidants in Olive Leaf may help support heart health by protecting the body from free radical damage.

Hibiscus Hibiscus Hibiscus sabdariffa is a genus of the Malvaceae or Mallow family. REF Hibiscus has numerous cardiovascular benefits. REF Hibiscus is rich in antioxidants and has soothing properties, which can protect the heart and support healthy blood clotting.

REF Served hot or over ice, brighten any day with our delightful Organic Hibiscus Herbal Tea. Garlic Recognized for its numerous health benefits, Garlic Allium sativum contains compounds such as allicin, which have antioxidant and soothing properties.

REF Ginseng Traditionally used in Chinese medicine for its potential health benefits, Ginseng Panax ginseng is believed to have protective effects on the cardiovascular system. REF Gaia Herbs' Ginseng Supreme supplement is a high-quality blend of ginseng, including American Ginseng, Eleuthero , and Asian Ginseng, to support stamina and vitality.

Ginger Ginger Zingiber officinale is a flowering plant used for centuries in traditional medicine. REF Ginger can significantly support healthy blood triglyceride levels and blood pressure levels, as well as support overall heart function.

REF Gaia Herbs Ginger Supreme is a high-quality supplement that supports a healthy immune response, digestive and cardiovascular health, and circulation. REF One study found that taking cinnamon supplements for 12 weeks contributed to healthy blood triglyceride levels, a significant risk factor for heart disease.

REF In a meta-analysis of clinical trials, individuals who took cinnamon had healthier cholesterol levels compared to those who received a placebo.

REF Gaia Herbs Cinnamon Bark supplement is made from pure, organic cinnamon and can support healthy glucose and lipid metabolism. Featured Products Best Seller. Featured Products. Best Seller.

In addition, danshen dilates coronary arteries at low dosages but constricts noncoronary arteries at higher dosages. Another commonly used herbal therapy is garlic. Studies have shown that garlic use can lower serum cholesterol levels from 5 to 15 percent, reduce plaque size, and cause a modest reduction in hypertension.

Nevertheless, knowledge about the active compounds and the exact mechanisms of action are lacking. Other cardiovascular benefits can potentially occur with ginkgo, ginseng, hawthorn, horse chestnut seed, and yohimbine therapy. The authors emphasize that the studies on the efficacy of these medications are usually small, and there are a limited number of placebo-controlled trials to support them.

They also caution that many herbal therapies may have an adverse effect on the cardiovascular system see accompanying table.

One of the most common adverse effects is platelet dysfunction. The therapies that have been linked to platelet dysfunction include danshen, garlic, ginger, and kava. Therapy with these products could become a potential problem in patients who are taking antiplatelet medications or have a bleeding disorder.

Before initiating anti-platelet therapy, information about the use of herbal remedies should be obtained.

Another potential source of problems with herbal therapy is drug interactions. This is particularly true with warfarin therapy. Dong quai and garlic may increase the International Normalized Ratio INR in patients who are taking stable warfarin dosages.

One case report of ginseng therapy showed a decreased INR in a patient who was taking a stable dosage of warfarin, but there is no other supporting data.

Another drug interaction with herbal remedies that should be monitored is the potential impact on digitalis. The use of St. John's wort reduces serum digoxin levels. Herbal laxatives such as buckthorn, cascara sagrada, and senna can cause potassium loss that can lead to digitalis toxicity.

A number of herbs including oleander, adonis, black Indian hemp, black hellebore, lily-of-the-valley, squill, and strophanthus contain an active cardiac glycoside that can potentiate digoxin.

The authors conclude that the growing use of herbal remedies in the United States has surpassed the available information on their potential benefits, risks, and drug interactions. Physicians should become familiar with the evidence about these alternative therapies.

This will allow patients who wish to use herbal therapies an opportunity to do so in a safer manner. Valli G, Giardina EG. Benefits, adverse effects and drug interactions of herbal therapies with cardiovascular effects. J Am Coll Cardiol. April 3, ; This content is owned by the AAFP.

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Herbal cardiovascular support

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How Herbal Medicine Can Help With Cardiac Problems And 6 Herbal Remedies

Herbal cardiovascular support -

Discover the power of time-honored botanical wisdom as you embrace a path to cardiovascular well-being.

Trust in nature's gifts and prioritize your heart's health with our cardiovascular support remedies. Your heart deserves nothing but the best.

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Beet Juice Capsules. Garlic Capsules. Hawthorn Capsules. Bilberry Capsules. Dandelion Leaf Capsules. Ginkgo Capsules. Aronia Berry Capsules. HBP Complete Powder. Hawthorn is used to dissipate food accumulation, to improve blood circulation, and to disperse blood stasis.

Modest decreases in BP have been observed in a few human-based studies with a demographic of hypertensive patients Walker et al. In a randomized, double-blind, placebo-controlled study where mildly hypertensive subjects were treated with mg of hawthorn extract for 10 weeks, a promising tendency for a reduction in diastolic BP was reported Walker et al.

In another clinic study, administration of hydro-alcoholic extracts of hawthorn flowers to hypertensive patients age range 40—60 years for 3 months induced a decrease in both systolic BP and diastolic BP by around 13 and 8 mmHg, respectively Asgary et al. Crocus sativus L, also known as Saffron, a plant indigenous to Southwest Asia, Spain, Greece, and Morocco, is a stemless herb.

Several reports support the use of saffron for anti-hypertensive benefits. A clinical study reports that mg of Saffron tablets administered for 7 days are able to significantly reduce the systolic BP and mean arterial pressure in healthy humans by 11 and 5 mmHg, respectively Modaghegh et al.

Six weeks old stroke-prone SHRs are given crocetin for 3 weeks and this treatment significantly moderates the increase in systolic BP observed with age Higashino et al. Saffron also demonstrates vasorelaxant activities in different animal models, including male Sprague-Dawley rats Fatehi et al.

Also known as Roselle, Hibiscus sabdariffa is widely used for hypertension, fever, and other diseases in folk medicine. Different parts of this plant buds, calyx, flowers, leaves, and petals—fresh or dried are used for health purposes and as refreshing beverages, food items jams, preserves , or lotions.

The blood lowering effects were notable subsequent to treatment with dried extract of Roselle calyx for 4 weeks in patients with stage 1 or 2 hypertension Herrera-Arellano et al. Hippophae rhamnoides L is also called Saji or Sea buckthorn and its dry fruits are used in China as an herbal medicine.

Analysis showed that the powder made of dry hippophae fruits contains the vitamins C, B1, B2 and E, provitamin A, rutin, serotonin, cytosterol, selenium and zinc.

The stroke-prone SHR were fed ad libitum with blocks of rat chow supplemented with Hippophae powder and the effect of lowering BP was examined. The mean arterial BP and heart rate were significantly decreased by the Hippophae treatment Koyama et al.

Nigella sativa L, also known as Black Cumin or Habbatul barakah seed of blessing , has been used in the kitchens of Europe, the Middle East, Africa, and Asia for centuries. Thymoquinone, one of the most abundant and bioactive components, has been identified as the major element in its healing effects.

Similar to other herbs, N. sativa and its constituents have been shown to reduce BP in humans and different animal models of hypertension. Again, in a randomized, placebo-controlled, double-blind study with 70 healthy subjects, N.

sativa oil caused a significant decrease of Panax ginseng , also called Panax or Renshen, has been used in folk medicine for several centuries. Ginseng is prepared and administered in various forms, either as a solid: tablets, capsules, dried roots; or as a liquid: oil, extracts or tea.

There are four most common species of Ginseng, including P. ginseng Asian or Korean Ginseng , P. quinquefolius American Ginseng , P.

japonicas Japanese Ginseng and P. notoginseng Chinese Ginseng are the four most common species of ginseng. Heterogeneous triterpenoid saponins and steroid glycosides or ginsenosides or panaxosides are the active principle components of ginseng.

Several clinical trials have been conducted to assess the efficacy of ginseng in BP regulation. The mode of action may be related with antagonizing a calcium ion channel in vascular tissues, which may result in lowering BP. However, conflicting reports of elevated BP also exist Jang et al. For example, studies have shown that low doses of ginseng raise BP, while higher concentrations are hypotensive Jang et al.

It is also known as Kudzu root or Gegen. Kudzu root has traditionally been used in Chinese medicine for treating CVDs and Type II diabetes. It is a rich source of polyphenolic compounds, including isoflavones, isoflavonoid glycosides, coumarins, puerarols, butenolides and their derivatives.

Puerarols attract more attention to investigate the direct effect on BP. Verapamil is a positive control inhibiting Angiotensin II type I receptor and angiotensin-converting enzyme 2 in SHRs. Similar to it, puerarin treatment significantly repressed the mRNA levels of Angiotensin II type I receptor and angiotensin-converting enzyme 2 in cardiac tissues Ye et al.

Further interdisciplinary collaboration to bridge the gap between traditional medicine and modern biomedical medicine is needed for the development of Kudzu root as an effective medicine for the management of hypertension and other CVDs. Danshen is one of the oldest and most frequently consumed Chinese traditional herbs and is commonly used for the treatment of CVDs.

Sal A, Sal B, Danshensu, and tanshinones are its most effective ingredients. A combination treatment of Danshen and Gegen was shown to lower BP in SHRs and to induce relaxation of several kinds of arteries including porcine coronary arteries, rat aorta, and basilar arteries Al Disi et al.

The dried roots of S. baicalensis , also known as Huangqin in China, have been widely employed in traditional CHM as popular antibacterial and antiviral agents. Baicalein and its glycoside, baicalin, are the major ingredients responsible for its beneficial effects. However, the baicalein exerts a complex effect on the agonist contracted rat mesenteric arteries.

Within a relative low concentration range 0. Since the increased vessel contraction is absent upon removal of the endothelium while the relaxant effect of baicalein remains Chen et al. Atherosclerosis, one of the primary causes of CVDs, is a vascular disease that occurs at susceptible sites in major arteries.

It is an inflammatory process and ultimately causes stenosis or thrombosis with potentially lethal distal ischemia. The main elements involved in the complex pathogenesis of atherosclerosis include hyperlipidemia, endothelial injury, LDL subendothelial retention and oxidation, monocyte migration and activation, VSMC migration and proliferation, foam cell formation, apoptosis and efferocytosis and unresolved inflammation.

Among them, dyslipidemia is the primary independent risk factors, which is characterized by elevated level of total cholesterol TC , triglyceride TG , LDL-C and by lowered level of high-density lipoprotein cholesterol HDL-C in serum. The description of the clinical manifestations and treatment of atherosclerosis can be found in the classic traditional Chinese medicine book Inner Canon of yellow Emperor, as early as BC.

Atherosclerosis, dyslipidemia and its resulting heart disease have been treated with numerous herbal remedies for centuries. Then, we present a comprehensive alphabetical list of plant products which are most commonly used to attenuate atherosclerosis and lower hyperlipidemia.

Allium fistulosum L is widely cultivated in Southern China. Treatment with Fistular onion stalk, the derivant from A.

The extract also reduces the levels of the inflammatory cytokines IL-1β, IL-6, MCP1 and TNFα and downregulated the local activity of the rennin-angiotensin-aldosterone system in the aortic tissue.

et al. These data indicate that fistular onion stalk extract may be useful for the attenuation of atherosclerosis, and the mechanism includes the regulation of the local inflammatory responses. In addition to the anti-hypertensive effect, there is also wide spread belief among general public that Allium sativum L garlic has beneficial effects on dyslipidemia in patients.

Seventy type 2 diabetes patients with newly diagnosed dyslipidemia were divided into two groups and were given tablet garlic mg containing 1. In a double-blind, crossover study of moderately hypercholesterolemic men, treatment with 7.

These effects were Although one recent meta-analysis concluded that garlic decreases TC to a modest extent, an effect driven mostly by the modest decreases in TG, with no appreciable effect on LDL or HDL cholesterol Reinhart et al. Since some meta-analysis has been based on trials with inadequate study designs, methodological deficiencies, the effect of garlic on atherosclerosis and dyslipidemia awaits further investigation.

The dried root of Astragalus propinquus , Radix Astragali, is also known as Huangqi. Polysaccharides, flavonoids, and sponins are the main active components of membranous milkvetch root.

Studies have shown that Huangqi extract significantly decreased the area of atherosclerosis plaques Effects of its extract and components on lipid profile are also summarized in a review, in which the serum of TG, TC, and LDL-C levels were reduced by both Astragalus mongholicus extracts treatment at 0.

Accordingly, the HDL-C levels were increased by these treatments Guo et al. Rhizoma Coptidis, also known as Huanglian, is derived from the dried root and rhizome of Coptis chinensis Franch. Cheng et Hsiao, and Coptis teeta Wall. Its main components include lignans and alkaloid, in which berberine is the active component for lipid lowering.

Studies have shown that berberine administration significantly decreased the serum TG, TC, LDL-C, when taken orally or injected intraperitoneally Zhou et al. In addition, Caucasian obese human subjects were orally given mg berberine, three times a day for 12 weeks.

The blood lipid was significantly reduced and TG, TC were decreased by 23 and In a meta-analysis, berberine induced a significant reduction in these biomarkers in participants in11 randomized controlled trials Ma et al.

Known as hawthorn, its hypolipidemia effect has been investigated widely in animal studies. Then, the specific effects of aqueous and ethanol extracts of hawthorn on lipid profiles were compared. In a high-fat emulsion fed mice, both ethanol and aqueous extracts possessed hypolipidemia activities and the ethanol extract exhibited more favorable effects than the aqueous extract Shao et al.

This lipid lowering effect of hawthorn mostly contributes to inhibition of the progression of atherosclerosis which was evidenced by the significantly inhibited pathological changes and reduced intima-media thickness in the arteries Zhang et al. In-depth exploration demonstrated that the lipid-lowering action may be due to the anti-inflammation activities, the upregulation of PPARα to facilitate β-oxidation-related enzymes in liver leading to lipid degradation, enhanced expression of hepatic LDL receptors resulting in a greater influx of plasma cholesterol into the liver, and the suppressed cholesterol biosynthesis and increased degradation of cholesterol to bile acids Niu et al.

The hypolipidemic effects of hawthorn in clinic remain further study. Epimedium brevicornum Maxim, an important traditional CHM, has been used widely for s of years in China, Korea, and Japan.

Icariin, a flavonoid isolated from Epimedium brevicornum Maxim, is considered as the main pharmacological active constituent.

In the high cholesterol diet-induced atherosclerosis rats, the levels of blood lipids including TC, TG, LDL-C, and malonaldehyde were significantly increased, while HDL-C and SOD were significantly decreased. Icariin succeeded in improving these biochemical parameters toward the normal values Hu et al.

Its dried root tuber is Radix Polygoni Multiflori, also known as Heshouwu. Raw and prepared pharmaceutical forms are frequently used. Guo et al. Similarly, these lipid profiles in the hyperlipidemic rats were lowered by the treatment of the ethlacetate extracting fraction and stilbene glycoside from the tube of Radix Polygonum Multiflorum too Guo et al.

Fermentum Rubrum, popularly known asred yeast rice, is the fermented product of Monascus purpureus on rice. It is composed of 13 kinds of natural statins, unsaturated fatty acids, ergosterol, amino acids, flavonoids, alkaloid, trace element, and so forth.

Some clinic studies have demonstrated the lipid lowering effects of the red yeast rice. A twice daily dose of red yeast rice at mg for 8 weeks was found to reduce LDL-C by Similar effects were observed in 72 patients with idiopathic persistent nephritic syndrome with secondary dyslipidemia Gheith et al.

Xuezhikang capsule is the extract of red yeast rice. Scholars in China made a systematic review on the clinical randomized controlled trials for hyperlipidemia treatment with Xuezhikang, which included a total of participants in 22 randomized trials.

It was concluded that Xuezhikang remarkably lowered TC, TG, and LDL-C compared with the inositol nicotinate Fallah Huseini et al. The beneficial effects of Olea europaeal L. According to the European Pharmacopeia, the most abundant substances in standardized dry leaf extracts are oleuropein, hydroxytyrosol, caffeic acid, tyrosol, apigenin, and verbascoside, with oleuropein being the major component of olive leaf extract.

Olive leaf extract treatment reduces the atherosclerostic lesions size and the thickness of intima in atherosclerotic rabbits, accompanied with decreased levels of atherosclerotic markers, including serum TG, TC, LDL, HDL, and malonaldehyde with a parallel downregulation of MCP1, vascular cell adhesion molecule-1, NFkB and TNFα Wang et al.

Consistent with it, another animal study showed that a 1-month intake of hydroxytyrosol by rabbits consuming an atherogenic diet results in a reduced size of atherosclerotic lesions compared to control animals Gonzalez-Santiago et al. However, the results originating from in vivo models are divergent.

The intake of hydroxytyrosol in an in vivo apo-E knockout mice model showed that this compound, when administered for 10 weeks, leads to atherosclerotic lesions associated with the activation of monocytes and modification of the blood lipid profile Acin et al.

These studies indicate that under certain conditions the phenol could be rather harmful than cytoprotective. Ginseng saponin is divided into Rb1, Rb2, RC, Rd, Re, and Rl. Ginseng radix can be metabolized into compound k in small intestinal.

In vitro , the metabolites significantly activate the AMP-activated protein kinase AMPK to affect the lipid metabolism in insulin-resistant HepG2 human hepatoma cells Kim et al. Also known as Kudzu Root, its effects on hyperlipidemia are investigated in a series of studies.

Furthermore, hepatic lipid metabolism was also enhanced in ovariectomized rats by oral administration of Kudzu root Wang et al. Reynoutria japonica Houtt is a synonym of Polygonum cuspidatum siebold and Zucc. Its dried root and rhizome is known as Huzhang in Chinese medicine.

Polydatin and resveratrol are the primary active components. Rheum palmatum Linn. Ex Balf. Radix Et. Rhizoma Rhei, also known as Dahuang or rhubarb, is derived from the root and rhizome of Polygonaceae members.

The main active component includes rhein, aloe emodin, emodin, chrysophanol, and physcion. There is a series of studies exhibited the lipid-lowering effects in animals or patients.

Thus the lipid-lowering effect of rhubarb, at least, partially dues to the component rhein. Danthron is another extract of rhubarb. It was observed that danthron dose-dependently promoted the phosphorylation of AMPK and acetyl-CoA carboxylase in both HepG2 and C2C12 cells.

Meanwhile, danthron significantly reduced sterol regulatory element-binding protein 1c synthesis and fatty acid synthase gene expressions, contributing to the inhibitory effect on lipid metabolism Han et al. However, some side-effects, including vomiting, headache, diarrhea and abdominal pain, are reported by some volunteers.

Scutellaria baicalensis , known as Huangqin, is derived from the dried root of Scutellaria baicalensis Georgi. The most effective lipid-lowering component is flavonoid compound. In addition, treatment with flavonoids from the Huangqin leaves increased the activity of lecithin cholesterol acyltransferase in hyperlipidemia rats Regulska-Ilow et al.

The ripe seed of Senna obtusifolia Linn. Fabaceae or Cassia tora Linn. Leguminosae is Semen Cassia, known as Juemingzi. Anthraquinone glycosides are the active component. Similar results were induced by administration with the total anthraquinone from Semen Cassia for 2 months in alcohol treated SD rats Guo et al.

There are many other herbs which show the hypolipidemic effects and widely used in Chinese medicine. These herbs include Rhizoma Chuanxiong , Rhizoma Curcumae Longae Jianghuang , Rhizoma Alismatis Zexie , Semen Plantaginis Cheqianzi , and Folium Nelumbinis Heye. The oral administration of the extracts or the active components exerts the hypolipidemic effects and improving lipid metabolism Guo et al.

In addition, there are some formulae for dyslipidemia which are applied in clinic basing on syndrome differentiation China Association of Chinese Medicine, The formulae are listed in Table 2. Cardiovascular diseases involving the heart includes angina, myocardial infarction, cardiomyopathy, congenital heart disease, and heart failure, etc.

Some of the diseases interact on each other or on other vascular diseases. For example, coronary artery diseases involve atherosclerosis, which may be caused by hypertension, hyperlipidemia, whereas heart failure can arise as consequence of large myocardial infarctions.

Thus, herbs applied in treatment of hypertension, atherosclerosis and lowering lipid profiles should contribute to attenuating heart diseases too. Here, we present formulae and the natural plants frequently used in clinic and lab studies in alphabetical order.

There are some formulae which are frequently used to treat heart diseases. With 1 H NMR and UHPLC-MS measurement, day application of Sini decoction effectively reversed the urinary metabolic profiles in the myocardial infarction rat model Tan et al. Another formula consists of Terminalia arjuna, Cactus grandiflorous, Crataegus oxyacantha , and Piper nigrum.

Preadministration and postadministration of this herbal mixture restore the levels of biomarker of cardiotoxicity, including cardiac marker enzymes, lipids profile, and antioxidant enzymes Lin et al.

Rhodiola formulation is claimed to relieve the symptoms of ischemic heart disease and improve the electrocardiography in a number of clinical studies Yu et al. In addition, the ORs of symptomatic and electrocardiography improvement in Rhodiola formulations versus other CHMs, versus routine western medicine, and Rhodiola formulations plus routine western medicine versus routine western medicine were 1.

These findings indicate that the formulations have a positive effect on treating ischemic heart disease alone or in combination with routine western medicine. In addition, there are some formulae for angina pectoris or coronary heart disease or heart failure which are based on syndrome differentiation China Association of Chinese Medicine, and are listed in Tables 3 and 4.

TABLE 3. Formulae for coronary heart disease and angina pectoris based on syndrome differentiation. Injection of Astragalus , also known as Huangqi, is one of the most commonly used Chinese patent medicines for the treatment of chronic heart failure in China as complementary treatment to recommended Western therapies.

Fu et al. Although the available studies are not adequate to draw a conclusion on the efficacy of the Huangqi injection, it is observed to enhance myocardial contractility, improve circulation, and protect myocardial cells with modern pharmacological tools.

For example, in an in vivo rat model of persistent myocardial ischemia produced by occlusion of the left anterior descending coronary artery, pretreatment of Huangqi extract significantly decreased the myocardial infarct size and the serum levels of lactate dehydrogenase, creatine kinase isoform MB, and cardiac troponin.

Cecropia pachystachya , popularly called ambay, is extensively used in herbal medicine of South America. Cecropia pachystachya Mart growing in a temperate region produced a positive inotropic effect on isolated rat hearts independent of beta-adrenergic effect.

In contrast, the inotropic effect was prevented by pretreatment with high potassium media stimulating Na-K-ATP pump , indicating an inhibition of the pump by ambay Consolini et al. It has been described in previous sections hawthorn.

In isolated perfused hearts, extracts of hawthorn have been reported to show cardioprotective effects without affecting coronary blood flow Nasa et al.

Simultaneously, they demonstrated vasodilator actions and positive cardiac inotropic effect Blesken, These results were verified in a multicenter, placebo-controlled, double-blind study, in which WS , the special extract of hawthorn, improved cardiac function determined by heart rate product systolic BP × heart rate in patients with NYHA class II heart failure Weikl et al.

More studies are needed to investigate the mechanisms of hawthorn to attenuate CVDs. It has been described in previous sections and the main extract from the olive leaves is oleuropein. The rabbits were subjected to a 30 min period of regional ischemia of the heart followed by a 3 h reperfusion.

Chronic pretreatment with oleuropein reduced the infarct size compared with the control Andreadou et al. In doxorubicin-induced cardiomyopathy, oleuropein effectively improved the impaired cardiac geometry and function evidenced by transthoracic echocardiography Andreadou et al.

Reflow in ischemic hearts induced oxidized glutathione release and membrane lipid peroxidation, which were prevented by oleuropein.

The reported data demonstrated the direct cardioprotective effect of oleuropein in the acute events that follow coronary occlusion, and the nutritional benefit of olive oil in the prevention of coronary heart disease Weikl et al.

The root of Panax notoginseng , known as Sanqi, Sanchi or Tianqi in East Asian countries, has been identified over 80 variants according to different substitute patterns. A myriad of studies demonstrate the protective effect of notoginseng in cardiac injury. Secondly, it could reduce infarct size and serum level of creatine kinase in rat models of myocardial ischemia Yue et al.

Thirdly, it decreased serum levels of lactate dehydrogenase, cardiac troponin I, malondialdehyde and several cytokines, including TNF-a, IL-1β and C-reactive protein Han et al. These findings suggest considerable therapeutic potentials of notoginseng for myocardial infarction.

Interestingly, Notoginseng combined with the powdered extract of Carthamus tinctorius , an anti-thrombus herbal medicine, or with Sals, the active ingredient of C.

tinctorius , showed stronger effects to reduce infarct size than either drug alone Yue et al. Thus, combination medication remedy should be considered for CVDs treatment. In addition to hypertension and hyperlipidemia, the dried root of Salviae miltiorrhizae Danshen is widely used in China for the treatment of angina pectoris and acute ischemic stroke.

It has a range of potentially beneficial effects, including improving microcirculation, causing coronary vasodilatation, suppressing the formation of thromboxane, inhibiting platelet adhesion and aggregation, and protecting against myocardial ischemia.

Danshen is widely used either alone or in combination with other herbal ingredients for patients with coronary artery disease or CVDs. An acute myocardial infarction model was induced and both infarct size and echocardiographic response were evaluated at different time after surgery.

Both Sal and tanshinone two hypdrophilic and lipophilic compounds delayed the development of ischemia by decreasing infarct size and improving systolic function post myocardial infarction Wang et al.

However, a recent review of randomized controlled trials of Danshen in ischemic disease published in mainland China identified trials from to , but concluded that the quality of these trials has not improved significantly over recent years and the overall quality is still poor Yu et al.

Since clinical studies have various methodological problems, further high-quality randomized controlled trials should be performed to assess the efficacy of this herb. For over years, CVDs have been treated with numerous herbal remedies. However, these herbal remedies have not been well studied using modern cellular and molecular techniques.

Based on the existing investigations into mechanisms of single herbal compounds, a summary of these studies is presented in the following section wherein the compounds are discussed according to their target site of activity.

The blood vessel tonicity is principally controlled by the contraction and relaxation of VSMCs. Herbal medicine that regulates proteins or molecules in this pathway would modulate vascular contraction or relaxation.

Firstly, blocking contractile and structural proteins may be one of the ways which natural plants could facilitate vasodilation and vascular remodeling. It has been shown that Tianma the tuber of an orchid enhances acetylcholine-induced vasorelaxation or phenylephrine-induced contraction in aortic rings Feng et al.

Secondly, phosphorylation of myosin light chain protein is another target for herbs to determine vascular smooth muscle contraction.

A10 cells, rat smooth muscle cells, were treated with kinds of herbs and it was observed that four herbs, Liu-Wei-Di-Huang-Wan, Jia-Wei-Xiao-Yao-San, Danshen and Gegen, reduced phosphorylation of myosin light chain, suggesting that these most common herbs may be beneficial for smooth muscle cell contractility Lin et al.

Extracellular matrix is another target involved in vascular tone regulation. ECM proteins such as Postn is specifically induced upon tissue injury and could promote cellular adhesion and movement as well as collagen fibrillogenesis.

ECM glycoproteins include Eln, Fbln5 and Prelp, being essential to maintain arterial morphogenesis and vessel elasticity. Tianma could induce up-regulation of ECM glycoproteins and down-regulation of ECM proteins in vascular system, thereby regulating blood vessel tonicity by increasing the arterial elasticity and stabilizing the arterial structure Feng et al.

Calcium levels in VSMCs also contribute to regulating the vascular contraction. Tetramethylpyrazine TMP, also known as Ligustrazine , is a vasoactive component derived from Ligustium Wollichii Franchat.

Using dog mesenteric arterial ring preparations, TMP not only caused a dose-dependent inhibition of vascular contractile responses to KCl and phenylephrine in solution with calcium, but also inhibited the responses to phenylephrine in Ca-free medium containing 50 μM EGTA.

This effect was mimicked by a structurally unrelated lipoxygenase inhibitor, 5,8,eicosatriynoic acid and was restored by addition of 12 S -hydroxyeicosatetraenoic acids Saito et al.

Then, the BK Ca -mediated vascular contraction is further explored. The cAMP and the cGMP pathways are major regulators of smooth muscle contractility. By cyclic nucleotide assays, baicalin enhanced both cAMP and cGMP levels in mesenteric arteries.

Baicalin was observed to enhance BK Ca currents in a concentration-dependent manner, which were abolished by combining inhibitors of AC SQ and sGC ODQ , by combining inhibitors of PKA KT and PKG KT , and PKC activator PMA in mesenteric artery smooth muscle cells.

These results indicate that baicalin-induced mesenteric artery relaxations could be due to BK Ca channel activation occurs not only as a result of PKA and PKG, but also as a result of cross-interaction with PKC Lin et al.

The effects of Camellia japonica on VSMCs migration was evaluated with a wound healing assay. Camellia japonica concentration-dependently suppressed platelet-derived growth factor-BB induced VSMCs wound healing for 24 and 48 h after injury, indicating the migration inhibiting effects Park et al.

In addition, baicalein and baicalin induced anti-proliferative and anti-mitogenic effects in VSMCs of rabbit, rat and bovine were well summarized Huang et al. These results provide additional evidence for the beneficial cardiovascular effects of natural products.

Andrographolide is the most active and critical constituent isolated from the leaves of Andrographis paniculata , a herbal medicine widely used as an anti-inflammatory drugs in Asia. The mechanisms of the inflammatory effects of andrographolide in VSMCs were investigated by exposing VSMCs to a proinflammatory stimulus, TNF-α.

Treating TNF-α-stimulated VSMCs with andrographolide suppressed the expression of inducible nitric oxide synthase NOS , JNK, Akt, and p65 phosphorylation. Thus, andrographolide-mediated inhibition of NF-κB activity in TNF-α-stimulated VSMCs occurs through the JNK-Akt-p65 signaling cascade mechanism, which is independent of IκBα degradation Chen et al.

These results collectively suggest that therapeutic interventions using andrographolide can benefit the treatment of vascular inflammatory diseases. In addition to cellular powerhouses, mitochondria are known as critical regulators of cell death.

And they are the major cellular source of ROS which causes damage to mitochondrial DNA in human VSMCs in a number of cardiovascular pathologies. Thus, mitochondrial dysfunction may lead to the impairment of various aspects of tissue functioning. It has been known that cultured rat aortic VSMCs treated with AngII for 24 h exhibited mitochondrial dysfunction, including a decrease in mitochondrial oxygen consumption rates, ATP production and mtDNA levels, as well as the disruption of mitochondrial structural integrity Lu et al.

Together with the mitochondrial morphological changes, these alterations were reversed by Astragaloside IV, the major active ingredient of Astragalus membranaceus Fisch. a traditional CHM. Moreover, treatment with Astragaloside IV also reversed the AngII-induced increase in the production of ROS, the increase in NADPH oxidase and xanthine oxidase activity, as well as the decrease in mitochondrial membrane potential and manganese-SOD activity.

These results indicate that Astragaloside IV exerts beneficial effects on AngII-induced mitochondrial dysfunction in rat VSMCs and that these effects are mediated through the inhibition of ROS overproduction, as well as the promotion of mitochondrial autophagy and mitochondrial biogenesis Lu et al.

Overall, herbal medicines discussed here do appear to show pharmacological effects in vitro and in animal studies, which may influence CVDs. FIGURE 1. Endothelial cells, which constitute the inner cellular lining of blood vessels, have a key role in regulating vascular homeostasis and function, such as vasorelaxation, vascular integrity, and local inflammation.

Endothelium-dependent vasodilation was commonly applied to examine the endothelium function, in which NO is a potent vasodilator and plays an important role in regulating vascular tones. Some herbal medicine functions by targeting at the NO producing process.

In studies at the arterial levels, both Lysimachia clethroides and gypenosides elicit vasorelaxation which was abolished by endothelial NOS eNOS or guanylyl cyclase inhibitors Tanner et al.

Sal B, a hydrophilic caffeic acid derivative of Danshen, exerts an important regulatory function on endothelial tissue of isolated mouse aorta by promoting NO production through the inhibition of arginase activity Joe et al.

Fo Shou San, an ancient herbal decoction Chuanxiong Rhizoma and Angelicae Sinensis Radix Danggui in a ratio of , reversed homocysteine-induced impairment of acetylcholine-evoked endothelium-dependent relaxation in rat aortic rings Bi et al.

In studies at the cellular levels, gypenosides induced a concentration-dependent increase in NO production from cultured bovine endothelial cells Tanner et al. Consistent with it, magnesium tanshinoate B another compound purified from Danshen or Fo Shou San, also stimulated the release of NO and its metabolites from a human endothelial cell line ECV O et al.

By exploring the mechanisms by which NO production is induced, it was observed that the cellular NOS activities were significantly enhanced with a concomitant increase in the levels of constitutive NOS protein mass O et al. Inflammation plays a crucial role in the pathophysiology of CVDs, in which adhesion molecules, pro-inflammatory cytokines and chemokines are involved.

The anti-inflammatory effects of Danshen and its active ingredients Sal B, Tanshionone IIA, Protoc et al. were extensively investigated in traditional Chinese medicine for therapy of CVDs.

Incubation with TNFα or ADP is widely used to induce inflammation in vitro. In TNFα treated HUVECs, although neither Sal B nor Tanshinone IIA inhibit the inflammation Stumpf et al.

In ADP-treated human platelets, pre-treatment with both Sal B, Tanshionone IIA and Danshen significantly attenuated platelet P-selectin expression Stumpf et al. Gypenoside XLIX, a dammarane-type glycoside, is a prominent component of G. Studies demonstrate that Gypenoside XLIX inhibits TNFα-induced VCAM-1 over expression and hyperactivity in human endothelial cells via a PPARα-dependent pathway Huang et al.

These findings provide useful insight into the rational basis of CHM in the treatment of CVDs. There are a myriad of herbs that demonstrate effects of endothelial cell protection by different mechanisms. For example, Sal B decreases ROS production in the aortic rings. Since ROS easily acts with NO to produce peroxynitrite anions, which is a potent and potentially toxic oxidant that damages various types of biomolecules, it can be deduced that Sal B may exert its protective function by precluding NO consumption through adverse reactions such as peroxynitrite formation and preserving NO bioavailability Joe et al.

EGb Ginkgo biloba extract suppresses oxidative stress in a dose-dependent manner in high glucose-stimulated HUVEC. In addition to inhibition of ROS generation and 8-OHdG content, it attenuated oxidative DNA damage, indicating herbs could exert endothelial protection by alleviating endothelial DNA oxidation He Y.

Echium amoenum extract a major source of anthocyanins demonstrated antioxidant and cytoprotective effect in H 2 O 2 -treated HUVECs. KRGE reduces the H 2 O 2 -induced cell injury in HUVECs too. The inhibited effect on cell death was blunted by HO-1 inhibitor zinc protoporphyrin.

HO-1 is considered to augment the cellular defense against various agents inducing cytotoxic injury. KRGE was observed to induce up-regulation of HO-1 expression in HUVECs, which was abolished by specific silencing of Nuclear factor-eythroid 2-related factor 2 Nrf2, a important anti-oxidant transcription factor expression Yang et al.

These results suggest that Korean Red Ginseng may exert a vascular protective effect through Nrf2-mediated HO-1 induction in human endothelial cells. Ophiopogonin D is one of the most bioactive components of Radix Ophiopogon japonicas. Its pretreatment showed a series of antioxidation-related protective effects: 1 reducing H 2 O 2 -induced lipid peroxidation and protein carbonylation, 2 attenuating mitochondrial ROS generation and cell apoptosis, 3 restoring cellular total antiboidative capacity, 4 inhibiting the release of inflammatory cytokines and blocking activation of NFκB and ERK signaling cascades, 5 suppressing the enzymatic activity of catalase, HO-1, and caspases Qian et al.

In general, these findings support the protective role of herbs as an effective antioxidant in endothelial injury. Although endothelial cell dysfunction occurs in many different disease processes, caspase-dependent apoptotic cell death induced by the extrinsic or intrinsic pathways is identified as a common denominator.

Protective effect of KRGE was examined in a serum-deprived apoptosis model, which demonstrated that it could prevent serum deprivation-induced HUVEC apoptosis Kim et al. Cytosolic cytochrome c is known to play a crucial role in the activation of the initiator caspase-9 and the effector caspase KRGE prevented subcellular redistribution of cytochrome c from the mitochondrion into the cytosol, resulting in suppression of the extrinsic pathway of apoptosis activation Kim et al.

The cytoprotective property of KRGE may be valuable for developing new pharmaceutical means that limit endothelial cell death induced during the pathogenesis of vascular diseases. Angiogenesis, the formation of new blood vessels from preexisting endothelium, is critical to a variety of processes, both physiologically embryonic development and wound healing and pathologically malignancy and chronic inflammation.

It is a complex biologic function comprising several steps, including sequential basement membrane degradation, endothelial cell migration and proliferation, tube formation, inhibition of endothelial proliferation, and the stabilization of new vessels.

Modulation of any of these steps would affect new vessel formation. Scutellarin, a known flavone glycoside, is the primary active component of the traditional CHM Erigeron breviscapus Vant.

It has been shown to induce endothelial cell proliferation and migration, promote capillary-like tube formation, and significantly upregulate platelet endothelial cell adhesion molecule-1 Gao Z.

These results suggest that herbal medicine promotes angiogenesis and may form a basis for angiogenic therapy. Endothelial cell hyperpermeability is another factor implicated in CVDs, in which the importance of tyrosine phosphorylaton and kinase activity in oxidant-mediated loss of cell junction structures has been demonstrated.

Extract of salvia miltiorrhiza and its major ingredients, Danshensu and Sal B inhibited TNFα-induced endothelial permeability, evidenced by attenuated junctional protein phosphotyrosine and prevention of beta-catenin disassociation from the cytoskeleton Ding and Yuan, The mechanism of pharmacological action was further explored.

The extract, Danshensu and Sal B also repressed expression of vascular endothelial growth factor and ERK activation in TNFα treated HUVEC cells. In addition, it was found that the extract attenuated the disorganization of vascular endothelial-cadherin, which is likely due to a reduction of vascular endothelial growth factor protein expression as a result of modulation of the ERK signaling pathway Ding et al.

These findings suggest that active herbal ingredients may help to attenuate CVDs by maintaining the integrity of endothelial junction structure. In general, herbal medicines do show the beneficial effects in endothelial cells.

As shown in Figure 1 , these natural plants exert the protective effect by inhibition of inflammation, oxidative stress and apoptosis, activation of eNOS-NO signaling pathway, induction of angiogenesis and suppression of endothelial permeability.

Pathological cardiac hypertrophy induced by increased sympathetic drive can subsequently lead to congestive heart failure, which represents the major cause of morbidity and mortality worldwide. In addition, Astragalus polysaccharide pretreatment not only alleviated the augmentation of intracellular free calcium during cardiac hypertrophy but also upregulated expression of calcineurin, translocation of nuclear factor of activated T cells, cytoplasmic 3 into nucleus and activation of calmodulin kinase II reflected by p-CaMKII Dai et al.

Chlorogenic acid is an important component of CHM, which acts as an antioxidant scavenging free radicals and preventing inflammation. Pre-treatment of chlorogenic acid in the isoprenaline-induced neonatal rat myocytes, decreased the levels of the hypertrophic markers, ANP, B-type natriuretic peptide and β-MHC.

The level of the intracellular ROS was reduced and the nuclear translocation of NF-κB was blocked, whereas NF-κBIA, an inhibitor of NF-κB, was upregulated accordingly. These data reveal that chlorogenic acid may inhibit cardiac hypertrophy by attenuating NF-κB signaling pathway and suppressing ROS production Li et al.

Many data have demonstrated that ROS production by myocardial endothelial mitochondria contributes to heart disease and oxidative stress within ventricular myocytes can also be detrimental to the heart. In fact, much of the contractile dysfunction and adverse myocardial remodeling, which has been observed in a wide range of cardiomyopathies, involves oxidative stress and eNOS uncoupling leading to a decrease in NO.

There are a series of targets at which herbal medicine act to improve myocardial endothelial function by attenuation of oxidative stress.

Thus, free radical scavenging and inhibition of oxidases will exert protective effect in cardiac injury. Baicalein may provide such therapy by deletion of free radicals, reducing hydroxyl radicals generation by suppressing iron-catalyzed Fenton reaction or decreasing ROS production by inhibiting activities of NADH-oxidase and xanthine oxidase Huang et al.

Thus it is easy to understand the oxidized LDLs-induced endothelial dysfunction could be restored by L -arginine and NO. The olive products constitute a rich source of polyphenols such as oleuropein and its derivatives, including hydroxytyrosol, which scavenge free radicals and inhibit the chemical oxidation of LDL.

Studies have shown that treatment with high doses of oleuropein at min 1 of reperfusion significantly reduced levels in plasma NOx in hypercholesterolemic rabbits coupled with reduction of infarct size in this group Andreadou et al. Therefore, plant products may function as a NO donor to inhibit formation of peroxynitrite and NOx.

The decrease in these biomarkers indicates the protective action of oleuropein, baicalein, crocetin, Allium chinense and Astragalus against oxidative stress by scavenging free radicals Nasa et al. Qian-Kun-Nin, a CHM formulation was observed to significantly decreased cell death and attenuate oxidation of DCFH in cells exposed to the mitochondrial site III inhibitor, antimycin A, consistent with a decrease in oxidative stress Shao et al.

These findings indicate herbal medicine may inhibit oxidative stress by improving mitochondrial function. Thus, keeping the function of antioxidant enzymes standards for another target to inhibit oxidative stress and protect cardiac injury. Herbs such as American ginseng could enhance this antioxidant system in rat cardiac H9C2 cells Li et al.

The antioxidant systems include Nrf2 protein expression, Nrf2 nuclear translocation, Nrf2 transcriptional activity, direct Nrf2 binding to its target gene promoters, and expression of a group of anti-oxidative genes.

Thus, herbs may serve as antioxidant enhancer to provide cardioprotection against pathological cardiac injury and remodeling.

This may help indentifying novel therapeutic targets in the effect of plant products to protect the heart from injury. H 2 O 2 treatment induces both oxidative damage and apoptosis, contributing to cardiac injury in cultured rat cardiomyocytes.

Cynaroside, a flavonoid compound, has been shown to enhance the endogenous anti-oxidative activity, thereby inhibiting intracellular ROS generation. It also showed the protective effects against H 2 O 2 -induced apoptosis in H9c2 rat cardiomyoblasts.

The mechanism by which cynaroside reduced the apoptotic rate were further explored. Moreover, cynaroside pretreatment showed an inhibitory effect on the H 2 O 2 -induced increase in JNK and P53 protein expression Sun et al.

These findings suggest that flavonoid products prevent cardiomyocytes apoptosis in vitro by reducing the endogenous production of ROS, maintaining mitochondrial function, and modulating the JNK and P53 pathways.

Cardiac myocyte is the cell types in which K ATP channels were originally discovered. It is well established that K ATP channels are present at high density in the sarcolemma of cardiac myocytes where they link membrane excitability with the cellular bioenergetic state.

Pinacidil is a potassium channel opener which mediate preconditioning at the beginning of sustained hypoxia by opening of sarcolemmal K ATP channels Budas et al. Similar to it, Guanxinkang treatment benefit the heart function by increasing mRNA and protein expression of K ATP subunits Kir6.

Keep in line with it, extracts of Astragalus demonstrated its anti-apoptotic effect in H 2 O 2 -injured cardiomyocytes only when the K ATP channels were open, whereas the protective effect was not observed when the channels were inhibited by the K ATP channel blocker 5-HD, glibenclamide Nasa et al.

These findings suggest enhancing the open of K ATP channel is one of the important mechanisms by which herbs protect myocardial cells from ischemic injury. Atrial natriuretic peptide is secreted by the heart atrium cells. ANP binds to a specific set of receptors and acts to reduce the water, sodium and adipose loads on the circulatory system, thereby reducing cardiac output and systemic BP.

Emodin, an active anthraquinone constituent isolated from the rhubarb, was observed to increase ANP secretion concomitantly with a decrease in atrial pulse pressure and stroke volume in a concentration-dependent manner. This study provides a rationale for the use of herbal medicine in the treatment of impairment of the regulation of the cardiovascular homeostasis.

In the milieu of cardiovascular risk factors that disturb vascular homeostasis, inflammation represents a key early event in vascular pathology, in which monocytes activation, adhesion to the endothelium and infiltration of macrophages into blood vessels are thought to play important pathogenic roles in atherosclerosis and other inflammatory CVDs.

The transcriptional and translational regulation of iNOS in various cell types can be induced by cytokines, growth factors, and endotoxins. Lipopolysaccharide LPS stimulation has been shown to enhance iNOS expression, NO production, and macrophage arginase activity in RAW In addition, cytoprotective molecule HO-1 expression was upregulated by these Danshen products too Joe et al.

SnPP is well characterized as a potent competitive inhibitor of HO activity. Since the iNOS expression, NO production, and TNFα production, were completely abolished by SnPP, the anti-inflammatory effect of Sal B in macrophages may be related to modulation of HO Hb serves as a CO scavenging compound.

Preincubation of Hb for 30 min reversed the inhibitory effect of Sal B on LPS-induced iNOS expression, NO production and NFκB activation in the RAW Although the mechanism by which HO-1 down-regulates iNOS is incompletely clear, it may involve transcriptional inhibition through CO formation or reduction of heme bioavailability for iNOS synthesis.

Consistent with the effect of Sal B, Tanshinone IIA another major compound extracted from Danshen exerts its anti-inflammatory effects by inhibition of iNOS gene expression and NO production, as well as inhibition of inflammatory cytokine IL-1β, IL-6 and TNFα expression in RAW Since Tan IIA has a similar structure to that of 17β-estradiol, the estrogenic activities was examined in the immune cells.

In fact, the most commonly used alternative herbal medicines for estrogen replacement are soy, black cohosh, dong quai and ginseng. Thus, these herbal medicines may serve as a potential selective estrogen receptor modulator to treat inflammation-associated CVDs without increasing the risk of breast cancer.

Activation of the nuclear receptor, PPARα, has been demonstrated to modulate many aspects of lipoprotein metabolism and inflammation both in vitro as well as in vivo. The tissue distribution of PPARα is extensive and it may mediate many of anti-inflammatory and anti-atherogenic effects.

Gypenoside XLIX, a dammarane-type glycoside, is one of the prominent components in Gynostemma pentaphyllum. It has been identified as a potent PPARα activator in HUVEC study Huang et al. Tissue factor is involved in many diseases including CVDs and hence may be an attractive target for directed CVDs therapeutics.

In human monocytic THP-1 cells transfected with promoter reporter constructs pTF-LUC, Gyp XLIX 0— mM concentration-dependently inhibited LPS-stimulated tissue factor promoter activity, mRNA and protein overexpression.

This effect was similar to those of Wy, a potent synthetic PPARα activator, and completely abolished in the presence of the PPARα selective antagonist MK Huang et al.

These data indicate that Gyp XLIX inhibits LPS-induced tissue factor overexpression and enhancement of its activity in human THP-1 monocytic cells via PPARα-dependent pathways, providing new insights into the mechanism of the Chinese herbal plants in CVDs treatment.

These effects are achieved by inhibition of iNOS-NO signaling pathway, which may be through activation of estrogen receptor and nuclear receptor PPARα-dependent signaling pathways Figure 1. One may predict that herbal remedies will receive even more attention in the coming years.

However, some objective limitations should be considered based on the existing literature. Firstly, the CHM are widely studied in China. Accordingly, many articles published on the Chinese literature which may limit these work to be retrieved and public to the world.

In addition, a location bias cannot be excluded since trials published in local journals are more likely to report significant results than those published in worldwide mainstream medical journals.

Poorly designed and reported clinic trails usually exaggerate the treatment effects which will misled decision making in clinic. Thirdly, compounds contained in one herb, even in an extract of one herb are very complicated.

Fourthly, many herbal medicine remedies used today have not undergone careful scientific assessment and there still lack preclinical study on the side effects, toxic effects and major drug-to-drug interactions in record.

Therefore, to develop new agents with effectiveness and safety from traditional Chinese medicine is a promising way for prevention and treatment of patients with CVDs. In addition, international collaboration may be encouraged, promoted and financed from the governments in order to improve the overall research quality.

CL drafted the work; YH revised the manuscript. Both CL and YH contributed substantially to the conception or design of the work, approved the final version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

This work was supported by National Natural Science Foundation of China , Zhejiang Provincial Natural Science Fund for Distinguished Young Scholars of China LR17H, Hangzhou Science and Technology Plan Project of China B36 and the Scientific Research Foundation for the Returned Overseas Chinese Scholars, Ministry of Education of China to CL.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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